New analysis of COVID-19 studies shows mortality benefit of inexpensive steroids.

A meta-analysis of pooled data from seven completed studies involving 1,703 critically ill COVID-19 patients showed that the administration of corticosteroids reduced mortality compared to standard-of-care (SOC) treatment. The results were published online in Journal of the American Medical Association (JAMA). Patients were randomized to receive systemic dexamethasone, hydrocortisone or methylprednisolone on top of SOC treatment or placebo + SOC. The primary outcome measure was all-cause mortality 28 days after randomization. The overall 28-day all-cause mortality rate was 38.0% (n=647/1,703). The mortality rate in patients receiving corticosteroids was 32.7% (n=222/678) compared to 41.5% (n=425/1,025) in those receiving SOC only, implying a 21.2% relative reduction in mortality risk. Results were consistent across the studies. Results from an Oxford University-led study, RECOVERY, reported almost three months ago, showed a similar mortality benefit from dexamethasone in severely ill patients on ventilators, cutting the risk of death by 28 - 40%. Mortality risk was reduced by 20 - 25% in COVID-19 patients receiving supplemental oxygen. It did not appear to help patients with milder symptoms. These corticosteroids have been off patent for years and are available at low prices worldwide. See- "Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19-A Meta-analysis"-The WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group AMA. Published online September 2, 2020. doi:10.1001/jama.2020.17023.