VUMC doctors respond to first life-saving drug found to combat COVID-19

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NASHVILLE, Tenn. (WKRN) — Researchers in England said they have the first evidence that a drug can improve COVID-19 survival. It’s a cheap, widely available steroid called dexamethasone that has reduced deaths by up to one third in severely ill hospitalized patients.

“This is very optimistic at first glance​,” Dr. William Schaffner said, infectious disease specialist at VUMC. Dr. Schaffner said dexamethasone has been around for decades, it’s inexpensive and widely available.

“If the results of this trial pan out and we can use this drug,” Dr. Schaffner said. “It may reduce the prediction of the number of people who will die of this infection.”​​

Steroid drugs reduce inflammation, which sometimes develops in COVID-19 patients as the immune system overreacts to fight the infection. This overreaction can prove fatal, so doctors have been testing steroids and other anti-inflammatory drugs in such patients. The World Health Organization advises against using steroids earlier in the course of illness because they can slow the time until patients clear the virus.

During the trial, the steroid was given either orally or through an IV. After 28 days, it had reduced deaths by 35% in patients who needed treatment with breathing machines and by 20% in those only needing supplemental oxygen. It did not appear to help less ill patients.

“Dexamethasone is a powerful anti-inflammatory drug, without proper monitoring it can cause problems, it can cause blood sugar to go up and so its use in people with diabetes needs to be closely monitored​,” Dr. David Aronoff said.

The preliminary results – not yet published in a scientific journal – did not observe any notable side effects or adverse reactions. Dr. Aronoff said he’s looking forward to when the researchers findings are published so he can learn more about the possible treatment.

“I think were going to have to dig into the data a bit deeper before we widely roll this out,” Dr. Aronoff said. “One of the problems with a press release is it can change prescribing behavior right away and sometimes that turns out, in retrospect, to be the right decision, sometimes not​.”

Researchers estimated that the drug would prevent one death for every eight patients treated while on breathing machines and one for every 25 patients on extra oxygen alone.

Even though the drug only helps in severe cases, “countless lives will be saved globally,” said Nick Cammack of Wellcome, a British charity that supports science research.

“Here we have a good solid prospective trial done in a very rigorous way that suggests that survival can be improved,” Dr. Schaffner said. “Boy, have we been eager for that kind of information. We look forward to getting the complete data so we can assess it carefully and decide what patients will really benefit.”

Either way, both VUMC doctors agree this is a sign of hope, but said we must continue social distancing and washing our hands.

“Therapy is good,” Dr. Schaffner said. “But as Ben Franklin told us: ‘An ounce of prevention is worth a pound of cure.'”​​

COVID-19 in Tennessee

(This reflects what the TDH reports each day. )

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