Preliminary results from the RECOVERY trial indicate that dexamethasone may prevent death from Covid-19. Early results of the as yet unpublished trial, released in mid-June, highly suggest this treatment reduces death among those requiring oxygen therapy or mechanical ventilation. This readily available and inexpensive cortisone type steroid represents the first drug apparently capable of reducing fatalities among hospitalized Covid-19 patients.
The RECOVERY trial of dexamethasone and Covid-19 was envisioned as a consequence of complications such as the cytokine storm. An overaggressive immune system reaction to the virus continues unabated and without restraints ultimately leads to severe illness or death in patients with Covid-19. Once initiated, the virus no longer remains a critical element in the downward progression of the disease. In some ways the course parallels a stack of falling dominoes.
Mortality plummeted by a statistically significant 35% among the sickest patients receiving mechanical ventilation. While the fatality rate among those treated with standard therapy was 41%, this fell to only 28% in those assigned to the dexamethasone group. Although this represented an amazing improvement, still more than 1 in 4 patients died.
Usual care was associated with a fatality rate of 25% when patients required supplemental oxygen but not mechanical ventilation. This improved by 20% to only a 20% mortality rate with dexamethasone. There were no differences in outcome in Covid-19 patients on room air with or without dexamethasone.
