Dexamethasone Lowers Death Rate Among Ventilated COVID-19 Patients

Low-dose dexamethasone appeared to reduce death by up to one-third in hospitalized patients with severe COVID-19, according to new data pre-published online to the preprint server medRxiv. Dexamethasone is a steroid that is widely used in treatment of myeloma and lymphomas and conditions such as asthma and rheumatoid arthritis.

The findings come from the RECOVERY trial sponsored by Oxford University, a randomized clinical trial of potential COVID-19 treatments, which enrolled more than 11,500 patients hospitalized with the disease across 175 hospitals in the U.K. A total of 2,104 patients were randomized to receive dexamethasone 6 mg once per day for 10 days, either via oral pill or intravenous injection, and 4,321 patients were randomized to receive only standard care. The study looked at 28-day mortality rates and found that overall, 21.6% of patients who received dexamethasone died during that period, compared with 24.6% of patients receiving usual care.

The study also compared mortality rates depending on intubation. Treatment with dexamethasone reduced 28-day mortality by one-third in patients who were ventilated compared with those receiving standard care (29.0% vs. 40.7%; 95% CI 0.51-0.82), and by one-fifth in patients receiving oxygen without intubation (21.5% vs. 25.0%; 95% CI 0.70-0.92). No benefit was found in patients not receiving respiratory support (17.0% vs. 13.2%; 95% CI 0.93-1.61).

“Dexamethasone is the first drug to be shown to improve survival in COVID-19,” said Peter Horby, MD, one of the lead investigators and a professor at the University of Oxford. “Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.’”

Sources: STAT, June 17, 2020; Oxford University news release, June 16, 2020; Horby P, Lim WS, Emberson J, et al. Effect of Dexamethasone in Hospitalized Patients with COVID-19: Preliminary Report. medRxiv. 2020 Jun 22.