As President Donald Trump remains in hospital due to Covid-19, the team of doctors treating him said on Sunday that the President was administered dexamethasone, a steroid typically used on patients with severe cases of illness. Although White House physician Sean Conley told reporters on Sunday that Trump's condition has continued to improve since being taken to hospital, it once again raises question on how unwell is he.
Speculation has been rife that Trump isn't in that good condition as is being projected by the White House and he may have to spend several days in hospital now. However, the only good thing is that a randomized study has shown coronavirus patients do better if they are given dexamethasone.
Trump Given Steroid
Trump's medical team suggested that he was recovering faster than expected and he could leave the hospital as early as Monday. But the news of the President being given dexamethasone further complicates the picture of just how unwell he is. One indication is that his condition is worrying, as dexamethasone should not be administered to anyone who is not ill enough to justify the downsides of taking steroids, given that it suppresses the immune system. At the same time,
White House physician Dr. Sean Conley had earlier said that he was using a "multi-prong" approach to treat Trump. On Sunday, he said that it included dexamethasone as Trump's blood oxygen level dropped twice. "We decided that in this case the potential benefits, early on in the course, probably outweighed the risks at this time," Conley told reporters outside Walter Reed national Military Medical Center Sunday.
What is Dexamethasone?
Both the World Health Organization (WHO) and the National Institutes of Health recommend that doctors should use dexamethasone to treat only serious cases of coronavirus. This gives a clearer picture that the President is somewhat serious. An affordable, widely available steroid, Dexamethasone and similar steroids are known to improve survival when used in hospitalized patients who need extra oxygen.
However, it can be harmful for less sick patients, according to medical experts. Although the British government has authorized its use among some patients, it remains unclear how beneficial the treatment may be for less serious Covid-19 cases. At least one large, randomized study has shown coronavirus patients do better if they are given dexamethasone, a corticosteroid drug that tamps down dangerous inflammation. This may be a reason why the medical team decided to use it early on.
How Beneficial has the Steroid Proved?
A preliminary trial of dexamethasone in the UK showed that it reduces mortality in patients on ventilators by one-third, and reduces mortality in patients receiving oxygen in other ways by one-fifth. The study's results are promising and raise hope as dexamethasone is already a common treatment for other illnesses, meaning that the drug has passed safety trials.
However, even then the big question when Trump actually got infected as dexamethasone isn't used in the early stages of Covid-19. Generally, Covid-19 comes in two phases. Dr. Onyema Ogbuagu, an infectious disease doctor and associate professor of medicine at Yale, said: "People get the virus, it replicates, and that's the first phase of the illness. Afterward, around 10 days into the infection, people start to produce antibodies and inflammatory reactions to the virus." These inflammatory chemicals can at times create severe Covid-19 complications, such as acute respiratory distress syndrome, which makes it difficult for oxygen to enter the bloodstream and reach organs.
Early findings of the study suggest Covid-19 patients who do not have severe symptoms, such as requiring a respirator, should not take dexamethasone. That said, oral dexamethasone has been shown to reduce the length of hospital stays and ICU admissions in adults with respiratory issues like pneumonia.