Can Steroids Treat COVID-19?

A breakthrough meta-analysis published in the Journal of the American Medical Association suggests steroids could be an effective treatment for COVID-19, the infectious disease that has claimed almost one million lives since appearing in December 2019. The report drew on data from seven trials, including the national Recovery Trial led by Oxford University and run at NHS hospitals across the UK.

After pooling the results, lead author of the meta-analysis Jonathan Sterne says the use of dexamethasone and hydrocortisone reduces the risk of death in severe COVID-19 patients by 20%. A professor of medicine and epidemiology at Bristol University, Sterne says “steroids are a cheap and readily available medication, and our analysis has confirmed that they are effective in reducing deaths amongst the people most severely affected by Covid-19.”

Meta-analysis prompts WHO recommendations

The meta-analysis findings prompted the World Health Organisation to recommend dexamethasone and hydrocortisone as treatments for severe COVID-19 patients. Both steroids are affordable and widely available, with Recovery Trial data suggesting the drugs saved the lives of one in eight patients put on ventilators.

“The results were consistent across the trials and show benefit regardless of age or sex,” adds Sterne. “We’ve got a consistent message from all these trials, and the effect of hydrocortisone appears consistent with the effect of dexamethasone.”

Steroids affordable and widely available

Martin Landray, deputy chief investigator of the Recovery Trial and a professor of medicine and epidemiology at Oxford University, says steroids should be prescribed as soon as a patient experiences trouble breathing and is given oxygen.

The affordability of both drugs is a major bonus, with Landray asserting the benefits far outweigh the low price point. “This is not a drug that costs $3,000 to reduce a hospital stay by a few days. This is not anywhere near the sorts of costs in many, many other areas of acute and preventive medicine. So this is a widely available, widely useful strategy. I mean, treating people with dexamethasone is, give or take, 60 quid to save a life.”

NHS commits to taking “immediate action”

Sir Simon Stevens, chief executive of the NHS, says research such as the Recovery Trial is critical to the COVID-19 response strategy, promising the publicly-funded healthcare service will continue to explore and spearhead new treatments.

“One of the distinctive benefits of having our NHS is that we’ve been able to mobilise quickly and at scale to help researchers test and develop proven coronavirus treatments,” he says. “Just as we did with dexamethasone, the NHS will now take immediate action to ensure that patients who could benefit from treatment with hydrocortisone do so, adding a further weapon in the armoury in the worldwide fight against Covid-19.”

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