Steroids Can Save the Lives of Severely Ill COVID Patients, Several Trials Confirm
Cheap and widely available steroids can save the lives of seriously ill coronavirus patients, a review of several trials confirmed.
The review, published in the Journal of the American Medical Association (JAMA) Wednesday, builds on the promise of a June study that found that the steroid dexamethasone reduced the risk of death for COVID-19 patients on ventilators or oxygen.
"I had a big smile on my face when I saw the results," Dr. Derek C. Angus, analysis coauthor and chair of the department of critical care medicine at the University of Pittsburgh, told The New York Times. "This is a case of, 'A question asked, a question answered,' and that's so rare."
#BREAKING Steroids cut death rates among critically ill #coronavirus patients, according to a new @WHO analysis,… https://t.co/oyE9ZrUFy0— Global Health Strategies (@Global Health Strategies)1599057342.0
The findings prompted the World Health Organization (WHO) to update its clinical care guidance Wednesday to recommend corticosteroids for severely or critically ill COVID-19 patients. The organization began work on the guidance in June, following the initial dexamethasone study, and helped with the subsequent trials.
"The evidence shows that if you give corticosteroids ... (there are) 87 fewer deaths per 1,000 patients," WHO clinical care lead Janet Diaz said during a live social media event, as Reuters reported. "Those are lives ... saved."
🆕 guideline on use of dexamethasone & other corticosteroids advises: ✅ for oral or intravenous usage in treatment o… https://t.co/ab4oepcbLa— World Health Organization (WHO) (@World Health Organization (WHO))1599072453.0
The metaanalysis was based on seven randomized trials involving 1,703 patients that were conducted by researchers in Britain, Brazil, Canada, China, France, Spain and the United States. In addition to dexamethasone, the trials also looked at the impacts of the steroids hydrocortisone and methylprednisolone.
All told, the steroids reduced death risk in seriously ill patients by 20 percent, the meta-analysis found. The New York Times offered a treatment-by-treatment breakdown of the results:
- Dexamethasone: Reduced deaths by 36 percent for 1,282 patients in three trials.
- Hydrocortisone: Reduced deaths by 31 percent for 374 patients in three trials.
- Methylprednisolone: Reduced deaths by nine percent in a smaller trial of 47 patients.
Doctors use steroids to suppress the immune system to reduce inflammation, swelling and pain. Researchers thought the drugs might help coronavirus patients because many people die of the immune system's overreaction to the virus, not the virus itself. However, there were also risks to consider.
"In intensive care we often use steroids to treat inflammatory conditions and severe infections," Imperial College London professor and hydrocortisone trial leader Anthony Gordon told The Guardian. "But we know they can also suppress the immune system, and with a new virus that none of us were immune to, that could make things worse."
Luckily, the steroids made things better. They are already being widely used, Oxford University medicine professor Martin Landray, who helped with the initial June study, told The Guardian. The number of hospital patients treated with dexamethasone rose from around seven to eight percent in May to around 55 percent by the end of June.
"This is not a drug that costs $3,000 to reduce a hospital stay by a few days," Landray said. "This is not anywhere near the sorts of costs in many, many other areas of acute and preventive medicine. So this is a widely available, widely useful strategy. I mean, treating people with dexamethasone is, give or take, 60 quid to save a life."
In its guidance, the WHO noted that it only recommended steroids for severely or critically ill cases.
"We suggest not to use corticosteroids in the treatment of patients with non-severe COVID-19 as the treatment brought no benefits, and could even prove harmful," the agency wrote.
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People across New England witnessed a dramatic celestial event Sunday night.
EcoWatch Daily Newsletter
By David Reichmuth
Over the last month, I've seen a number of opinion articles attacking electric vehicles (EVs). Sadly, this comes as no surprise: now that the Biden administration is introducing federal policies to accelerate the roll out of electric vehicles, we were bound to see a reaction from those that oppose reducing climate changing emissions and petroleum use.
The majority of EVs sold in 2020 were models with a starting price (Manufacturers Suggested Retail Price) under $40,000 and only a fifth of models had a starting price over $60,000.
On Friday, China set out an economic blueprint for the next five years, which was expected to substantiate the goal set out last fall by President Xi Jinping for the country to reach net-zero emissions before 2060 and hit peak emissions by 2030.
The Great Trail in Canada is recognized as the world's longest recreational trail for hiking, biking, and cross-country skiing. Created by the Trans Canada Trail (TCT) and various partners, The Great Trail consists of a series of smaller, interconnected routes that stretch from St. John's to Vancouver and even into the Yukon and Northwest Territories. It took nearly 25 years to connect the 27,000 kilometers of greenway in ways that were safe and accessible to hikers. Now, thanks to a new partnership with the Canadian Paralympic Committee and AccessNow, the TCT is increasing accessibility throughout The Great Trail for people with disabilities.
Trans Canada Trail and AccessNow partnership for AccessOutdoors / Trails for All project. Mapping day at Stanley Park Seawall in Vancouver, British Columbia with Richard Peter. Alexa Fernando<p>This partnership also comes at a time when access to outdoor recreation is more important to Canadian citizens than ever. <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/200527/dq200527b-eng.htm" target="_blank" rel="noopener noreferrer">Studies from the spring of 2020</a> indicate that Canadian's <a href="https://www.bnnbloomberg.ca/moneytalk-mental-health-during-covid-19-1.1567633" target="_blank" rel="noopener noreferrer">mental health has worsened</a> since the onset of social distancing protocols due to COVID-19. </p><p>The <a href="https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/safe-activities-during-covid19/art-20489385" target="_blank" rel="noopener noreferrer">Mayo Clinic</a> lists hiking, biking, and skiing as safe activities during COVID-19. Their website explains, "When you're outside, fresh air is constantly moving, dispersing these droplets. So you're less likely to breathe in enough of the respiratory droplets containing the virus that causes COVID-19 to become infected."</p><p>TCT leadership took this into consideration when embarking on the accessibility project. McMahon explains that there has never been a more important time to bring accessibility to the great outdoors: "Canadians have told us that during these difficult times, they value access to natural spaces to stay active, take care of their mental health, and socially connect with others while respecting physical distancing and public health directives. This partnership is incredibly important especially now as trails have become a lifeline for Canadians."</p><p>Together, these organizations are paving the way for better physical and mental health among all Canadians. To learn more about the TCT's mission and initiatives, check out their <a href="https://thegreattrail.ca/stories/" target="_blank">trail stories</a> and <a href="https://thegreattrail.ca/wp-content/uploads/2021/01/TCT_2020-Donor-Impact-Report_EN_8.5x14-web.pdf" target="_blank">2020 Impact Report</a>.</p>