Possible COVID-19 treatment welcomed

Australian researchers have welcomed news of a possible breakthrough in the search for a treatment for COVID-19, but added a note of caution as the results are as yet preliminary.

In the UK, the University of Oxford has released the results of a trial into dexamethasone, a low-cost steroid which, the researchers say, has been shown to reduce deaths by one-third in ventilated patients and by one-fifth in other patients receiving oxygen.

No benefit was found among patients who did not require respiratory support.

The study has yet to be published or peer-reviewed. It was part of RECOVERY, a randomised clinical trial to test a range of potential treatments for COVID-19.

In a statement, Peter Horby, one of the chief investigators for the trial, comments that dexamethasone is the first drug to be shown to improve survival in COVID-19.  “The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients.”

In Australia, among the first to be asked to comment was Brian Oliver from University of Technology Sydney and the Woolcock Institute, who describes it as “the first study that I have seen in which I am genuinely excited by the outcomes for patients with severe COIVD-19”.

“Dexamethasone is an older steroid which generally is not used in clinical practice as newer generations of steroids with fewer side-effects are available,” he says. “However, as an older drug it is off patent which makes it an extremely cheap medication, and importantly available worldwide, and as such had the potential to radically change the nature of COVID-19 treatment.”

In a similar vein, Gaetan Burgio from the Australian National University, notes that the preliminary results are the first to demonstrate that a drug can significantly increase survival for critically ill COVID-19 patients.

“Overall this is an important and significant result that in my view is likely to save lives,” he says. “Given these results and pending confirmation it wouldn’t be surprising to me if dexamethasone treatment will be quickly adopted as a standard of care for severe COVID-19 patients hospitalised in ICU.”

Among those welcoming the news but urging caution are Ian Musgrave from the University of Adelaide and Ian Seppelt from Sydney’s Nepean Hospital, who both note that, in Musgrave’s words, “[s]o far we only have press releases to go on, the actual study data have not been released so this needs to be examined carefully”.

Seppelt adds, however, that the RECOVERY trial is “a well-designed trial being conducted by a very high-quality team, and I am confident robust data will be published as soon as feasible”.

“As well, because dexamethasone is a powerful anti-inflammatory and immune suppressant, it still must be used with care,” Musgrave continues.

“Finally, we must be very clear that dexamethasone, if it proves to be as useful as the press release claims, is not a preventative or general treatment, but is only for the most severe cases of COVID-19 that require respiratory support. This in itself is good news, but it must not be exaggerated.”