After Hydroxychloroquine, another drug is hailed as wonder cure for Coronavirus (COVID-19). This came after a clinical trial in United Kingdom reported that deaths in hospitalized patients with severe respiratory complications can reduced up to one third by Dexamethasone. The hype sounds familiar when Hydroxychloroquine was promoted as a cure for COVID-19.
As the hype around Hydroxychloroquine dies, Dexamethasone is making headlines. So the questions arises, what exactly is Dexamethasone? And what’s its importance in Coronavirus treatment?
What is Dexamethasone?
To put it in single line, it’s a synthetic hormone. Right above the kidneys, Natural corticosteroids (commonly called as steroids) are hormones secreted by the adrenal glands. They are needed for many vital functions of the body. Babies born without adrenal glands cannot survive.
Around for decades, Dexamethasone is a long acting potent synthetic steroid available in tablet, ointment & injection forms. It can be used in some cases of Cancer, Tuberculosis & severe Asthma. It’s a potent drug for chemotherapy- which is highly vomit inducing.
There are many studies that have been done in Dexamethasone role in acute respiratory diseases & distress syndrome & the results have been mixed.
The RECOVERY Trial:
Randomized Evaluation of Covid-19 Therapy (RECOVERY) is the largest clinical randomized trial that is underway right now in United Kingdom to look & evaluate treatment possibilities for coronavirus. From 175 National Health Service hospitals, as many as 11,500 patients have enrolled in the trial.
It is testing for six different treatments in patients. The 35 page detailed trial protocol is publically available. It has been funded by The Bill and Melinda Gates Foundation & Public Health Organizations.
Findings in the Trial Regarding Dexamethasone:
2104 patients for 10 days six mg of Dexamethasone was given, while standard care were given to 4321 patients without Dexamethasone. After 28 days, the death rate was compared between two groups.
The deaths were reduced by one-third by Dexamethasone in ventilated patients & by one fifth in other patients receiving oxygen only. On Ventilator, one death would be prevented by treating around 8 patients. While among patients on oxygen support, one death would be prevented by treating 25 patients. Among the patients that require no respiratory support, there were no benefits. The final data is still awaited.
Dexamethasone Work in Covid-19:
It is not an anti-viral drug, it does not kill Coronavirus. It is anti-inflammatory. Dexamethasone helps in the problem of disarrayed immune response when the body damages its own normal organs and tissue especially the lung.
In India, Will the Mortality Rate Come Down?
In India, we are already using steroids for the moderate to severely ill Covid-19 patients. So it is doubtful. The use of Methylprednisolone is recommended by the Indian health ministry for Covid-19 treatment from the first revised guidelines published on March 31.
On June 13, the latest Indian guidelines released also recommends Methylprednisolone for three days in moderate illness and five-seven days for severe illness.
