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Dexamethasone Drug

  • 17 Jun 2020
  • 4 min read

Why in News

Recently, scientists administering the World Health Organisation’s RECOVERY trial have reported that dexamethasone reduced Covid-19 deaths in severe patients.

  • Dexamethasone is a cheap and widely available steroid drug.

Key Points

  • Highlights of the Research:
    • The drug was given either orally or through an IV (intravenous).
    • After 28 days, it had reduced deaths by 35% in patients who needed treatment with breathing machines and by 20% in those only needing supplemental oxygen.
    • The drug is not helpful for less ill patients and for those who do not need respiratory support.
    • According to the estimates, this drug can prevent one death for every eight patients treated while on breathing machines and one for every 25 patients on extra oxygen alone.
  • Drug Mechanism:
    • Multi-system Inflammatory State is a Covid-19 related illness that causes inflammation of the blood vessels leading to low blood pressure, affecting the entire body as it causes a build-up of fluid in the lungs and other organs.
    • The inflammation can be fatal so steroids and other anti-inflammatory drugs are used to reduce it.
    • Dexamethasone is not an anti-viral but works to modulate the immune response of the body when confronted by a viral infection such as Covid-19.
  • Benefits:
    • The survival benefit is clear and large in severe patients.
    • It is highly affordable, easy to make, can be scaled up quickly and only needs a small dosage.
    • It is a cheaper option than tocilizumab, an injectable, which is also being tested.
  • Concerns:
    • The WHO advises that steroids should not be used early in a course of illness because they can slow the time until patients clear the virus.
    • Excessive use of steroids can lead to adverse reactions like major mood swings, aggression and irritability, delusions, kidney/liver damage, increased blood pressure, etc.
  • India’s Reaction:
    • Indian doctors have welcomed the research as good news for Covid-19 patients on ventilators.
      • The drug is affordable and easily available in India.
    • Earlier, the Indian Council for Medical Research (ICMR) revised the protocol for clinical management of Covid-19 and allowed the use of remdesivir, tocilizumab and Convalescent Plasma Therapy (CPT) on certain groups of patients.
      • Remdesivir reduced hospital stays for very sick Covid-19 patients but has not been shown to improve recovery itself.
  • Other Findings from the Research:
    • Earlier, the same study showed that the malaria drug hydroxychloroquine was not working against the coronavirus.
    • The study enrolled more than 11,000 patients in England, Scotland, Wales and Northern Ireland who were given either standard of care or that plus one of the treatments mentioned below:
      • Dexamethasone.
      • HIV combo drug lopinavir-ritonavir.
      • Antibiotic azithromycin.
      • Anti-inflammatory drug tocilizumab.
      • Plasma from people who have recovered from Covid-19 that contains antibodies to fight the virus.

Source: IE

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