Multiple studies have revealed dexamethasone, an inexpensive generic steroid, dramatically reduced the risk of death in COVID-19 patients.
An analysis published September 2, 2020 by the American Medical Association of several studies involving 1,700 patients found that corticosteroids, anti-inflammatory drugs reduced deaths from COVID-19 by one-third, compared to patients who did not receive steroids.
One study, published on June 16, 2020 in the New England Journal of Medicine, found dexamethasone reduced the risk of death by roughly one-third in hospitalized COVID-19 patients on mechanical breathing support and by one-fifth in patients on oxygen.
Corticosteroids, such as dexamethasone, hydrocortisone, and methylprednisolone have been widely used for years and are inexpensive.
There is not convincing evidence, however, that dexamethasone is helpful to COVID-19 patients with milder symptoms, says John Hunt, M.D., pulmonologist, pediatrician, allergist, and policy advisor to The Heartland Institute, which publishes Health Care News.
“To me, this suggests that some people with severe COVID lung disease will benefit from Dexamethasone, and some will not, and that, as yet, we don’t know with scientific rigor how to differentiate the ones who will benefit from the ones that don’t,” Hunt said.
Preventing Conditions that Exacerbate COVID-19
One reason dexamethasone is showing promise is its ability to address inflammation, says Alieta Eck, M.D., physician and policy advisor to The Heartland Institute.
“We have been learning that the damage caused by COVID is caused by the cytokine storm,” Eck says. “Anything that reduces the inflammation in the lungs is helpful. Thus inhaled steroids make sense.”
Because the current research on dexamethasone and COVID-19 treatment is still in its early stages and the impact on those with mild symptoms is not fully understood, physicians need to focus on preventing inflammation, Eck says.
“Of course, our real goal should be to prevent the inflammation in the first place and ionophores such as hydroxychloroquine or quercetin (over-the-counter) which facilitate the entry of zinc into the cells is even more helpful,” Eck said.
Between Physician and Patient
Ultimately, treating the individual characteristics of each patient should guide the decision-making of the physician, not government directives, Hunt says.
“The governments must not try to dictate and control the use of the medications, for many reasons, one of which is that government coercion will obviate the extremely valuable components of physician experience and individual patient characteristics that are not possible to ascertain in randomized controlled studies,” Hunt said.
The main thing is to keep government out of treatment decision-making entirely, Hunt says.
“My personal choice as a physician differs from those of other physicians, and no way should government dictate their use or non-use. Government is the most incompetent doctor you can ever find, and it forces its therapies on people,” Hunt said.
Kelsey Hackem, J.D., (khackem@gmail.com) writes from Washington state.