British doctors report very favorable results from the treatment of COVID-19 patients with the drug dexamethasone. Mortality among ICU patients who were ventilated decreased by a third compared to patients who did not receive the drug.

Breakthrough of dexamethasone

Due to the urgency, British researchers made their findings public on Tuesday before they described the results of their study in a scientific journal. They speak of a breakthrough and promise to publish their results as soon as possible.

Not only ventilated COVID-19 patients, but also patients who only received extra oxygen, benefited from the treatment. In this group, the death risk decreased by a fifth, the researchers said. Dexamethasone did not decrease mortality under patients who did not require additional oxygen.

The study around dexamethasone

The British doctors have started their study  (Recovery) in March this year. Over 2100 patients received 6 milligrams of dexamethasone daily for then days in addition to the usual treatment, a group of over 4300 patients received only the usual therapy.

Of the ventilated patients, 41 percent died, of the patients who received extra oxygen alone, 25 percent died and of the group who did not require additional oxygen, 13 percent died.

Administration of dexamethasone prevented one death per eight ventilated patients and one death per 25 patients receiving oxygen only. The researchers argue that based on their study results, the medicine should be included immediately in standard treatment of all hospital patients with COVID-19 who receive supplemental oxygen.

Dexamethasone is a commonly used adrenal cortex hormone in the medical world, a cortisone preparation with a powerful anti-inflammatory effect.

Research leader Prof. Peter Horby of Oxford University calls the results of the study “fantastic”. “Dexamethasone is an inexpensive drug that is widely available and therefore applicable.”

Remarkable

Cardiologist intensivist Corstiaan den Uil, who works at Erasmus MC, calls the results reported by the Britisch researchers in an initial reaction ‘remarkable’. “It concerns a very large study and the results look like a succes. Although you have to be careful, because the study has not yet been published and has not yet been provided with scientific commentary

Den Uil finds the results logical in a way. “You sometimes see a strong inflammatory reaction in a Corona patients lungs to which they die. If you can do something about that with an anti-inflammatory, that’s a big advantage. Although you have to be careful, because if you provide too many anti-inflammatory drugs, it can counteract. I also notice that the researchers gave a low dose of dexamethasone.”

Recognition

American ICU doctor Professor Paul Marik recognizes the results of his British colleagues, he reports by email from Sentara hospital in Norfolk (East Virginia). “The results support the results of our own treatment protocol. Instead of dexamethasone we give the medicine methylprednisone, also a cortisone preparation. In addition, we give intravenous high doses of vitamin C and anticoagulants. These supplements enhance each other’s effect. If necessary, we add melatonin, vitamin B1, vitamin D, magnesium, antibiotics and a few other agents. We have shown though our own research that methylprednisone works better than dexamethasone.”

According to Marik, the mortality rate among Corona patients in two American hospitals where the combination treatment is applied is 3.5 percent.

The treatment of Marik and other intensivists who have united in the Frontline COVID-19 Critical Care Working Group is not undisputed. Critics point out that the therapy’s results have so far not been proven though double-blind studies involving multiple groups of patients. For medical ethical reasons, Marik and his colleagues do not think it is responsible to wait for that.