NYT – A steroid, The Drug For Corona Virus Dexamethasone, is the first drug shown to help save severely ill coronavirus patients, according to scientists in Britain.
LONDON — In an unexpected sign of hope amid the expanding pandemic, scientists at the University of Oxford said on Tuesday that an inexpensive and commonly available drug reduced deaths in patients with severe Covid-19, the illness caused by the coronavirus.
If the finding is borne out, the drug, a steroid called dexamethasone, would be the first treatment shown to reduce mortality in severely ill patients. Had doctors been using the drug to treat the sickest Covid-19 patients in Britain from the beginning of the pandemic, up to 5,000 deaths could have been prevented, the researchers estimated.
In severe cases, the virus directly attacks cells lining the patient’s airways and lungs. But the infection also can prompt an overwhelming immune reaction that is just as harmful. Three-quarters of hospitalized Covid-19 patients receive some form of oxygen.
The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
Until now, hospitals worldwide have had nothing to offer these desperate, dying patients, and the prospect of a lifesaving treatment close at hand — in almost every pharmacy — was met with something like elation by doctors.
“Assuming that when it goes through peer review it stands — and these are well-established researchers — it’s a huge breakthrough, a major breakthrough,” said Dr. Sam Parnia, a pulmonologist and associate professor of medicine at the Grossman School of Medicine at New York University. “I cannot emphasize how important this could be.”
The Drug For Corona Virus Dexamethasone
But the report also comes quick on the heels of a series of blunders and retractions in the scientific literature, as scientists rush to publish research about the coronavirus. While hospitals in the United Kingdom were able to begin treating severely ill Covid-19 patients with dexamethasone on Tuesday, many experts in the United States demanded to see the data and the study itself, which have not yet been peer reviewed or published.
“It will be great news if dexamethasone, a cheap steroid, really does cut deaths by ⅓ in ventilated patients with COVID19,” Dr. Atul Gawande, the surgeon and author, wrote on Twitter, “but after all the retractions and walk backs, it is unacceptable to tout study results by press release without releasing the paper.”
There is no vaccine against the coronavirus, and the only treatment known to be effective, an antiviral drug called remdesivir, only shortens the time to recovery.
“Dexamethasone is the first drug to be shown to improve survival in Covid-19,” one of the trial’s chief investigators, Peter Horby, a professor of emerging infectious diseases at the University of Oxford, said in a statement. “The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment.”
Dr. Horby added that dexamethasone should now become the “standard of care in these patients,” noting that it was inexpensive, was widely available and could be used immediately.
The drug was not studied in patients outside of the hospital, however, and was not beneficial to patients who were not on respiratory support.
Many steroids reduce inflammation in the body, and dexamethasone is among those that doctors have been trying in Covid-19 patients overwhelmed by so-called cytokine storms — uncontrolled immune responses so powerful they kill some patients.
Many doctors had feared the drug might actually exacerbate the infection by preventing the immune system from attacking the virus. Though Dr. Parnia had treated patients with steroids and seen improvement, “there had not been such a large trial comparing no steroids with steroids.”