WHO Relents, Changes Guidelines to Use Steroids in Severe Covid-19 Cases

New guideline is based on a preliminary report of the RECOVERY trial in June, which has now been published as a peer-reviewed paper

As researchers and biotech companies are fast-tracking the COVID-19 vaccine development process, the World Health Organization (WHO) which has been tracking potential vaccine candidates, has recommended doctors to use anti-inflammatory drugs corticosteroids to treat Coronavirus patients.

The UN agency has updated its guidance on the use of corticosteroid drugs in patients with COVID-19 based on the analysis of seven international clinical trials which showed that such drugs mitigate the risk of death by 20 percent in critically ill SARS-CoV-2 patients.

The analysis involved data in methylprednisolone, dexamethasone, and hydrocortisone. It was noticed that such medicines improve survival rates among Coronavirus patients who required admission to intensive care in the hospital.

WHO Logo
WHO Logo Wikimedia Commons

Why WHO Changed Recommendation for Corticosteroid Drugs

The WHO said, "This guideline was triggered on 22 June 2020 by the publication of the preliminary report of the RECOVERY trial, which has now been published as a peer-reviewed paper. Corticosteroids are listed in the World Health Organization (WHO) model list of essential medicines, readily available globally at a low cost, and of considerable interest to all stakeholder groups."

The recommendation is based on three new studies and four earlier trials, all involving corticosteroid. This week, three new trial results were published in the Journal of the American Medical Association. One of the trials involved dexamethasone in 299 patients in Brazil, while the other trials included hydrocortisone doses in 76 patients in France and 379 patients in the U.S and seven other countries.

However, currently, Remdesivir, developed by Gilead Sciences is the only widely accepted medication to treat severe COVID-19 patients. Dexamethasone, an old drug, is used to reduce inflammation and treat auto-immune disorders like rheumatoid arthritis and some forms of cancer. Earlier, in the U.K., healthcare experts addressed dexamethasone as a breakthrough drug that can help to reduce the death toll of the ongoing global pandemic. The U.K. government also authorized this drug for treating the Coronavirus infection in June.

Steroid use against novel Coronavirus Wikimedia commons

However, while talking about the steroids to improve survival rates in COVID-19 patients, recently researchers said in a statement that "This is equivalent to around 68 percent of (the sickest COVID-19) patients surviving after treatment with corticosteroids, compared to around 60 percent surviving in the absence of corticosteroids."

Study Analysis

Jonathan Sterne, a professor at Bristol University said the recent analysis included trials conducted by researchers in the U.S., Brazil, Canada, China, France, Spain, and the U.K. The accumulated data from all these trials have pointed out that the drugs were beneficial in extremely ill patients, irrespective of age, sex or how long they had been sick.

Based on this analysis, the Geneva-based UN health body, which has been monitoring the pandemic situation, has updated its treatment guidelines to recommend that systemic corticosteroids can be used to treat severe and critical COVID-19 patients.

In a statement, WHO said that it suggests not to use the steroids in the treatment of "patients with non-severe Covid-19 as the treatment brought no benefits," and may cause more harm. The world health body stated that such treatments should be under the supervision of a clinician.

WHO also said that the agency encourages countries to maintain sufficient stocks of corticosteroids to treat SARS-CoV-2 infection and the other disease for which "they are effective, while not maintaining excessive stocks, which could deny other countries access."

Related topics : Coronavirus