There is some excitement among doctors treating COVID-19 because new medical research has found a standard drug can be used to treat patients who are breathing through a ventilator, perhaps the most lethal stage of the disease.
It is a corticosteroid called dexamethasone, routinely used to treat inflammation for decades. Now, researchers working out of Oxford University say the drug reduced deaths by up to one-third for those with respiratory problems from the virus.
The numbers look good: 2,000 patients treated with dexamethasone and 4,500 given standard care is a guide that the treatment may work and save lives. It also is a standard medicine, so it may go into immediate use.
"Is it grade A evidence? No. But is it grade B evidence? Yes. So we are kind of excited that we have two choices now," said Dr. Sanjay Sethi, a professor of medicine and division chief of pulmonary critical care for the University at Buffalo's Jacobs Medical School.
Sethi wished more of the data behind the study were available for him to review.
"You still want to see it, because were they randomized at the same time?" Sethi asked. "They said in that little paragraph they put out that only 94% of the people they had data for. I'd like to see 100% of people. So there are some caveats, but it seems like a very good group of people. So I think it's going to hold up."
Sethi said this is not a major cure, but it cuts the death rate substantially and it may become a leading drug in the COVID-19 war, along with the antiviral remdesivir, which is being used early while the steroid would be used if the patient goes on a ventilator.
He said it is tricky, because dexamethasone is a very good anti-inflammatory but it can lower body immunity to other problems, often an infection. Antibiotics can deal with a bacterial infection.
"The nice thing about this, it looks like the anti-viral has a larger benefit earlier. Now it's not being tested in really early disease, but that is what you would expect," Sethi said. "So if you get the virus, the virus starts off in the inflammatory process. Most of the time, the inflammatory process and the immune process is good because it contains the process and clears it."
