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UPDATE 1-Steroids cut death rates among critically ill COVID-19 patients, major study finds

Wed, 2nd Sep 2020 16:45

* Finding comes from analysis of 7 international trials

* Spurs WHO to update advice on COVID-19 treatment

* Steroid dexamethasone already in widespread ICU use
(Adds WHO comment, paras 4 and 5)

By Kate Kelland

LONDON, Sept 2 (Reuters) - Treating critically ill COVID-19
patients with corticosteroid drugs reduces the risk of death by
20%, an analysis of seven international trials found on
Wednesday, prompting the World Health Organisation to update its
advice on treatment.

The analysis - which pooled data from separate trials of low
dose hydrocortisone, dexamethasone and methylprednisolone -
found that steroids improve survival rates of COVID-19 patients
sick enough to be in intensive care in hospital.

"This is equivalent to around 68% of (the sickest COVID-19)
patients surviving after treatment with corticosteroids,
compared to around 60% surviving in the absence of
corticosteroids," the researchers said in a statement.

The WHO's clinical care lead, Janet Diaz, said the agency
had updated its advice to include a "strong recommendation" for
use of steroids in patients with severe and critical COVID-19.

"The evidence shows that if you give corticosteroids
...(there are) 87 fewer deaths per 1,000 patients," she told a
WHO social media live event. "Those are lives ... saved."

"Steroids are a cheap and readily available medication, and
our analysis has confirmed that they are effective in reducing
deaths amongst the people most severely affected by COVID-19,"
Jonathan Sterne, a professor of medical statistics and
epidemiology at Britain's Bristol University who worked on the
analysis, told the briefing.

He said the trials - conducted by researchers in Britain,
Brazil, Canada, China, France, Spain, and the United States -
gave a consistent message throughout, showing the drugs were
beneficial in the sickest patients regardless of age or sex or
how long patients had been ill.

The findings, published in the Journal of the American
Medical Association, reinforce results that were hailed as a
major breakthrough and announced in June, when dexamethasone
became the first drug shown to be able to reduce death rates
among severely sick COVID-19 patients.

Dexamethasone has been in widespread use in intensive care
wards treating COVID-19 patients in some countries since then.

Martin Landray, a professor of medicine and epidemiology at
the University of Oxford who worked on the dexamethasone trial
that was a key part of the pooled analysis published on
Wednesday, said the results mean doctors in hospitals across the
world can safely switch to using the drugs to save lives.


"These results are clear, and instantly usable in clinical
practice," he told reporters. "Among critically ill patients
with COVID-19, low-dose corticosteroids ... significantly reduce
the risk of death."

Researchers said the benefit was shown regardless of whether
patients were on ventilation at the time they started treatment.
They said the WHO would update its guidelines immediately to
reflect the fresh results.

Until the June findings on dexamethasone, no effective
treatment had been shown to reduce death rates in patients with
COVID-19, the respiratory disease caused by the new coronavirus.

More than 25 million people have been infected with COVID-19
and 856,876? have died, according to a Reuters

Gilead Sciences Inc's remdesivir was authorised by
United States regulators in May for use in patients with severe
COVID-19 after trial data showed the antiviral drug helped
shorten hospital recovery time.

Anthony Gordon, an Imperial College London professor who
also worked on the analysis, said its results were good news for
patients who become critically ill with COVID-19, but would not
be enough to end outbreaks or ease infection control measures.

"Impressive as these results are, this is not a cure. We now
have something that will help, but it is not a cure, so it's
vital that we keep up all the prevention strategies."
(Reporting by Kate Kelland; Additional reporting by Stephanie
Nebehay in Geneva;
Editing by Mark Heinrich and Catherine Evans)

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