Steroid Use Cuts Death Rate in Seriously Ill COVID Patients

An ampoule of corticosteroid dexamethasone. (Yves Herman/Reuters)

"This is equivalent to around 68 percent of [the sickest COVID-19] patients surviving after treatment with corticosteroids, compared to around 60 percent surviving in the absence of corticosteroids."  Researchers

"The evidence shows that if you give corticosteroids [there are] 87 fewer deaths per one thousand patients. Those are lives ... saved."  Janet Diaz, critical care lead, World Health Organization

"Steroids are a cheap and readily available medication, and our analysis has confirmed that they are effective in reducing deaths amongst the people most severely affected by COVID-19."  Jonathan Sterne, professor of medical statistics and epidemiology, Bristol University, U.K.

"These results are clear, and instantly usable in clinical practice. Among critically ill patients with COVID-19, low-dose corticosteroids ... significantly reduce the risk of death."  Martin Landray, professor of medicine and epidemiology, University of Oxford, U.K.

Potential steps in the development and evolution of SARS-CoV-2 infection that may be affected beneficially or adversely by inhaled corticosteroids (ICS): 1: infection with SARS-CoV-2; 2: development of COVID-19 disease; 3: progression of COVID-19. European Respiratory Journal

Worldwide to the present, over 26 million people have contracted the SARS-CoV-2 virus that causes COVID-19. Out of that colossal figure, 853,546 people have died from the effects of COVID-19. In laboratories all over the world, scientists are frantically searching for a safe and effective vaccine to end the nightmare that has virtually shut down all normal human activities in a bid to try to control the final outcomes of community transmission of the virus that has brought terror and loss to the human community.

Although no vaccine has yet proven to be all that the world hopes for to rescue it from the menace of the novel coronavirus, some pharmaceutical companies are confident that inoculations may be possible before the end of 2020 when trials have been completed, authority given, and production initiated, to lead to wide distribution of vaccine doses. Some are so confident that their trial candidates will receive the critical go-ahead, that pre-authorization they are in early production.

Other types of trials going forward in hospitals with the use of previously authorized drugs meant for respiratory illnesses have realized a partial but profound victory in concluding that treating critically ll COVID patients with corticosteroid drugs affects patients' condition by reducing the risk of death by 20 percent, according to an analysis of seven international trials. The World Health Organization has reacted by updating its advice on treatment.

Data was pooled from separate trials of low-dose hydrocortisone, dexamethasone and methylprednisolone, finding that steroids improve survival rates of patients struck with COVID-19 who wee sufficiently ill to find themselves in hospital intensive care. Its results convinced the WHO to recommend the use of steroids for patients suffering from severe and critical COVID-19. 

The trials -- according to Jonathan Sterne of Bristol University -- which took place through the participation of researchers in Britain, Brazil, Canada, China, France, Spain and the United States, produced a reliably consistent message, indicating the drugs to be beneficial in those most ill patients irrespective of age or sex, or for the length of time they had been ill.

Published in the Journal of the American Medical Association, the findings reinforce results recognized as a major breakthrough when they were announced back in June, when dexamethasone was the first drug demonstrably seen as being capable of reducing death rates among severely ill COVID-19 patients. The drug has been in widespread use in the treatment of COVID patients in some countries' intensive care wards since that time.

Medical workers attend to a COVID-19 patient in an intensive care unit at a hospital in Sanaa, Yemen, in June. Steroids reduce the risk of death by 20 per cent among COVID-19 patients sick enough to be in intensive care in hospital, the new analysis shows. (Hani Mohammed/The Associated Press)