Steroids Can Be Lifesaving for Covid-19 Patients, Scientists Report

New data in hand, the W.H.O. recommended that doctors give the drugs to critically ill patients worldwide.

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W.H.O. Recommends Steroids for Critically Ill Coronavirus Patients

The World Health Organization said steroids should be used to treat patients hospitalized with severe Covid-19, but advised against giving the drugs to patients with mild cases.

“A strong recommendation for steroids — systemic steroids. That means steroids, either oral steroids or through the IV, in patients with severe and critical Covid. So that’s the first recommendation. And the reason we made this recommendation was because the evidence shows that if you give corticosteroids you will have — and I’m going through different numbers — so 87 fewer deaths per 1,000 patients.” “So that’s something that clinicians who are caring for patients with Covid should do for those are the sickest who are taking in oxygen, either through a ventilator or through a mask. That’s right?” “Yeah, and we have —” “They should be taking corticosteroids.” “— and in the guideline it’s very clear how we’re defining the severe disease and the critical disease in both of those subgroups, both of those groups of patients.” “And these are generally patients who would be hospitalized.” “These are under the medical care of physicians.” “Yeah so, I want to be clear because the second recommendation is very important as well. This was a conditional recommendation not to use corticosteroids — so against the use of corticosteroids — in patients with non-severe Covid. So that means the patients that have mild, you know they may have symptoms, and then maybe those symptoms are bothersome, you know not to discount symptoms you know symptoms of mild disease because those can be very bothersome, but they don’t have physiological signs. And I’m going to say that in a scientific way, physiological signs of an inflammatory response that’s leading to respiratory distress.”

By Roni Caryn Rabin

International clinical trials published on Wednesday confirm the hope that cheap, widely available steroid drugs can help seriously ill patients survive Covid-19, the illness caused by the coronavirus.

Based on the new evidence, the World Health Organization issued new treatment guidance, strongly recommending steroids to treat severely and critically ill patients, but not to those with mild disease.

“Clearly, now steroids are the standard of care,” said Dr. Howard C. Bauchner, the editor-in-chief of JAMA, which published five papers about the treatment.

The new studies include an analysis that pooled data from seven randomized clinical trials evaluating three steroids in more than 1,700 patients. The study concluded that each of the three drugs reduced the risk of death.

JAMA published that paper and three related studies, along with an editorial describing the research as an “important step forward in the treatment of patients with Covid-19.”

Corticosteroids should now be the first-line treatment for critically ill patients, the authors said. The only other drug shown to be effective in seriously ill patients, and only modestly at that, is remdesivir.

Steroids like dexamethasone, hydrocortisone and methylprednisolone are often used by doctors to tamp down the body’s immune system, alleviating inflammation, swelling and pain. Many Covid-19 patients die not of the virus, but of the body’s overreaction to the infection.

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