New studies confirm that multiple types of steroids improve survival for severely ill COVID-19 patients, cementing the cheap drugs as a standard of care.
An analysis of pooled results from seven studies found that steroids reduced the risk of death in the first month by about one-third compared to placebo treatment or usual care alone in these seriously ill patients who needed extra oxygen.
The work was led by the World Health Organization and published Wednesday by the Journal of the American Medical Association.
Based on the results of the studies, the WHO has made two recommendations. The first, it says a strong corticosteroid therapy for 7 to 10 days should be used in patients with severe or critical COVID-19. The second, this therapy should not be used in patients with non-severe COVID-19, because it may increase the risk of death.
“In contrast, in patients with non-severe COVID-19, based on data from 1,535 patients in one study, systemic corticosteroids may increase the risk of 28-day mortality,” researchers wrote.
Compared to other treatments for COVID-19, these types of steroids are generally low cost, easy to administer and readily available across the globe.
“Dexamethasone and prednisolone are among the most commonly listed medicines in national essential medicines lists; listed by 95% of countries. Dexamethasone was first listed by WHO as an essential medicine in 1977, while prednisolone was listed 2 years later,” the WHO wrote.
The WHO added that clinicians should exercise caution in use of corticosteroids in patients with diabetes or those who are immunocompromised and could become severely ill do to COVID-19.