Dexamethasone Reduces Coronavirus Deaths, Scientists Say

LONDON — Scientists at the University of Oxford said on Tuesday that they had identified what they called the first drug proven to reduce coronavirus-related deaths, after a 6,000-patient trial in Britain showed that a low-cost steroid prevented the deaths of some hospitalized patients.

The steroid, dexamethasone, a well-known anti-inflammatory drug, appeared to help patients with severe cases of the virus: It reduced deaths by a third in patients receiving ventilation, and by a fifth in patients receiving standard oxygen treatment, the scientists said. They found no benefit from the drug for patients who did not need respiratory support.

Medical experts said that further study was needed to determine precisely how the steroid helped patients but that it appeared to reduce damage to lung tissue. Experts said it appeared that the steroid tamped down the overactive inflammatory response to the virus in some patients, known as a cytokine storm, rather than inhibiting the virus itself.

The trial results have not been published in a peer-reviewed journal, but the findings will be welcomed as scientists around the world race to find ways to treat a virus that has killed nearly 440,000 people and infected more than eight million.

Matt Hancock, Britain’s health secretary, said doctors in the country’s National Health Service would begin using the steroid as the standard treatment for hospitalized coronavirus patients on Tuesday afternoon.

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.

“Dexamethasone is the first drug to be shown to improve survival in Covid-19,” one of the chief investigators for the trial, Peter Horby, who is 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.”

Professor Horby said that dexamethasone should now become the “standard of care in these patients,” noting that it was inexpensive, widely available and could be used immediately.

Some doctors urged caution about the results. With scientists rushing to identify treatments for the virus as the outbreak spread around the world, some high-profile findings have had to be retracted or walked back in recent months.

But outside experts said the early results were promising.

“This outcome for patients suffering from severe Covid-19 in need of respiratory assistance is of tremendous importance,” Dr. Stephen Griffin, an associate professor in virology at the University of Leeds, said in comments to Britain’s Science Media Centre. “The low cost and broad availability of this drug means that there is potential for considerable clinical impact by including it as part of standard treatment.”

  • Frequently Asked Questions and Advice

    Updated June 12, 2020

    • Does asymptomatic transmission of Covid-19 happen?

      So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

    • What’s the risk of catching coronavirus from a surface?

      Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

    • How does blood type influence coronavirus?

      A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

    • How many people have lost their jobs due to coronavirus in the U.S.?

      The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

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      Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

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      Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.

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      States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.

    • What are the symptoms of coronavirus?

      Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

    • How can I protect myself while flying?

      If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


Dr. Griffin said further research would be important in establishing how the steroid might be combined with virus-targeted therapies like remdesivir.

As part of the trial, about 2,100 patients were given low doses of dexamethasone, orally or intravenously, once a day. Their outcomes were compared to another 4,300 patients who received the usual care.

Based on their findings, the Oxford scientists said, the drug would prevent one death for every eight ventilated patients.

Source: nytimes.com

Tags: health

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