Analysis: Steroid treatment reduced deaths for seriously ill COVID-19 patients

Data from seven studies with about 1,700 seriously ill COVID-19 patients found that corticosteroids reduce mortality by about one-third, according to analysis published Wednesday in JAMA. Why it matters: Corticosteroids, which are anti-inflammatory drugs, could likely be a low-cost, first line of defense for critically ill coronavirus patients. “In contrast […]

Data from seven studies with about 1,700 seriously ill COVID-19 patients found that corticosteroids reduce mortality by about one-third, according to analysis published Wednesday in JAMA.

Why it matters: Corticosteroids, which are anti-inflammatory drugs, could likely be a low-cost, first line of defense for critically ill coronavirus patients.

  • “In contrast to other candidate treatments for COVID-19 that, generally, are expensive, often unlicensed, difficult to obtain and require advanced medical infrastructure, systemic corticosteroids are low cost, easy to administer, and readily available globally,” the World Health Organization said in guidance published Wednesday.

The state of play: The three studies, a meta-analysis and guidance from the WHO recommend the use of corticosteroids among critically ill patients only.

  • Those with a mild case of COVID-19 are not recommended for this type of treatment.
  • The authors also note it’s too soon to know how the corticosteroids work to treat the illness. The data show, however, that they appear to hinder a fatal immune response doctors refer to as “cytokine storm.”

By the numbers: Between February and June, steroids dexamethasone, hydrocortisone and methylprednisolone were used on 678 severely ill patients.

  • 32.7% died, compared with 41.5% of patients receiving usual care or placebo.
  • “These trials and the meta-analysis have strengthened confidence, further defined the benefit, and shifted usual care of Covid-19–related [acute respiratory distress syndrome] to include corticosteroids,” according to the JAMA editorial.

The bottom line: For every 12 patients treated with corticosteroids, one life is saved, corresponding author of one of the studies, Jonathan Sterne, said in a JAMA interview Wednesday.

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