Effect of Dexamethasone in Hospitalized Covid-19 Patients-Preliminary Report
Author(s): Sakshi Sharma, Lokesh Vaishnav, Abhishek Joshi* and Ashok Mendhale
Introduction: Covid19 is a viral disease caused due to Severe Acute Respiratory Syndrome Coronavirus 2 . It causes mild to moderate lung damage.. Most of the patients are either presenting with no symptoms or with mild symptoms but there are some patients who presented with severe lung damage and needed hospitalization. Severe covid 19 is marked by inflammatory organ injury. The use of Corticosteroids helped in suppressing inflammation and reduced chances of landing in respiratory failure. Method: The trial referred to as RECOVERY (Randomized Evaluation of COVID-19 Therapy) which is controlled, randomized, open trial was performed in which 6mg dexamethasone was randomly given once daily to the patients for ten days and was then compared to the patients given basic care only. The 28-day mortality was reduced as a result. Result: 4321 patients were randomly selected for usual care treatment whereas 2104 patients were treated with dexamethasone. As a result, about 1065 (24.6%) patients on usual care and 454 patients with dexamethasone died within 28days. The reduction in mortality rate varied based on the respiratory support level at randomization. It was observed that in patients receiving dexamethasone along with invasive mechanical support; mortality rate reduced by one-third whereas it was reduced by 1/5th in patients given oxygen with mask and no decline was noticed in patients without any mechanical ventilation at randomization. Conclusion: Dexamethasone was found to reduce 28-day mortality in patients hospitalized with covid-19 who were getting either invasive mechanical ventilation or oxygen alone at the time of randomization but not in those who were not receiving any respiratory support.