Steroid Drug Dexamethasone Hailed as ‘Major Breakthrough’ in Treating Coronavirus

A randomized clinical trial to test low-dose dexamethasone (a steroid treatment) as potential treatment for COVID-19 has shown that the drug had a meaningful benefit.

The study of dexamethasone was a part of the RECOVERY (Randomized Evaluation of COVid-19 thERapY) trial to test a range of potential treatments for COVID-19 that enrolled over 11,500 patients from over 175 NHS hospitals in the UK.

A total of 2,104 patients were randomized to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for 10 days and were compared with 4,321 patients randomized 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 and provided no benefit among those patients who did not require respiratory support. Based on these results, one death would be prevented by treatment of around eight ventilated patients or around 25 patients requiring oxygen alone. Given the public health importance of these results, the researchers are now working to publish the full details as soon as possible.

“Dexamethasone is the first drug to be shown to improve survival in COVID-19,” said Peter Horby, Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine, University of Oxford, and one of the Chief Investigators for the trial. “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.”

“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,” said Martin Landray, Professor of Medicine and Epidemiology at the Nuffield Department of Population Health, University of Oxford, one of the Chief Investigators. “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.”

“This is tremendous news today from the Recovery trial showing that dexamethasone is the first drug to reduce mortality from COVID-19,” said the UK government’s Chief Scientific Adviser, Sir Patrick Vallance. “It is particularly exciting as this is an inexpensive widely available medicine. This is a ground-breaking development in our fight against the disease, and the speed at which researchers have progressed finding an effective treatment is truly remarkable. It shows the importance of doing high quality clinical trials and basing decisions on the results of those trials.”