Dexamethasone: the cheap medicine that can save the lives of the most severe coronavirus patients

Amid so much bad news about the pandemic (up to 5,500 nurses are seriously affected by the Covid-19 and there is already a flare-up in Beijing), it doesn't hurt to receive a hopeful one. And it has come from the UK. A team from the University of Oxford has discovered that a corticosteroid, called dexamethasone, can reduce mortality by up to a third in hospitalized coronavirus patients with respiratory complications who need mechanical ventilation.

The study, called Recovery, has been conducting clinical trials with various drugs since March 250 UK hospitals. Dexamethasone, specifically, has been tested in a group of 2,104 patients with very encouraging results.

But this finding also comes with doubts and questions under the arm. To answer them, we have spoken with the Dr. Manuel Menduiña, Internist at the Virgen de las Nieves University Hospital in Granada and PhD doctor.

What is the importance of this news?

First of all, prudence. "This is not really a discovery. The use of corticosteroids in this type of patient is something that we already do in other circumstances," explains Dr. Menduiña. In fact, the specialist assures that during the coronavirus pandemic he has used methylprednisolone – a corticosteroid very similar to dexamethasone – in seriously ill patients. "This treatment has been used in practically all ICUs in Spanish hospitals. It had previously been used in Italy," explains the doctor.

In which patients is dexamethasone used?

Dr. Menduiña advises that this type of drug should only be used in seriously ill patients whose clinical picture may lead to a cytochemical storm or hyper immune response syndrome. This clinical picture is triggered by the virus and causes the body to secrete a series of pro-inflammatory substances. The doctor assures that more or less a third of the coronavirus patients reaches this state and it is necessary to intubate them. This type of patient has a previous marker, which is a high level of ferritin, so dexamethasone can even be used preventively.

Far from what it may seem, patients with this type of picture are not old. "In fact, there were patients with an age range of between 45 and 60 years ", the doctor warns. Of course, most were diabetics, hypertensive and some were also overweight.

What are the advantages of dexamethasone?

From the discovery of the active ingredient of a drug until it is widely used in patients, it can take between 2 and 4 years, according to Dr. Menduiña. But that is not the case of dexamethasone: it has been used for years to treat some autoimmune diseases. Further, "It is cheap and the supply is more than assured. It can be produced in industrial quantities, "explains the specialist. This makes it available to the majority of the population.

Does it have side effects?

Yes, these types of drugs are immunosuppressants, the doctor warns. In fact, "we use corticosteroids as anti-inflammatory treatment in outbreaks of systemic diseases such as lupus or rheumatoid arthritis."

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