Low-cost drug lowers death by third among ventilated COVID-19 patients

Low doses of the steroid dexamethasone can reduce deaths by one-third in ventilated COVID-19 patients, according to researchers who assessed the performance of the inexpensive drug in more than 2,100 patients.

The analysis is part of the Randomised Evaluation of COVid-19 thERapY trial which was established to test a range of potential therapies for COVID-19, including low-dose dexamethasone -- a steroid treatment.

The RECOVERY trial included over 11,500 patients, enrolled from more than 175 hospitals in the United Kingdom, noted a statement by the University of Oxford.

In the trial, a total of 2,104 patients were randomised to receive dexamethasone 6 milligrammes once per day -- either by mouth or by intravenous injection -- for ten days, and were compared with 4,321 patients randomised to usual care alone.

Among the patients who received usual care alone, mortality was highest in those who required ventilation (41 per cent), intermediate in those patients who required oxygen only (25 per cent), and lowest among those who did not require any respiratory intervention (13%), the scientists said.

They found that dexamethasone reduced deaths by one-third in ventilated patients, and by one fifth in other patients receiving oxygen only.

However, the researchers said there was no benefit from dexamethasone among the patients who did not require respiratory support.

Based on these results, the scientists believe that the drug could prevent nearly one death in the treatment of around eight ventilated patients, or around 25 patients requiring oxygen alone.

"Dexamethasone is the first drug to be shown to improve survival in COVID-19. This is an extremely welcome result," said Peter Horby, one of the chief investigators of the trial from the University of Oxford in the UK.

"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," Horby said.

The drug, according to the scientists, is inexpensive, on the shelf, and can be used immediately to save lives worldwide.

"These preliminary results from the RECOVERY trial are very clear -- dexamethasone reduces the risk of death among patients with severe respiratory complications," said Martin Landray, another chief investigator of the trial from the University of Oxford.

"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," Landray added.