Results of seven different clinical trials conducted by the World Health Organization and published on Wednesday in the Journal of the American Medical Association show that the risk of death from Covid-19 I reduced by one third by treating novel coronavirus infected hospitalized patients with inexpensive and readily available steroid drugs.
A similar single but large study conducted in June also reported similar survival benefit – inline with the positive steroid findings — the result of a pooled look at data known as a meta-analysis. For critically ill patients with Covid-19, the first, and so far only, therapy shown to improve the odds of survival are the use of corticosteroids.
A call for the use of corticosteroids to become the standard of care for patients with “severe and critical” Covid-19 was given by the WHO along with new treatment guidelines based on the newly published data. According to the diagnosis of a WHO panel, such critical Covid-19 patient should receive 7-10 days of treatment. But the WHO also cautioned not to use steroids on patients with non-severe illness, and said that “indiscriminate use of any therapy for COVID-19 would potentially rapidly deplete global resources and deprive patients who may benefit from it most as potentially life-saving therapy.”
“The consistent findings of benefit in these studies provide definitive data that corticosteroids should be first-line treatment for critically ill patients with COVID-19,” said Hallie Prescott and Todd Rice, professors of medicine at the University of Michigan and Vanderbilt University, respectively, in an accompanying JAMA editorial.
“There has been widespread adoption of steroids in the care of critically ill patients with Covid-19” since the first trial results in June, said Nahid Bhadelia, medical director of the Special Pathogens Unit at the Boston University School of Medicine. “This is particularly true in many resource-limited countries where I work. This meta-analysis adds further confidence” to those results, she added.
Similar guidelines recommending the use of steroids to treat patients with severe Covid-19 have already been issued by a number of other groups such as the National Institutes of Health and the Infectious Diseases Society of America.
In the latest study, 1,025 patients were treated with the usual care or a placebo while 678 random patients were subjected to treatment with steroids. All of the patients had been confirmed to have been infected with Cvoid-19 and were admitted to the hospital. Most of the patients were on mechanical ventilation. Twenty-nine percent of the patients were women.
After a period treatment of 287 days, 33 per cent of the patients being treated with steroids died while about 41 per cent of those on the usual care or placebo treatment passed away. The researcher found, through a meta-analysis, that the difference in absolute mortality was a 34 per cent reduction in the risk of death among those patients who had been treated with steroids which is considered to be a statistically significant result.
The researchers also found that irrespective of the type of steroid given, the dose, or whether patients were on ventilation or were simply given supplemental oxygen, the survival benefit remained consistent for steroid treatment.
(Adapted from CNBC.com)