Coronavirus: Steroids reduce risk of death in critically ill Covid-19 patients, new study shows

WHO recommends use of corticosteroids, such as dexamethasone, as standard treatment for patients with ‘severe and critical’ Covid-19

The use of inexpensive steroids in treating patients hospitalised with Covid-19 has been found to reduce the risk of death by 20 per cent, according to a new international study.

The research encompassed seven clinical trials, which focused on three different types of anti-inflammatory corticosteroids, and was co-ordinated by the World Health Organisation (WHO).

Following the publication of the findings, the WHO issued new guidelines in which it recommended the use of corticosteroids as standard treatment for patients with “severe and critical” Covid-19.

The study, analysed by the National Institute for Health Research (NIHR) at the University of Bristol, looked at patient mortality over a 28-day period after treatment.

It found that corticosteroid treatment led to an estimated 20 per cent reduction in the risk of death.

Researchers said it was equivalent to about 68 per cent of critically ill patients surviving after treatment with the steroids, compared to approximately 60 per cent surviving without them.

Jonathan Sterne, professor of medical statistics and epidemiology at the University of Bristol, said: “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.

“The results were consistent across the trials and show benefit regardless of age or sex.”

Professor Jonathan Van-Tam, deputy chief medical officer, said: “These findings offer further evidence that corticosteroids can be an important part of Covid-19 treatment for severe patients.”

The seven control trials recruited 1,703 critically ill coronavirus patients from 12 countries from February to June.

Patients were randomised to either receive one of the three drugs or a placebo.

After 28 days, 33 per cent of the steroid-treated patients had died, compared to 41 per cent of the patients on usual care or a placebo.

The study analysed the effectiveness of hydrocortisone, methylprednisolone and dexamethasone — a cheap steroid that has already been shown to reduce deaths by one-fifth in patients on oxygen feeds and by one-third among those requiring ventilators.

Researchers said the mortality results were consistent across the seven trials, with dexamethasone and hydrocortisone giving “similar effects”.

However, there were too few patients involved in tests of methylprednisolone to enable researchers to estimate its impact with precision.

The research, which included patients from Oxford University’s study into dexamethasone, found that the steroids benefited patients regardless of whether they were on a ventilator.

Eighteen percent of patients on steroids reported side effects compared to 23 per cent of patients on usual care or placebo.

Corticosteroids are anti-inflammatory drugs that work by reducing the severity of the immune response triggered by Sars-Cov-2 — the virus responsible for Covid-19 — that is seen within the lungs of some of the most critically ill patients.

Although evidence is continuing to grow of the effectiveness of steroids in treating hospitalised patients, the WHO has cautioned against their use for individuals with mild symptoms, saying that “indiscriminate use of any therapy for Covid-19 would potentially rapidly deplete global resources and deprive patients who may benefit from it most as potentially life-saving therapy.”