The steroid medication dexamethasone has been proven to help people severely ill with COVID-19. Now a new study hints that other drugs in the same class may also work -- in the right patients.
Steroid medications like dexamethasone and prednisone -- which are anti-inflammatory and suppress the immune system -- make sense in that scenario, according to Cron. But if a COVID-19 patient does not have serious systemic inflammation, a steroid might backfire -- hampering the immune system's ability to fight the virus."If you use them," Cron said,"you want to do it in patients who are having an overly exuberant immune response.
The U.K. trial that tested dexamethasone found that only certain hospitalized patients benefited. In this case, it was those who were sick enough to need oxygen or a mechanical ventilator. The drug cut their risk of dying by one-fifth to one-third.The current study turned up a different line of demarkation: Blood levels of a substance called C-reactive protein , a marker of inflammation.But if CRP was low , steroid therapy more than doubled those risks, the study authors reported.
That finding may be the more important one, according to study co-author Dr. Shitij Arora, a hospitalist at Montefiore and associate professor at Albert Einstein College of Medicine in New York City.CRP tests are standard and cheap, according to Arora. But it's not clear that CRP alone is the best way to identify patients who should receive steroids, he said. Other lab tests, in combination with CRP, might be even better, both Arora and Cron said.
Ongoing studies are testing other steroids. For his part, Cron said he'd be"very surprised" if dexamethasone was the only effective one. Having additional options would be a good thing, he noted, so the world is not reliant on one drug.WebMD News from HealthDaySOURCES: Shitij Arora, MD, associate professor, medicine, Albert Einstein College of Medicine and hospitalist, Montefiore Medical Center, Bronx, N.Y.
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