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Doctor’s Note: Can Dexamethasone Treat COVID-19?

With the coronavirus pandemic tightening its grip on the world and economies grinding to a standstill, the race is on to find a vaccine. But while that could take up to 18 months, existing drugs are being fast-tracked to see if they can be effective in treating people with the disease and helping save lives.

With about 14 percent of COVID-19 patients needing to be hospitalised for respiratory problems, effective treatments are desperately needed.

In March, the World Health Organization (WHO) announced a large global trial, called Solidarity, to find out whether any existing drugs can treat infections caused by COVID-19. Something on this scale has not been done before. The trial involves looking at scientific data from several countries, thousands of patients and hundreds of hospitals.

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The idea is, instead of coming up with new drugs from scratch (which can take years), to see if drugs that are known to help with other conditions might also be effective in treating those with COVID-19.

Researchers are looking at certain drugs in particular, including lopinavir-ritonavir (also called Kaletra), used in the treatment of human immunodeficiency viruses (HIV). Other researchers have meanwhile trialled the steroid dexamethasone, which has yielded some promising results.

Dexamethasone

A recent announcement by a research team at Oxford University, England allowed for a glimmer of hope in what can only be described as a dark few months.

The drug dexamethasone had been trialled on around 2,000 patients who required hospital treatment as a result of COVID-19. The drug was shown to significantly reduce the number of deaths among those seriously ill with the coronavirus, so much so that the results have been fast-tracked and shared with the wider medical profession so other countries can benefit from these positive findings.

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Dexamethasone is a steroid-based medication. It has long been used in the treatment of common conditions such as croup in children, asthma exacerbations, rheumatoid arthritis and for some conditions that cause brain swelling.

Part of the way it works is by suppressing the immune system. What we do know about patients that suffer the worst complications of COVID-19, such as breathing difficulties, is that their own immune system over- responds to the virus, so as well as attacking infected cells it also attacks healthy cells such as those found in the lungs.

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Dexamethasone helps prevent this over-reaction so that only infected cells are targeted by the immune system.

The study showed that the drug reduced the number of deaths in coronavirus patients requiring a ventilator by one-third, and for those requiring oxygen, the number of deaths was reduced by one-fifth.

As the drug has been used for so long to treat other conditions, it is no longer on patent, which means no single pharmaceutical company has the right to it. As a result, it is relatively cheap to use and poorer countries, where the virus is having devastating effects, can also access it.

This is good news, but it is important to say that this does not prevent people from getting the virus and nobody should be buying or taking dexamethasone without medical supervision.

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