The first drug to be clinically proven to reduce death rates in patients with severe cases of the coronavirus has been created by scientists, a news agency reported on Tuesday.
“Giving low doses of the generic steroid drug dexamethasone to patients admitted to hospital with COVID-19 reduced death rates by around a third among those with the most severe cases of infection,” Reuters reported. “The results, described as a ‘major breakthrough’ by scientists leading the UK-led clinical trial known as RECOVERY, suggest the drug should immediately become standard care in patients treated in hospital with the pandemic disease.”
“This is a result that shows that if patients who have COVID-19 and are on ventilators or are on oxygen are given dexamethasone, it will save lives, and it will do so at a remarkably low cost,” said Martin Landray, an Oxford University professor and co-leader of the drug’s trial.
“Since the appearance of COVID-19 six months ago, the search has been on for treatments that can improve survival, particularly in the sickest patients,” Landray said. “These preliminary results from the RECOVERY trial are very clear – dexamethasone reduces the risk of death among patients with severe respiratory complications. COVID-19 is a global disease – it is fantastic that the first treatment demonstrated to reduce mortality is one that is instantly available and affordable worldwide.”
Said Peter Horby, professor of Emerging Infectious Diseases at Oxford, said: “Dexamethasone is the first drug to be shown to improve survival in COVID-19. This is an extremely welcome result. The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.”
“It is a major breakthrough,” he said.
Oxford University said in a statement:
In March 2020, the RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial was established as a randomized clinical trial to test a range of potential treatments for COVID-19, including low-dose dexamethasone (a steroid treatment). Over 11,500 patients have been enrolled from over 175 NHS hospitals in the UK.
On 8 June, recruitment to the dexamethasone arm was halted since, in the view of the trial Steering Committee, sufficient patients had been enrolled to establish whether or not the drug had a meaningful benefit.
A total of 2104 patients were randomized to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for ten days and were compared with 4321 patients randomised to usual care alone. 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.
The new findings follow a report this week in which National Pulic Radio said “Mounting evidence suggests the coronavirus is more common and less deadly than it first appeared.”
The evidence comes from tests that detect antibodies to the coronavirus in a person’s blood rather than the virus itself. The tests are finding large numbers of people in the US who were infected but never became seriously ill. And when these mild infections are included in coronavirus statistics, the virus appears less dangerous.
The current best estimates for the infection fatality risk are between 0.5% and 1%,’ says Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. That’s in contrast with death rates of 5% or more based on calculations that included only people who got sick enough to be diagnosed with tests that detect the presence of virus in a person’s body.
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