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Meta-analysis reinforces efficacy of commercially available steroids in hospitalised COVID-19 patients

Published on 04/09/20 at 12:34pm

A new meta-analysis of seven studies worldwide investigating the benefit for commercially available steroid therapies in the treatment of COVID-19 has reinforced their efficacy in stimulating recovery in some patients requiring respiratory support in intensive care.

A previous study released in June and led by the University of Oxford supported the efficacy of the corticosteroid dexamethasone in treating COVID-19 patients requiring respiratory intervention.

These findings were corroborated by the meta-analysis published in the [Journal of the American Medical Association], which incorporated 1,703 patients in total from a range of nations including Brazil and France.

Dexamethasone use has soared in the treatment of COVID-19 since these findings began to emerge, rising from usage in around 7-8% of hospitalised patients in May to 55% by the end of June. However, the studies evaluated also revealed the efficacy of another readily available steroid, hydrocortisone.

According to the research, these steroids could save eight out of every 100 patients hospitalised with COVID-19 and in intensive care; the studies showed that the mortality rate among patients receiving standard of care was 40%, and this dropped to 32% in those treated with steroids.

“Steroids are a cheap and readily available medication, and our analysis has confirmed that they are effective in reducing deaths amongst the people most severely affected by COVID-19,” explained Jonathan Sterne, lead author on the meta-analysis and Professor of Medicine and Epidemiology at Bristol University, adding that the results “were consistent across the trials and show benefit regardless of age or sex.

“This is not a drug that costs $3,000 to reduce a hospital stay by a few days,” he continued. “This is not anywhere near the sorts of costs in many, many other areas of acute and preventive medicine. So this is a widely available, widely useful strategy. I mean, treating people with dexamethasone is, give or take, 60 quid to save a life.”

Based on this analysis, the World Health Organization has released updated guidance, strongly backing the use of hydrocortisone and dexamethasone for the treatment of hospitalised COVID-19 patients.

NHS Chief Executive Sir Simon Stevens also remarked on the findings: “Just as we did with dexamethasone, the NHS will now take immediate action to ensure that patients who could benefit from treatment with hydrocortisone do so, adding a further weapon in the armoury in the worldwide fight against COVID-19.”

Matt Fellows

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