On June 17, Beijing time, a news report in the international top academic journal “Nature” said that the British RECOVERY trial has found that a cheap and commonly used steroid drug can save the lives of critically ill patients with COVID-19. The drug, called dexamethasone, is the first drug proven to reduce the death of patients with covid-19. In this trial, taking dexamethasone reduced the death of patients with covid-19 by about a third.
“This is a shocking result,” said Kenneth Baillie, a intensive care physician at the University of Edinburgh in the UK. The experiment is called RECOVERY. “This will obviously have a huge impact on the world.”
The RECOVERY trial started in March and is one of the largest randomized controlled trials in the world for coronavirus treatment. The study recruited 2,100 participants who received low or moderate doses of six milligrams of dexamethasone daily (for a total of 10 days) and compared them to approximately 4,300 people who received routine care for coronavirus infection. Critical patients use dexamethasone most effectively when they are on the ventilator. Those who received oxygen therapy but did not use a ventilator also improved: these participants had a 20% lower risk of death. In mild COVID-19 cases (patients not receiving oxygen or ventilation), steroids have no effect on the outcome.
“This is a major breakthrough,” said Peter Horby, an infectious disease expert at Oxford University in the UK and the lead investigator of the trial. Horby pointed out that the use of steroids to treat viral respiratory infections (such as COVID-19) has been controversial. He said that the coronavirus-induced SARS and steroid test data during the Middle East respiratory syndrome outbreak are inconclusive. Nonetheless, given the widespread use of dexamethasone and some encouraging results from previous steroid studies in the outbreak, Horby said RECOVERY researchers believe it is important to test the treatment in rigorous clinical trials.
The treatment guidelines of the World Health Organization and many countries have warned against corticosteroids in patients with steroids, and some researchers have expressed concern about reports of widespread steroid treatment. These drugs can suppress the immune system, thereby alleviating the symptoms of patients with lung damage. But these patients may still need a fully functional immune system to defend against the virus itself.
The RECOVERY trial showed that at the doses tested, the benefits of steroid therapy may outweigh the potential harm. The researchers said that the study found no prominent adverse events caused by the treatment. Horby said: “Almost anyone can receive this treatment.” He pointed out that the team aims to quickly release its results and share their findings with UK and international regulators.
WellcomeNick Cammack, a charity for biomedical research in London, UK, said: “Looking for effective treatments will change the impact of the COVID-19 pandemic on global life and economy.” “Although this study shows that dexamethasone is only beneficial for critically ill patients, Countless lives will be saved globally.”
To date, in a large, randomized, controlled clinical trial, the only drug shown to benefit patients with COVID-19 was the antiviral drug Radecivir. Although it was shown that radixivir shortened the time patients may need to spend in hospital, it did not have a statistically significant effect on death.
Redcive was therefore in short supply. Although the manufacturer of the drug, Gilead Sciences, has taken measures to increase the production of Rindixvir, it is currently only used in limited hospitals worldwide. The administration method of redoxivir is complicated: it must be administered by injection within a few days.
In contrast, dexamethasone is a medical drug available on drug shelves around the world. Oxford Land’s epidemiologist Martin Landray and another principal investigator of the RECOVERY trial said: “With less than £50, you can treat 8 patients and save a life.”