Lose Dose Corticosteriod (Dexamethasone) Found Effective in Treating COVID-19

According to RECOVERY* trial, it was found that corticosteroid (dexamethasone) reduces death in hospitalized patients with COVID-19.

*: a randomised trial investigating whether treatment with either Lopinavir-Ritonavir, Hydroxychloroquine, Corticosteroids, Azithromycin, Convalescent plasma or Tocilizumab prevents death in patients with COVID-19.

In a trial, patients (n=2014) were randomized to receive 6 mg dose dexamethasone once daily (orally or by intravenous injection) for 10 days compared to patients (n-4321) randomized to standard of care.  UK scientists reported:

Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).  Dexamethasone reduced deaths by one-third in ventilated patients (rate ratio 0.65 [95% confidence interval 0.48 to 0.88]; p=0.0003) and by one fifth in other patients receiving oxygen only (0.80 [0.67 to 0.96]; p=0.0021). There was no benefit among those patients who did not require respiratory support (1.22 [0.86 to 1.75; p=0.14). Based on these results, 1 death would be prevented by treatment of around 8 ventilated patients or around 25 patients requiring oxygen alone.

Source: University of Oxford

About the drug dexamethasone

It was originally approved by the US Food and Drug Administration in October 30, 1958.  Brand name: Decadron (active ingredient: dexamethasone) as its structure is shown below.

FDA NDA Number: 011664 (by Merck)

How It Is Indicated for

  • Allergic States: Control of severe or incapacitating allergic conditions
  • Dermatologic Diseases
  • Endocrine Disorders
  • Gastrointestinal Diseases
  • Hematologic Disorders
  • Miscellaneous: diagnostic testing of adrenocortical hyperfunction, trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used with appropriate antituberculous chemotherapy.
  • Neoplastic Diseases: for the palliative management of leukemias and lymphomas.
  • Nervous System: acute exacerbations of multiple sclerosis, cerebral edema associated with primary or metastatic brain tumor, craniotomy, or head injury.
  • Ophthalmic Diseases: sympathetic ophthalmia, temporal arteritis, uveitis, and ocular inflammatory conditions unresponsive to topical corticosteroids.
  • Renal Diseases
  • Respiratory Diseases: berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis.
  • Rheumatic Disorders: as adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis, acute rheumatic carditis, ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy). For the treatment of dermatomyositis, polymyositis, and systemic lupus erythematosus.

Last Updated: 2020-06-16

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