Take a fresh look at your lifestyle.

A simple blood test can determine which Covid patients are most likely to have dexamethasone

A simple blood test can tell which coronavirus patients are most likely to have dexamethasone – the only drug proven to save the lives of critically ill people.

Patients with high levels of inflammatory markers in their blood were less likely to die or be placed on a ventilator when treated with steroids such as dexamethasone.

But doctors warned that the drugs can be dangerous when given to patients with normal levels of C-reactive protein.

The inflammatory marker can help indicate which coronavirus patients will benefit from dexamethasone, a steroid that costs £ 5 and has been around for decades.

Currently, doctors decide whether to use the drug depending on whether the patient has severe breathing problems.

NHS officials approved dexamethasone for use in critically ill patients after results from the world’s largest Covid-19 drug study found it could reduce their risk of death.

Scientists at the University of Oxford claimed it can save up to 35 percent of patients who rely on fans – the most dangerously ill – and reduce the risk of death by a fifth for all patients who need oxygen at any one time.

Doctors around the world have tested a cocktail of drugs to save lives during the pandemic and are slowly building a picture of what works best for different patients.

A simple blood test could reveal which Covid-19 patients will benefit most from dexamethasone - the only drug proven to save the lives of the critically ill (photo)

A simple blood test could reveal which Covid-19 patients will benefit most from dexamethasone – the only drug proven to save the lives of the critically ill (photo)

Covid-19 causes inflammation, which is the body’s natural but intense response to the virus.

Sometimes this can lead to death because the inflammation seriously damages the lungs and other organs.

Approved for use in the UK in mid-June, dexamethasone reduces inflammation in the lungs, according to the RECOVERY study.

The new study was led by the Albert Einstein College of Medicine and the Montefiore Health System, both located in New York City.

Researchers led by Dr. Marla Keller published their results in the Journal of Hospital Medicine.

Approved for use in the UK in mid-June, dexamethasone reduces inflammation in the lungs caused by an overreaction by the immune system

Approved for use in the UK in mid-June, dexamethasone reduces inflammation in the lungs caused by an overreaction by the immune system

Approved for use in the UK in mid-June, dexamethasone reduces inflammation in the lungs caused by an overreaction by the immune system

WHAT IS DEXAMETHASONE?

Dexamethasone is a type of corticosteroid drug used as an anti-inflammatory to treat a wide variety of conditions.

It was first created in 1957 by the American physician Philip Showalter Hench and approved for medical use in 1961.

The drug, which is sold under the brand names Ozurdez and Baycadron, is on the World Health Organization’s list of essential medicines.

It is given by injection or once-a-day tablet and is used to treat various conditions.

It is even used to reduce the side effects of chemotherapy in cancer patients.

The steroid is also used to treat conditions that cause inflammation, conditions related to the activity of the immune system and hormone deficiency.

These include:

  • allergic reactions
  • Rheumatoid arthritis
  • psoriasis
  • lupus
  • eczema
  • flare-ups of intestinal disorders, such as ulcerative colitis
  • multiple sclerosis
  • pretreatment for chemotherapy to reduce inflammation and side effects of cancer drugs
  • adrenal insufficiency (a condition in which the adrenal glands do not produce enough hormones)

Dexamethasone is known to cause a number of mild to moderate side effects, including vomiting, heartburn, anxiety, high blood pressure, muscle weakness, and insomnia.

What did the RECOVERY trial show?

A trial to test potential treatments for coronavirus patients was started on June 16, 2020 by the Nuffield Departments of Public Health and Medicine at Oxford University.

Although the trial is expected to last until June 2021, a preliminary report on the findings was published on July 18.

About 11,800 Covid-19 patients had enrolled in the trial as of June.

The study, randomized evaluation of COVID-19 therapy (RECOVERY), found that dexamethasone improves survival rates of hospital patients with Covid-19 receiving oxygen or on a ventilator.

However, this was only the case in patients who had difficulty breathing and needed respiratory support.

People who did not need respiratory support saw a worse survival rate when treated with the drug, although this may have been a coincidence.

The World Health Organization (WHO) states that dexamethasone should be reserved for critically ill and critical patients receiving COVID-19 treatment in a hospital setting.

The WHO Director General said, “The WHO emphasizes that dexamethasone should only be used under strict clinical supervision for patients with severe or critical illness. There is no evidence that this drug works in patients with mild disease or as a preventative measure, and it can cause harm. ‘

Based on those preliminary results, treatment with dexamethasone has been recommended by the National Institutes of Health in the US and the NHS in the UK.

It is only for patients with Covid-19 who are mechanically ventilated or who need supplemental oxygen but are not mechanically ventilated.

Dexamethasone is not recommended in patients with COVID-19 who do not require supplemental oxygen or hospitalization.

How does it help Covid-19 patients?

In coronavirus patients, the steroid reduces inflammation in the lungs caused by an overreaction by the immune system.

One in 10 symptomatic Covid-19 patients suffers from the annoying symptom known as acute respiratory distress syndrome (ARDS).

ARDS causes the immune system to become overactive and attack healthy cells in the lungs.

This makes breathing difficult and the body eventually struggles to get enough oxygen to the vital organs.

The academics compared the results for two groups of people who were hospitalized after they tested positive for Covid-19.

A group of 140 patients were treated with steroids within 48 hours of hospitalization, while a control group of 1,666 comparable patients received no steroid therapy.

Almost all patients initially had a blood test to measure the levels of C-reactive protein (CRP), which the liver produces in response to inflammation.

A normal CRP level reported in the study is less than 0.8 milligrams per deciliter of blood. The higher the CRP level in the blood, the greater the inflammation.

The findings show that early steroid use did not affect mortality or mechanical ventilation.

However, it did show a difference in outcome depending on the inflammation levels in each patient.

The study found in patients with high levels of inflammation – a CRP level above 20 – steroids reduced the risk of mechanical ventilation or death by 75 percent.

But critically, the study also found that for patients with normal or low levels of inflammation, CRP levels below 10, steroid use increased the risk of mechanical ventilation or death by 200 percent.

William Southern, a professor of medicine and the lead author of the study, said, “Our findings suggest that steroid therapy should be reserved for people with high inflammation, as evidenced by markedly elevated CRP levels.

“It’s a different story for people who don’t have significant inflammation: for them, any benefit outweighs the risks of using steroids.”

Luis Ostrosky, an infectious disease physician at the Health Science Center at the University of Texas at Houston, said of the study, “Steroids are Goldilocks drugs: they should be given at the right time.”

To talk with Scientific news, he said, giving steroids too early can keep the immune system in check too much so that it cannot effectively fight the corona virus, causing the virus to do more damage.

And “if you give steroids too late, the damage is already done,” he added.

The findings confirm those of the large-scale British study of steroid use for COVID-19 patients called RECOVERY.

It compared treatment with steroid dexamethasone with standard care, involving more than 6,000 patients with Covid-19.

Dexamethasone reduced mortality by about one-third of patients on ventilator and about one-fifth of those who needed oxygen but did not need respirators.

However, this was only the case in patients who had difficulty breathing and needed respiratory support.

People who did not need respiratory support saw a worse survival rate when treated with the drug, although this may have been a coincidence.

For that reason, the drug is only recommended by the National Institutes of Health in the US and by the NHS in the UK for people with severe breathing difficulties.

Dr. Keller and colleagues said today that their findings identified “patient groups that may cause harm from treatment” with steroids.

Second, based on a publicly available laboratory test (CRP), we have identified patient groups that are likely to benefit (or be harmed). “

Dr. Shitij Arora, a hospital physician and co-author of the study, said of the blood test, “It’s a cheap $ 20 test.”

In addition, the researchers in New York said for the first time that they could show that dexamethasone is not the only beneficial steroid.

Most patients treated with steroids in the study received prednisone, while some received methylprednisolone.

Dr. Keller said, “Our study is in line with the promising findings from Britain.

“But for the first time, we can demonstrate that people can see the same life-saving benefits with steroid formulations other than dexamethasone.”

Larger trials are needed to confirm the findings.

However, the authors wrote, “The public health implications of these findings are difficult to overestimate.

“Given the global growth of the pandemic and those glucocorticoids [steroids] are widely available and cheap, glucocorticoid therapy can save many thousands of lives.

“Equally important because we were able to identify a group that may have been harmed, some patients can be saved because glucocorticoids are not being given.”

The study also found that patients got better with steroid treatment, regardless of their gender or ethnicity.

.