translated from Spanish: Dexamethasone against coronavirus: what is it and what evidence it is that it works to treat covid-19

A cheap and widely available drug in the world has become a hope for the treatment of severe covid-19 patients.
This is dexamethasone, a steroid drug that, when supplied in low doses, has proven to be one of the best advances in the fight against the virus, say the UK experts tested it.
The drug is part of the world’s largest test of existing drug treatments that try to find out if they can work for coronavirus.

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In the case of dexamethasone, the risk of death in serious patients already connected to artificial respirators decreased by one third.
And for patients who needed oxygen, the risk of death fell by one-fifth.

Dexamethasone is a steroid drug.
In the UK, where more than 42,000 people have died as of this Tuesday, up to 5,000 lives could have been saved with this drug if it had been applied since the start of the pandemic, the researchers say.

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And the beneficial potential may be greater in poorer countries that have a high number of covid-19 patients.
Who would it work for?
Dexamethasone is already used to reduce inflammation in a variety of other conditions.
In covid-19 tests, it has helped stop some of the damage that can occur when the body’s immune system becomes overloaded while trying to fight the coronavirus.
That reaction from the body to the virus, which causes a cytokine storm, can be deadly.

Dexamethatone helps serious patients, such as those connected to respirators.
Nearly 19 out of 20 covid-19 patients in the UK recover from the disease without being hospitalized. Of those who enter, most also recover, but some may need oxygen or mechanical ventilation.
And these are the high-risk patients for which dexamethasone has been effective.

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The test, led by a team at the University of Oxford, administered dexamethasone to some 2,000 inpatients and compared with 4,000 who did not receive treatment.
For patients in need of artificial respiration, the risk of death increased from 40% to 28%. For patients who need oxygen, it reduced the risk of death from 25% to 20%.
“This is the only drug so far that has been shown to reduce mortality and reduce it significantly. It’s a breakthrough,” said the study’s chief investigator, Peter Horby.

The test director, Martin Landray, said that “there is a clear, very clear benefit” and explained that the results suggest that a life could be saved in:

every eight patients with artificial respirator
every 20-25 treated with oxygen

“Treatment is up to 10 days with dexamethasone and costs about 5 euros (about 5 thousand Chilean pesos) per patient. So it essentially costs £35 (34,500 pesos) to save a life,” he said.

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He also noted that dexamethasone “is a drug that is available worldwide”.
Landray suggested that hospitalized patients could start receiving treatment without delay.
But it is not recommended for the general public to go and buy it from pharmacies to take it home or consume it there.
Dexamethasone has shown no benefit for patients with mild covid-19 symptoms, who do not need mechanical or supplemental support for their breathing.

Researchers in the UK have tried existing drugs and how they act against covid-19.
The Recovery Trial, which has been conducted since March, also tested the malaria drug hydroxychloroquine, which was ruled out because it increases deaths and heart problems.
Meanwhile, the antiviral drug remdesivir, which seems to shorten recovery time for people with coronavirus, has already been distributed among health services.

Analysis by Fergus Walsh, BBC Health Correspondent
The first drug tested to reduce covid-19 deaths is not a new or expensive drug, but an old and inexpensive steroid.
That’s something to celebrate, sos means that patients around the world could benefit immediately.
And that’s why the results of this trial have been published quickly, because the implications are very big globally.
Dexamethasone has been used since the early 1960s to treat a wide range of conditions, such as rheumatoid arthritis and asthma.
Half of coivd-19 patients who require a respirator do not survive, so reducing that risk by a third would have a big impact.
The drug is administered intravenously in intensive care and tablet form for patients with less severe diseases.
So far, the only other proven drug that benefits coronavirus patients is remdesivir, which has been used for Ebola.
It has been shown to reduce the duration of coronavirus symptoms from 15 to 11 days.
But the evidence was not strong enough to show whether it reduced mortality.
Unlike dexamethasone, remdesivir is a new drug with limited supplies and a price has not yet been announced.

Original source in Spanish

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