Dexamethasone Reduces Coronavirus Deaths, Scientists Say

Dexamethasone Reduces Coronavirus Deaths, Scientists Say


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 critical care doctor and associate professor of medicine at the Grossman School of Medicine at New York University. “I cannot emphasize how important this could be.”

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dexamethasone on Tuesday, many experts in the United States demanded to see the data and the study itself, which have not yet been peer reviewed or published.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.”

The government started stockpiling dexamethasone several months ago based on signs that it could help patients, Mr. Hancock said, and now has 200,000 doses on hand.

The trial led by Dr. Horby was a randomized, controlled clinical trial, the gold standard for medical research. About 2,100 severely ill Covid-19 patients were given low doses of dexamethasone, orally or intravenously, once a day. Their outcomes were compared with 4,300 patients who had received the usual care.

The trial was stopped early, because the investigators felt that the benefit was obvious. But they said that the drug did not help moderately ill patients who were not receiving oxygen.

Corticosteroids like dexamethasone were used during outbreaks of SARS and MERS, which were also caused by coronaviruses. Those drugs were associated with worse outcomes, another reason for hesitation.

An earlier, much smaller trial in Spain of patients with acute respiratory distress, also seen in those ill with Covid-19, found that dexamethasone treatment may reduce the amount of time patients are on ventilators and may reduce deaths.


“What this is effectively doing is tamping down inflammatory responses in patients,” Stuart Neil, a professor of virology at King’s College London, said in an interview. “It’s almost certain this is affecting the body’s response against the virus, rather than inhibiting the virus itself.”



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