When SARS-CoV-2 marched onto the international stage earlier this year, scientists around the world banded together to search tirelessly for a vaccine or treatment that could save lives being taken at alarming rates. The search for a vaccine has been very encouraging as of late and there is also good news regarding treatment for patients who have already been infected with COVID-19. In particular, three new studies have demonstrated the effectiveness of steroids for improving patient outcomes.
Three research groups — one from France, one from Brazil and one from the University of Pittsburgh — published their findings in the journal, “JAMA” on Sept. 2. According to a “JAMA” editorial by Drs. Hallie Prescott and Todd Rice, the publication of this research “represents an important step forward in the treatment of patients with COVID-19.” The scientists involved in the studies demonstrated the effectiveness of the steroid dexamethasone, which had shown promise in a U.K study back in June. The steroid significantly reduced mortality among the most dire COVID-19 cases — in particular patients who required ventilators or supplemental oxygen. The new studies also supported the use of hydrocortisone (another frequently used steroid).
“It’s good news to have a strong, clear signal on what is a widely available, inexpensive class of therapies.”
Dr. Derek Angus, a critical care specialist at the University of Pittsburgh Medical Center, said, “It’s good news to have a strong, clear signal on what is a widely available, inexpensive class of therapies.” Three studies confirming the same result increases the reliability of each research group’s claims. In addition, the studies made use of randomized controlled trials. Research on other potential treatments for COVID-19 that have been less successful, such as those studying anti-malaria drugs, did not include a comparison group or randomize the participants in each study.
Dr. Angus also said, “It is reassuring that we can get randomized trials executed successfully and rapidly in the face of a pandemic, and it definitely puts us on a surer footing.” However, some people worry that using steroids without proper precautions could be dangerous. Steroids work by calming down the body’s immune system, which shifts into overdrive during a SARV-CoV-2 infection and can be deadly. Some doctors believe that lowering the immune response could prevent the body from effectively fighting off the virus. Steroids may also lead to systemic complications such as cardiovascular and autoimmune events as well as an increase in the risk of resistance to neuromuscular blocking agents. In addition, steroids have previously proven harmful against SARS-CoV-1 and MERS-CoV, two other coronaviruses. However, it is important to consider the recent research on COVID-19 and steroids; Modifying our opinions according to the latest data and welcoming new treatments could save lives.
That said, we should move forward with caution by allowing the promising results of new studies to quickly benefit patients while also monitoring patient outcomes closely, and changing our strategies if concerns arise. In addition, scientists should continue studying the potential harms of steroid use to cross-check with other research; This will boost confidence in new treatments.
The World Health Organization updated its guidelines for steroids after the new research was published early this month. The guidelines recommend the use of steroids for COVID-19 patients who are severely ill, such as those who require a ventilator or supplemental oxygen. However, it does not recommend steroid use for patients with milder cases.
We should be encouraged by this research not only for its immediate benefits, but also what it indicates about COVID-19 research in general. Scientists are winning the war against coronavirus at a rate faster than any other disease. The research community has thrust aside, or at least drastically reduced, its thirst for money and prestige. Collaboration with other scientists and open-source data have allowed us to make progress faster than most in the field have previously imagined. The end of this long journey may not be definitively known, but it is surely coming.