A UK clinical trial has identified the low-dose, low-cost steroid dexamethasone as the first drug to improve survival rates in hospitalised COVID-19 patients with respiratory complications.
The Randomised Evaluation of COVid-19 thERapy (RECOVERY) study, funded by the National Institute for Health Research (NIHR), aimed to identify treatments that may be beneficial for people hospitalised with suspected or confirmed COVID-19. Through the NIHR’s Clinical Research Network, over 11,500 patients have so far been enrolled into RECOVERY from over 175 NHS hospitals in the UK.
2104 patients were randomised to dexamethasone once per day for ten days and were compared with 4321 patients randomised to usual care alone. Among the usual care control group, 28-day mortality was highest in those on ventilators (41%), intermediate in those on oxygen only (25%), and lowest for those who were not receiving any respiratory intervention (13%). The study, found that dexamethasone reduced the risk of dying by one-third in ventilated patients and by one fifth in patients receiving oxygen only. There was no benefit among those who did not need respiratory intervention. Overall, dexamethasone reduced the risk of 28-day mortality by 17% with the most significant benefit for those on ventilators. The study did not include patients outside the hospital setting.
The UK government has 200,000 courses of the drug in its stockpile and says the NHS will make dexamethasone available to patients. The significance of this breakthrough is that this readily available and affordable medicine will be of benefit in poorer countries with high numbers of COVID-19 patient. However, it must be emphasised that this medicine is not a cure.
For more information on the trial, click here.