Steroid reduces likelihood of death in some COVID-19 patients, but not all

INDIANAPOLIS (WISH) — Dexamethasone reduces systemic inflammation in certain coronavirus patients, a new study reports. 

The article, published in The New England Journal of Medicine, randomized 6,425 hospitalized with COVID-19 as part of the research group’s RECOVERY trial. 

The RECOVERY trial is a collaboration among 176 health organizations across the U.K. making it one of the most extensive clinical interventions designed to evaluate potential treatments for the coronavirus. 

Of the total patients, 2,104 received 6 mg of the glucocorticoid, dexamethasone, for 10 days either orally or intravenously. The remaining 4,321 patients received usual care. Both groups were monitored over 28 days. Researchers tracked how many deaths occurred in the four weeks following to see if the number of deaths differed between those who received dexamethasone compared to usual care which acted as the control.  

Dexamethasone, according to the Mayo Clinic, is a pain reliever designed to reduce inflammation as a result of ailments such as arthritis, asthma and kidney problems, among others. Inflammation is a well known complication of the coronavirus. 

Results showed 23% (482) of patients treated with the steroid died within the four-week time frame compared to the 26% (1,110) who were in the control group. Treatment with dexamethasone was no better than usual care. The 3% difference was not statistically significant, according to the researchers.

However, results between the two groups were significant when they compared dexamethasone’s effectiveness in patients on oxygen support to patients in the usual care group who were also on either mechanical ventilators or supplemental oxygen. Death rates for the treatment group were much lower than the control group. Twenty-nine percent of patients in the treatment group died in the 28 days whereas 41.4% died under standard care. 

“Our preliminary results show that among hospitalized patients with COVID-19, the use of dexamethasone for up to 10 days resulted in lower 28-day mortality than usual care in patients who were receiving mechanical ventilation…and [supplemental] oxygen alone,” authors write. “However, there was no evidence that dexamethasone provided any benefit among patients who were not receiving respiratory support.”

News 8’s medical reporter, Dr. Mary Elizabeth Gillis, D.Ed., is a classically trained medical physiologist and biobehavioral science researcher. She’s been a health, medical and science reporter for over five years. Her work has been featured in national media outlets.