Steroid treatment should be reserved for sick patients with Covid: experts


The novel coronavirus has hit the world for almost a year (representative)


Most adults with moderate to severe COVID-19 are more likely to have a suppressed immune response to the novel coronavirus than life-threatening hyperinflammation. This comes from a study that suggests that steroids like dexamethasone should be reserved for the sickest patients.

Scientists, including those at St. Jude Children’s Research Hospital in the United States, examined levels of immune system protein cytokines and other health markers in 168 adults with COVID-19, 26 adults with flu, and 16 healthy volunteers.

They said more than 90 percent of COVID-19 patients were hospitalized and about half in intensive care, while more than half of flu patients were admitted for treatment and 35 percent in intensive care.

According to the study published in Science Advances, less than 5 percent of COVID-19 patients, including some of the sickest people, had the life-threatening, hyperinflammatory immune response known as cytokine storm syndrome.

The researchers explained that cytokine storms develop when excessive or abnormally regulated levels of cytokine proteins in the body lead to hyperinflammation and tissue damage.

While dexamethasone and other steroids are prescribed to treat cytokine storms, these drugs can backfire in patients whose immune response is already suppressed.


“We identified a subset of COVID-19 patients with a broadly upregulated range of cytokines. Overall, however, the average person with COVID-19 had less inflammation than the average person with the flu,” said study co-author Paul Thomas from St. Jude Children’s Research Hospital.

Based on the results, the scientists said that treatment to suppress inflammation may only be effective in a minority of patients with the hyperinflammatory profile.

They believe the need of the hour is a quick, reliable, and inexpensive test to measure cytokines and identify patients most likely to benefit from dexamethasone treatment.

“Targeting immunosuppressive therapies to the small subset of COVID-19 patients with an overactive immune response is the only way to determine whether these approaches ultimately help,” said Philip Mudd, another co-author of the Washington University School of Medicine study in the USA.

(Except for the headline, this story was not edited by GossipMantri staff and posted from a syndicated feed.)


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