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Standard steroid improves recovery of critically-ill COVID-19 patients

The study evaluated hydrocortisone in 403 patients with suspected or confirmed COVID-19

A study led by Imperial College London has discovered that critically-ill COVID-19 patients receiving a standard steroid medication, hydrocortisone, had a better chance of recovery compared to those who did not receive the drug.

The study evaluated hydrocortisone in 403 patients with suspected or confirmed COVID-19, who required respiratory or cardiovascular organ support. The patient population included participants of mixed ethnicities in the UK, Ireland, Australia, the US, the Netherlands, New Zealand, Canada and France.

Patients were randomised to receive different treatment regimens – one group were treated with a fixed dose of 50mg hydrocortisone four times a day for seven days, a second group were treated with the steroid if their blood pressure dropped and a final group received no hydrocortisone.

The trial found that using the fixed dose of hydrocortisone caused a 93% improvement in patient outcomes, which included an improved chance of survival and reduced need for organ support. In the second group, steroid treatment improved patient outcomes by 80%.

Another study, dubbed the RECOVERY trial,  was also investigating another type of steroid, dexamethasone, which also improved recovery in patients with COVID-19.

The findings from these studies were published in The Journal of the American Medical Association (JAMA), alongside two further clinical trials which also found that steroids improve outcomes for severely-ill COVID-19 patients.

“At the beginning of the year at times it felt almost hopeless, knowing that we had no specific treatments. It was a very worrying time. Yet less than six months later, we've found clear, reliable evidence in high quality clinical trials of how we can tackle this devastating disease,” said Professor Anthony Gordon, chair of anaesthesia and critical care at Imperial College London.

“The studies show that we now have more than one choice of treatment for those who need it most.  Steroids are not a cure, but they help improve outcomes. Having a choice of different types of steroids, all of which seem to improve patient recovery, is great as it helps ease the problem of drug supply issues,” he added.

Although steroids are not believed to be useful in the early stages of COVID-19 infections, the pooled data shows that these medications have efficacy for patients whose condition has significantly worsened.

This is because this type of medication is anti-inflammatory, with the evidence strongly suggesting that steroids can reduce the lung inflammation in severely-ill COVID-19 patients.

Article by
Lucy Parsons

3rd September 2020

From: Research

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