2020 Rationalist.org — Evolution Tree content
An inexpensive and readily available steroid prevents death by one-third among critically ill COVID-19 patients.
Warning: This is not medical advice. It is an announcement of the results of a scientific study. Please do not make any decisions regarding medication without consulting your healthcare professional.
Controlled and randomized studies in the UK have shown that this inexpensive and readily available steroid escape route could save the lives of severely ill COVID-19 patients.
This drug, called dexamethasone, became the first to show signs of reducing deaths from the coronavirus, which has killed more than 430,000 people worldwide.
The study discovered that dexamethasone reduced deaths by approximately one-third in patients using ventilators due to coronavirus infection. It lowered the risk of death from 40% to 28% in patients on ventilators and from 25% to 20% in patients requiring oxygen therapy.
Kenneth Baillie, an intensive care specialist at the University of Edinburgh in England and also on the executive committee of this study called "HEALING," believes this is a rather surprising result and that the study, conducted using these steroids, will have a global impact. The HEALING study announced its findings via a press release on June 16th. The researchers stated that they quickly published the results, sharing their goals and findings with authorities both in the UK and internationally.
one of the world's largest randomized, controlled trials of coronavirus treatments launched in March, are exploring a range of potential therapies. The trials enrolled 2,100 participants who received six milligrams of dexamethasone daily at a low or moderate dose for ten days, comparing their condition to approximately 4,300 people receiving standard care for COVID-19 . Dexamethasone's effect was particularly noticeable in critically ill patients requiring ventilators. Improvements were also seen in patients receiving oxygen therapy who did not require ventilators, with a 20% reduction in the risk of death. The steroid had no effect on patients with mild COVID-19 who did not require ventilators or oxygen therapy.
Shortly after the results were announced, the UK government declared that Dexamethasone, a type of corticosteroid drug, was authorized for use in COVID-19 patients requiring oxygen therapy, including those on ventilators. They also stated they had 200,000 doses in stock and would provide Dexamethasone to NHS (National Health Service) patients. Prime Minister Boris Johnson described it as "an extraordinary scientific achievement for the UK" and said it was something to be celebrated.
“We have taken steps to ensure we have enough supplies even in the event of a second wave of the virus.”
Professor Chris Whitty, head of Public Health England, said this would save many lives around the world.
Quite Hard Work
Peter Horby, an infectious disease specialist at Oxford University and one of the lead researchers on the study, says this is a significant breakthrough. He adds that the use of steroids in treating viral respiratory infections like COVID-19 is a controversial topic. He also notes that little conclusion has been drawn from steroid studies conducted during the SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) outbreaks caused by coronaviruses. Nevertheless, he says that given the availability of Dexamethasone and some promising recent studies on steroids, the researchers at SHIFA felt it would be right to put this treatment through a rigorous clinical trial.
The steroid Dexamethasone was tested on thousands of severe COVID-19 cases through a controlled and randomized trial.
Many countries, including the World Health Organization's treatment guidelines, had issued warnings about treating COVID-19 patients with steroids, and some researchers were concerned about certain reports of widespread steroid use.
As we explained in our article ' What is Coronavirus and What Should We Do? ', one of the main threats of COVID-19 was its ability to turn our own immune system against us. This excessive response, which we can also call a cytokine storm, that we can encounter in severe COVID-19 cases, could lead to fatal consequences. The drugs in question suppress the immune system in such a situation, and this can relieve patients with lungs damaged by an overactive immune response. However, these types of patients would still need a healthy immune system to fight the virus. It has been suggested that if continued at the doses tested in the SHIFA studies, the benefits of steroid treatment may outweigh the potential risks. Researchers said that no noticeable side effects of the treatment were observed. Horby says that this treatment can be applied to almost everyone.
This miraculous steroid was already being used against a range of inflammatory problems, including arthritis, asthma, and some skin diseases. However, Anthony Fauci, head of the US National Institute of Allergy and Infectious Diseases, says that the response is generally much greater in severe COVID-19 cases and minimal or nonexistent in mild cases, and that an overactive immune response would be harmful in the long term.
COVID-19 treatment science at Wellcome, the British biomedical research organization in London , said that finding such effective treatments would change the impact of the COVID-19 pandemic on lives and economies worldwide, adding: “While this study shows that dexamethasone only works in severe cases, we can say that it will save countless lives worldwide.”
An Easier Treatment
To date, the only large-scale, randomized, and controlled clinical trial showing benefit in COVID-19 patients was with the antiviral drug Remdesivir. While Remdesivir appeared to shorten the length of hospital stays for patients, it had no statistically significant effect on mortality. Another major disadvantage was that Remdesivir was not readily available. Although Gilead Science, the manufacturer based in Foster City, California, is trying to increase production, the drug is currently only available in a limited number of hospitals worldwide. Additionally, treatment with Remdesivir was quite complex and required administration via injection over several days.
In contrast, Dexamethasone is a readily available staple product in pill form, readily available on pharmacy shelves worldwide. This offers a significant advantage in countries with limited access to healthcare and a higher risk of COVID-19 . Martin Landray, an epidemiologist at Oxford University and another research leader in the SHIFA studies, stated, “For less than £50, eight patients can be treated and a life saved.” However, he added that people should not buy this medication for home use, as this steroid treatment will have no effect on COVID-19 patients with mild symptoms.
Baillie added that the findings could also be relevant to other severe respiratory illnesses. For example, steroid treatments are still controversial for a condition known as Acute Respiratory Distress Syndrome (ARDS). “Mortality rates could decrease as a result, and that’s really a reason for us to look at the situation more closely,” Baillie said, adding, “I think this will not only reduce the impact of COVID-19 .”
Translation and Compilation: A. Ege Palaz Editor: Ögetay Kayalı
References 1. Nature, “ Coronavirus breakthrough: dexamethasone is first drug shown to save lives ” https://www.nature.com/articles/d41586-020-01824-5
2. BBC, “Coronavirus: Dexamethasone proves first life-saving drug” https://www.bbc.com/news/health-53061281
Originally published on Medium on February 28, 2025. English translation of “Koronavirüse Karşı Hayat Kurtaran İlk İlaç Bulundu!”.