A lifesaving breakthrough for treating coronavirus patients

Dexamethasone, a cheap and globally available drug, has proved effective against severe respiratory issues caused by COVID-19.

The RECOVERY trial tested the pre-existing drug on a trial of patients with coronavirus and found that it dramatically increases their chance of survival. Oxford University ran the trial over 175 NHS hospitals and 2,000 people were given dexamethasone, compared to a control of 4,000 people who were given a placebo. This kind of randomised controlled trial is seen as the most error-free method, is highly accurate and is often used in drug research.

While there has not been a paper published on this research yet, the promising results of the trial are a welcome relief after the past six months of illness and deaths coronavirus has caused. On average, patients requiring ventilators had a 60% survival rate which increased to 72% for those treated with dexamethasone. Patients requiring oxygen had a survival rate of 75% which also increased to 80% with treatment. This shows the true life-saving potential of dexamethasone amid this global pandemic. It is estimated that one out of eight ventilated patients who would otherwise die.

Dexamethasone works by reducing the inflammation that occurs when the body’s immune system over-reacts to the infection. Some patients produce a response called a cytokinin storm. The patient’s immune cells attack the lungs, which causes blood leakage, clotting and eventually organ failure. Patients who suffer this intense reaction are most at risk of dying from the virus.

Thankfully, dexamethasone had already been approved as a treatment for joint inflammation problems and asthma, among other conditions. This means it’s a readily available and cheap treatment that can be quickly implemented in a hospital setting. Six milligrams of the drug are administered each day for a total of 10 days. All in all, it will cost the NHS around only £35 per patient receiving this treatment. It can be given intravenously to intensive care patients, or in tablet form.

It is important to note that dexamethasone has not been effective against treating mild symptoms of coronavirus and people are urged against purchasing it for home cases where the patient doesn’t suffer respiratory issues.

“Dexamethasone is the first drug to be shown to improve survival in COVID-19. This is an extremely welcome result. The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become the standard of care in these patients. Dexamethasone is inexpensive, on the shelf and can be used immediately to save lives worldwide.” Professor Peter Horby, one of the Chief Investigators for the trial

Prior to this discovery, remdesivir was another drug investigated for treating coronavirus, as it had been effective with Ebola. Studies showed that remdesivir did shorten the average recovery time, but there was not enough evidence to suggest an impact on mortality. It was also a relatively new drug, so its availability is limited, and the price was likely to be much higher than dexamethasone.

Another anti-inflammatory drug, Tocilizumab, and an antibiotic, Azithromycin, are also currently being trialled as potential treatments, however, the data for these trials are not yet conclusive.

Convalescent plasma is also being tested as a potential treatment. Convalescent plasma is removed from the blood of recovered patients and contains antibodies that the blood donor’s body generated in response to the virus. This is very similar to how the first vaccines were developed.

There are further improvements to be made in order to reduce the death rate of COVID-19 and social distancing measures should still be followed to limit the spread of infection. However, the results of this trial mark a crucial step to saving many lives worldwide.

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