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Use of dexamethasone as prophylactic treatment in moderate to severe COVID-19 condition

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23 Jul 2020

A Short Review Recommended To Carry Further Research The study proposed was aimed to identify and assess the effect of dexamethasone in mild and moderate cases of COVID-19. Coronavirus disease 2019 (COVID-19) is associated with diffuse lung damage, which was declared a pandemic by WHO. Corticosteroids may modulate immune-mediated lung injury and reducing progression to respiratory failure and death. The Randomised Evaluation of COVID-19 therapy (RECOVERY) trial is a randomized, controlled, open-label, adaptive, platform trial comparing a range of possible treatments with usual care in patients hospitalized with COVID-19. The method used was to compare dexamethasone six mg given once daily for up to ten days vs. usual care alone. The primary outcome was 28-day mortality. 2104 patients randomly allocated to receive dexamethasone were compared with 4321 patients concurrently allocated to usual care. Overall results showed that 454 (21.6%) patients allocated dexamethasone and 1065 (24.6%) patients allocated usual care did within 28 days. Dexamethasone reduced deaths by one-third in patients receiving invasive mechanical ventilation, by one-fifth in patients receiving oxygen without invasive mechanical ventilation, but did not reduce mortality in patients not receiving respiratory support at randomization. Hence, In patients hospitalized with COVID-19, dexamethasone reduced 28-day mortality among those receiving invasive mechanical ventilation or oxygen at randomization, but not among patients not receiving respiratory support. 

S. Arin Natania, 

Sarvesh Sabarathinam 

SRM College of Pharmacy, SRM IST, Kattankulathur, Chennai.

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Arin Natania

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