Several U.S. hospitals in states with fresh surges of COVID-19 cases have started treating their sickest patients with dexamethasone rather than await confirmation of preliminary results of a study by British researchers, who said the inexpensive steroid saves lives.
The move illustrates how the pandemic is changing the way hospitals work, at least regarding COVID-19 patients.
Traditionally, doctors wait for detailed data to be published in a peer reviewed journal – or for guidelines from medical societies – before embracing a new treatment, so they can better gauge the risks against the drug’s benefits. The urgency of the coronavirus pandemic and lack of other treatments has altered those calculations.
Dexamethasone is the first drug shown to lower the risk of death in severely ill COVID-19 patients in what researchers running the trial hailed as a “major breakthrough.”
The Oxford University researchers said in a news release that dexamethasone reduced death rates by around a third among COVID-19 patients requiring mechanical breathing assistance or oxygen. Britain’s health ministry has already approved its use in the state-run health service.
“It almost feels unethical not to use the drug,” said Dr. Kartik Cherabuddi, an infectious diseases specialist at the University of Florida’s (UF) medical school.
UF’s Gainesville hospital updated its COVID-19 treatment guidelines as of Tuesday to include using dexamethasone. It previously used the extremely cheap generic medicine sparingly for those patients.
Cherabuddi noted that his hospital – and many others – similarly started treating COVID-19 patients with Gilead Science’s (GILD.O) antiviral drug remdesivir based on data from a news release.
That drug, which unlike dexamethasone was not yet approved by regulators for any other conditions, shortened hospital recovery times in a clinical trial. It did not have an effect on mortality.
Several hospital systems, including New York’s Northwell Health and the University of Washington (UW) had not been using steroids on COVID-19 patients. There was some concern it could lead to worse outcomes because it suppresses the immune system.