New studies confirm that multiple types of steroids improve survival of severely ill COVID-19 patients.
An analysis of pooled results from seven studies, led by the World Health Organization and published on Wednesday by the Journal of the American Medical Association, found that steroids reduced the risk of death in the first month by about one-third.
"This result opens up more choices," said Dr Martin Landray of the University of Oxford, who led one of the studies. "The more options there are in terms of availability, the better."
Dr Anthony Gordon of Imperial College London called the result "a huge step forward," but added, "As impressive as these results are, it's not a cure."
Steroid drugs are inexpensive, widely available and have been used for decades. They reduce inflammation, which sometimes develops in coronavirus patients as the immune system overreacts to fight the infection. This overreaction damages the lungs and can prove fatal. These drugs are not the same type of steroids that are used or misused for athletic performance.
In June, a large study led by the University of Oxford found that a steroid called dexamethasone cut deaths by up to 35% in hospitalized COVID-19 patients who needed treatment with breathing machines and by 20% in those only needing extra oxygen. It did not help less sick patients and might even have even been harmful at that stage of illness.
Mark Shannon, a 61-year-old retired bank teller from Pittsburgh who spent 11 days on a breathing machine, received the steroid hydrocortisone in a study and recovered. His doctor told him, "That was pretty stupendous, to recover after being long on a ventilator.’’ "I realize how close I came to losing my life," he said.
The WHO issued treatment advice on Wednesday recommending steroids for patients with severe COVID-19 and suggested not using them for less sick patients.
Treatment guidelines in the U.S. now recommend dexamethasone or other steroids only when it's not available for hospitalized COVID-19 patients needing extra oxygen, but that could change with the new information.
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