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This is an archive article published on June 28, 2020

Covid-19: Low-cost steroid now part of govt’s treatment protocol

The move comes after Oxford researchers leading the RECOVERY clinical trials in the UK had announced that Dexamethasone reduced death by up to one-third in hospitalised Covid-19 patients who develop acute respiratory complications.

dexamethasone, coronavirus, coronavirus dexamethasone tablets, covid 19, covid 19 dexamethasone, covid 19 drug dexamethasone, coronavirus drug dexamethasone, covid 19 medicine, A pharmacist displays a box of Dexamethasone. Dexamethasone is a generic steroid widely used in other diseases to reduce inflammation. (Reuters)

The Centre Saturday issued revised clinical management protocols for treatment of Covid-19 patients, including the low-cost anti-inflammatory drug Dexamethasone as an alternative to another steroid, Methylprednisolone, for moderate to severe cases.

The move by the Union Ministry of Health and Family Welfare comes after Oxford researchers leading the RECOVERY clinical trials in the United Kingdom had announced that Dexamethasone reduced death by up to one-third in hospitalised Covid-19 patients who develop acute respiratory complications.

Both Dexamethasone and Methylprednisone are corticosteroids, which closely mimic cortisol, a hormone naturally produced in humans by adrenal glands. Dexamethasone is commonly used for treatment of rheumatological inflammatory conditions: inflammation of muscles, inflammation of blood vessels, chronic arthritis, and lupus.

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Even before Oxford University had announced the results of the Dexamethasone arm of the trial on June 16, India had already allowed the use of Methylprednisolone, as corticosteroid therapy in moderate and severe cases.

In the management of severe cases, the revised guidelines state: “For patients with progressive deterioration of oxygenation indicators, rapid worsening on imaging and excessive activation of the body’s inflammatory response, glucocorticoids can be used for a short period of time (3 to 5 days).”

The guidelines add a note of caution: “A larger dose of glucocorticoid will delay the removal of coronavirus due to immunosuppressive effects.”

In the Oxford Dexamethasone trial, 2,104 patients were administered the drug for 10 days, and the researchers said they saw fatalities fall by one-third in ventilated patients and by one-fifth in patients on oxygen.

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“Based on these results, 1 (one) death would be prevented by treatment of around 8 ventilated patients, or around 25 patients requiring oxygen alone,” the university said.

However, the study had found no evidence of benefit for patients who did not require oxygen. The trial did not study patients outside hospital settings either.

Kaunain Sheriff M is an award-winning investigative journalist and the National Health Editor at The Indian Express. He is the author of Johnson & Johnson Files: The Indian Secrets of a Global Giant, an investigation into one of the world’s most powerful pharmaceutical companies. With over a decade of experience, Kaunain brings deep expertise in three areas of investigative journalism: law, health, and data. He currently leads The Indian Express newsroom’s in-depth coverage of health. His work has earned some of the most prestigious honours in journalism, including the Ramnath Goenka Award for Excellence in Journalism, the Society of Publishers in Asia (SOPA) Award, and the Mumbai Press Club’s Red Ink Award. Kaunain has also collaborated on major global investigations. He was part of the Implant Files project with the International Consortium of Investigative Journalists (ICIJ), which exposed malpractices in the medical device industry across the world. He also contributed to an international investigation that uncovered how a Chinese big-data firm was monitoring thousands of prominent Indian individuals and institutions in real time. Over the years, he has reported on several high-profile criminal trials, including the Hashimpura massacre, the 2G spectrum scam, and the coal block allocation case. Within The Indian Express, he has been honoured three times with the Indian Express Excellence Award for his investigations—on the anti-Sikh riots, the Vyapam exam scam, and the abuse of the National Security Act in Uttar Pradesh. ... Read More

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