Dexamethasone on the third reduced mortality in patients with COVID-19 on a ventilator

Common anti-inflammatory drug dexamethasone reduced mortality in patients COVID-19 severe. According to the results of research scientists from the University of Oxford the reception of dexamethasone on the third reduced mortality in patients connected to a ventilator, and patients receiving oxygen through a mask — 20 per cent.

Among the severe complications of coronavirus pneumonia, which can lead to death, there is acute respiratory distress syndrome (ARDS). It develops as a result of the massive inflammation of lung tissues and increase the activity of cells involved in this inflammation. The neutrophils damage the pulmonary capillaries, breaking the barrier between blood vessels and lung alveoli.

As a result, the inflammatory exudate gets into lung tissue, damaging alveolocyte parallel type II — producers of surfactant, which is responsible for maintaining the alveoli in an expanded state. Collapsed and filled with fluid the alveoli are not able to maintain gas exchange, causing hypoxia — reduced oxygen level in the blood. Some people have all of the above added released from the vasculature fibrin, which leads to fibrosis of the lung area — the replacement of functional lung tissue by connective tissue. People die from the increasing hypoxia.

ARDS develops due to excessive functional activity of immune cells and proinflammatory cytokines produced by them. Often viruses provoke an excessive inflammatory response to infection. For the treatment of this condition apply steroid anti-inflammatory drugs (including dexamethasone cheap medication used since the middle of last century), which inhibit the release of mediators of inflammation and reduce the formation of new white blood cells. It is important to note that the virus (or other pathogen) steroid drugs are ineffective, they only reduce the activity of inflammatory reactions that this virus caused.

Peter Horby (Peter Horby) and his colleagues from the University of Oxford in the framework of the project RECOVERY (Randomised Evaluation of COVid-thERapY 19) conducted a randomized study in which they tested the effect of dexamethasone on people with a severe form of ARDS caused by the virus SARS-CoV-2019. Dexamethasone at a dosage of 6 milligrams once a day (oral or intravenous) within ten days of receiving the patient 2104. The control group consisted of 4321 patient, all of them received therapy with corticosteroids.

Dexamethasone reduced mortality in patients with ventilation (p = 0,0003) by 30 percent, and patients receiving only oil oxygen (p = 0,0021) by 20 percent. However, he did not cause the positive dynamics in patients who did not need respiratory support (p = 0.14). Overall, dexamethasone reduced the mortality over 28 days by 17 percent (p = 0,0007) in all groups of patients requiring respiratory support.

Who Director-General Tedros Ghebreyesus already called the study “life-saving scientific breakthrough”.

About another perspective, but causes a lot of debate among doctors and scientists, medication you can read in our big material “Wheel mishaps”.

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