Not to take for prevention: what you need to know about dexamethasone reducing mortality from COVID-19

Among physicians in the U.S. and Europe, you can see a lot of enthusiasm about the inexpensive drug that seems to help save the lives of people with severe COVID-19. You need to know about dexamethasone, says The Healthy.

Не принимать для профилактики: что нужно знать о дексаметазоне, снижающем смертность от COVID-19

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After the enthusiasm for the hydroxychloroquine decreased due to the fact that the risks of treatment outweighed the benefits, a new study has found that cheap, widely used drug could help patients with the most severe forms COVID-19.

And although it was only one promising study, many doctors are cautious hope that the steroid, dexamethasone, can save the lives of patients who need hardware help for breathing.

“At the moment this is the most potentially important result that we have in the treatment of severe forms COVID-19. Dexamethasone is the first drug that apparently reduces mortality”, says Charles Hennekens, doctor of medical Sciences, Professor and senior research Advisor at the Atlantic University of Florida.

Dexamethasone is often used in “ambulance”

Dexamethasone is a steroid that is often used to reduce inflammation and treat certain types of arthritis. It is used in the emergency Department if the patient comes in with edema or swelling of the throat, tongue or lips, said Robert Glatter, an emergency physician in new York.

Researchers at Oxford University in England found that dexamethasone can reduce mortality by one-third in people with COVID-19, which required mechanical ventilation, and one-fifth of those who were in need of oxygen. In other words, the researchers note that the drug will prevent one death for every 8 patients on a ventilator, and for every 25 patients who only need oxygen.

This is the most severe among all patients with coronavirus infection. According to the study from April 2020 to become one of the largest patient reviews COVID-19 hospitalized in the United States, 88% of people who need a mechanical device to breathe, would die.

“The benefit to survival is obvious and large, those patients who are sick enough to need oxygen treatment, therefore, dexamethasone should now become the standard treatment for these patients,” says Peter Horby, Professor of infectious diseases at Oxford University. It is one of the leading scientists of the study.

It is a widely available treatment may have saved the life of Dr. Scott Krakower. 40-year-old Krakower, head of the Department of psychiatry at the Zucker hillside hospital in Glen oaks, state of new York, ill COVID-19 in April. He had lost his sense of taste and smell, within a week he was getting worse.

“I coughed up blood, my throat is swollen to such an extent that I couldn’t breathe, and I was placed in the hospital,” he recalls. Krakower received dexamethasone intravenously together with additional oxygen.

Dexamethasone is inexpensive, fast acting and long

The UK government has approved the use of dexamethasone to standard treatment COVID-19 after the publication of the research results.

Dexamethasone cheap, affordable and can be used immediately, said Dr. Harbi. It is a generic drug, so it is cheaper than branded drugs, the production of which cost hundreds of millions of dollars. The cost of treatment with dexamethasone for 8 people will be about $ 50.

Dexamethasone acts rapidly, explains Glatter. Krakower felt this effect on myself.

“I felt the change immediately after it got steroids, he says. An hour later I stopped coughing, and the intensity of the symptoms was not as strong as before the introduction of steroid users”.

Krakower was discharged from the hospital in a few days and is currently taking steroids for the treatment of cough, which later returned.

According to Glatter, after the drug began to act; its effect lasts more than 50 hours.

The dexamethasone has side effects

“We have to see that show complete data, says Glatter. All this is encouraging, but we must be careful when we promote the treatment as a standard for patients with COVID-19, since everything is changing and evolving very quickly.”

Some possible side effects include upset stomach, vomiting, headache, restlessness and/or sleep problems, according to the American society of pharmacists.

How it works dexamethasone

This drug stops the reproduction of the coronavirus SARS-CoV-2.

“Dexamethasone reduces inflammation in the lungs, so they are less damaged and less prone to irreparable changes, which can cause respiratory distress and death,” says Dr. Hennekens.

According to him, needed other treatments that attack the virus and reduce the risk of death. He noted that an antiviral drug called ramdevpir developed to combat Ebola and related viruses considered to be promising. Management on sanitary inspection behind quality of foodstuff and medicines (FDA) has granted emergency authorization for the use of ramdevpir for the treatment COVID-19. Israel had also recently approved the use of ramdevpir for the treatment of coronavirus infections.

“It’s still not proven and we don’t know, does this drug is the risk of death from COVID-19,” says Dr. Hennekens.

Should not take dexamethasone for the prevention COVID-19

Steroids have known side effects, and doctors should not prescribe dexamethasone for the prevention of coronavirus infection, said Neil miner, MD, Professor of medicine, pulmonology, critical care and sleep medicine at the Mount Sinai hospital in new York.

“Steroids are not helpful at the first sign of infection. You must be very sick to take this drug and potentially to benefit,” he added.

Dexamethasone is also not recommended as first-line treatment for people who are just infected. Dr. miner says that for most people the first 5-10 days of the disease is not so severe.

“Do not rush to the hospital if you are feeling well and not getting worse, he says. — Stay home and watch for possible complications. Drink plenty of fluids, rest and take medications to reduce fever.”

Other steroids can exacerbate the symptoms Covid-19

Still not clear whether other types of steroids to combat inflammation. Some studies have shown that people taking steroids in moderate and high doses, are more likely to suffer from a severe course of the disease COVID-19, says Dr. miner. According to him, these people often take steroids for the treatment of the underlying disease, and steroids can suppress the immune system, making a person more vulnerable to infection.

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