Dexamethasone, a steroid that has been used for decades, helps people recover from severe COVID-19. In a trial, it only seemed to help people who needed oxygen or artificial ventilation. It did not seem to help people with milder disease.

Corticosteroids are used to treat inflammatory conditions including arthritis and inflammatory bowel disease. It was tested on 2,104 patients with COVID-19 as part of a randomised controlled trial.

People given dexamethasone who were on ventilators were one third less likely to die, compared with those not given the steroid. People who were on oxygen therapy but not ventilators were one fifth less likely to die if they took dexamethasone.

Doctors are excited because this is the first drug that has been clearly shown to improve the chances of recovery for people seriously ill with COVID-19. Importantly, the trial did not show any statistical benefit from the drug if used for people not needing oxygen or ventilation.

Where did the story come from?

The results of the study were widely reported in the press around the world and have been welcomed by the World Health Organisation. However, the study has not yet been published in a peer-reviewed journal and the full results are not available.

What is the basis for the claim?

The UK-based Recovery trial is testing six treatments or combinations of treatments on more than 11,500 patients admitted to 175 UK hospitals for COVID-19. The part of the trial looking at dexamethasone has now been halted as enough patients were recruited to show a clear benefit.

The researchers randomly assigned 2,104 patients to receive 6mg of dexamethasone once per day on top of usual care, while 4,321 patients received usual care alone.

There were one-third fewer deaths in 28 days among patients on ventilators who received dexamethasone (27 deaths amongst every hundred treated with dexamethasone compared to 41 deaths in every hundred receiving usual care). There were also one-fifth fewer deaths among patients on oxygen alone who received dexamethasone (20 deaths amongst every hundred treated compared to 25 deaths in every hundred receiving usual care). There was no benefit of dexamethasone for those who did not have oxygen or ventilation.

The researchers calculate that around one death would be prevented for every eight patients on ventilators given dexamethasone, and one death prevented for every 25 patients on oxygen given dexamethasone.

The researchers say they are working to publish the full study as soon as possible.

What do trusted sources say?

Dr Tedros Adhanom Ghebreyesus, World Health Organisation Director-General, said: ‘This is the first treatment to be shown to reduce mortality in patients with COVID-19 requiring oxygen or ventilator support.

This is great news and I congratulate the Government of the UK, the University of Oxford, and the many hospitals and patients in the UK who have contributed to this lifesaving scientific breakthrough.’ WHO added in a statement: ‘The findings reinforce the importance of large randomized control trials that produce actionable evidence.’

Dexamethasone should only be taken on the advice of a doctor.

Analysis by EIU Healthcare, supported by Reckitt Benckiser

Citation

  1. Low-cost dexamethasone reduces death by up to one third in hospitalised patients with severe respiratory complications of COVID-19. Statement from the Chief Investigators of the Randomised Evaluation of COVid-19 thERapY (RECOVERY) Trial on dexamethasone, 16 June 2020. https://www.recoverytrial.net/news/low-cost-dexamethasone-reduces-death-by-up-to-one-third-in-hospitalised-patients-with-severe-respiratory-complications-of-covid-19 (Accessed 25 June 2020)