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Tasfia Ahmad discusses the extent to which Dexamethasone could reduce COVID-19 related deaths. The steroid already exists on WHO's list of essential medicines, and it is thought that it could reduce severe respiratory conditions amongst patients. However, as is common with medical breakthroughs, there is some controversy as to whether or not it is a viable treatment for those suffering from acute respiratory distress.
When people are sick, they take certain precautions to prevent getting sicker and prevent others from getting sick, too. Such precautions include: staying at home, eating right, resting, and staying away from other people. Although these methods are beneficial, another common way to fight illness is with medicines - many of which are often antiviral. However, such treatments are not viable against this strain of the deadly coronavirus. Even over the past six months, no vaccine has been discovered. Thus far, there habe been about 8.7 million confirmed cases and a total number of 461, 715 deaths, according to the World Health Organization. A cure to end this madness is what people are waiting for the most, and those callings were answered on June 16th, when the RECOVERY (Randomized Evaluation of COVID-19 Therapy) announced that Dexamethasone, a steroid known for treating inflammation, could potentially save many COVID-19 patient’s lives.
The discovery was announced after researchers decided to focus on steroids which target the body’s immune system response, rather than attacking the virus as a whole. However, steroids, once in someone’s body, can rage out of control as people fight off an infection, causing inflammation and lung damage.
As mentioned previously, Dexamethasone is a steroid that relieves inflammation and is used to treat certain forms of arthritis; skin, blood, kidney, eye, thyroid, and intestinal disorders, along with severe allergies and asthma. Cancers and other conditions such as leukemia, anemia, cerebral edema, drug hypersensitivity, hypercalcemia, thrombocytopenia, and lymphoma also use dexamethasone to either reduce inflammation or suppress the body’s immune response. This medication is in the form of a tablet or liquid taken by the mouth, prescribed to someone by their doctor. Side effects may include upset stomach, stomach irritation, vomiting, headache, dizziness, insomnia, restlessness, depression, anxiety, acne, increased hair growth, easy bruising, irregular or absent menstrual periods.
Dexamethasone is a synthetic corticosteroid: a naturally-occurring chemical produced by the adrenal glands located above the kidneys. It was created in 1957 by Philip Showalter Hench, an American physician, and was approved for medical use in 1961. Dexamethasone is on the World Health Organization list of essential medicines, especially towards the improvement of rheumatoid arthritis during pregnancy, post-surgery, and infection. Dexamethasone has been essential for others for many years and will continue to be more essential due to the positive results from the patients with COVID-19.
In March 2020, the RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial was established as a clinical trial to test a variety of possible treatments for COVID-19, including Dexamethasone, but in low dosages. Over 11,500 patients have been enrolled from many hospitals in the United Kingdom. A total of 2,104 patients were randomly chosen to receive Dexamethasone 6 mg once per day, through mouth or injection. For ten days, the trial patients were compared to 4321 randomly-selected COVID-19 patients, who were receiving standard treatment.
“Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%)” - University of Oxford
Dexamethasone helped to reduce severe respiratory complications in COVID-19 patients near the brink of death. Although the patients did not face substantial side effects from taking Dexamethasone, those to be cautious of include: increased appetite, aggression, agitation, mood changes, blurred vision, dizziness, headache, tingling in arms and legs, irregular heartbeats, and so forth. However, professionals chose low to moderate doses of Dexamethasone for their trials to avert the side effects on the patients to see effective results.
Even though Dexamethasone has shown encouraging results, it has sparked a medical debate, as some argue that there is insufficient evidence to suggest that the drug could cure those suffering from acute respiratory distress - a form of lung failure that resembles some of the severe coronavirus infections. Many physicians explain that it is important for people to understand that Dexamethasone was not originally created to cure such a virus. The effects were only seen in patients with severe lung damage: those who required supplemental oxygen or a ventilator to function properly.
This discovery is just the beginning, and while significant progress has been made, there is a long way to go in preventing the loss of more lives.
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