Dexamethasone improves survival of COVID-19 patients in RECOVERY trial

The University of Oxford said that steroid dexamethasone has succeeded in reducing death in the ongoing RECOVERY trial in hospitalized patients with severe respiratory complications of COVID-19.

The RECOVERY trial was launched in March 2020 as a randomized clinical trial to evaluate a range of potential treatments for coronavirus, including low-dose dexamethasone, which is a steroid treatment. More than 11,500 patients have been taken into the RECOVERY coronavirus trial from more than 175 NHS hospitals in the UK.

Earlier this month, recruitment to the dexamethasone arm was stopped as the trial’s steering committee felt that enough patients had been enrolled to determine whether or not the drug had delivered a meaningful benefit.

According to the University of Oxford, a total of 2,104 patients were randomly grouped to be subjected to dexamethasone 6mg daily once by mouth or by intravenous injection for 10 days and were compared with 4321 patients randomly grouped to be subjected to usual care alone.

The university said that among the patients who were given only usual care, 28-day mortality was highest in those who needed ventilation, at 41%, intermediate in those patients who needed oxygen only, at 25%, and leat among those who did not need any respiratory intervention, at 13%.

Dexamethasone has been shown to have brought down deaths by one-third in ventilated patients and by one fifth in other patients who were given oxygen only. There was no benefit among those patients who did not need respiratory support, said the University of Oxford.

The university said that based on the results, one death would be avoided by treatment of nearly eight ventilated patients or about 25 patients needing oxygen support alone.

Martin Landray – Professor of Medicine and Epidemiology at the Nuffield Department of Population Health at the University of Oxford, one of the Chief Investigators, said: “Since the appearance of COVID-19 six months ago, the search has been on for treatments that can improve survival, particularly in the sickest patients. These preliminary results from the RECOVERY trial are very clear – dexamethasone reduces the risk of death among patients with severe respiratory complications.

“COVID-19 is a global disease – it is fantastic that the first treatment demonstrated to reduce mortality is one that is instantly available and affordable worldwide.”