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Dexamethasone: Becomes First-line Treatment of COVID’19 Patients

COVID’19 becomes pandemic and globally spreading health crises. All countries are trying their best to slow down the spreading of viruses as they are testing and treating the patients very efficiently. Researchers, investigators, and all scientists are doing their best to discover a medical treatment for coronavirus. Still there is no verified treatment or therapies suggested to treat novel coronavirus. More than 115 groups are working day and night to develop vaccines but it’s not an easy task to discover vaccines immediately. 

We all are aware of the dexamethasone steroidal drug and its uses. All doctors are well-aware and have experience in how to use this drug. Now dexamethasone has been administered to treat COVID’19 patients. The large-scale study conducted in the UK, Oxford University, suggested that dexamethasone is used to treat novel coronavirus. 

This content will provide you the latest information about how dexamethasone became a first-line drug, What treatment plans are used to treat COVID’19 patients? What are the benefits and downsides of using dexamethasone in COVID’19 patients?

Overview

Dexamethasone is the corticosteroid drug and has been used since the late 1950’s. All doctors and Paramedical staff are familiar with this drug. It is very cheap and inexpensive. Generally, this drug is used to treat inflammatory conditions. The trade of name dexamethasone is decadron, dexasone, Hexadrol, and maxidex, while the other name of this drug is dexamethasone sodium phosphate and dexamethasone acetate. 

What are the uses of dexamethasone?

Usually, dexamethasone is used in the treatment of arthritis, immune system disorder, allergic reactions, skin and eye condition, and cancer treatment. Dexamethasone is also used to treat Cushing’s syndrome. This drug helps to reduce the swelling and allergic reactions. This drug is classified as a glucocorticosteroid.

How does dexamethasone become a first-line treatment for COVID’19?

As we know dexamethasone is the cheapest, broadly and universally available drug. Now this drug helps to save the life of seriously ill patients with coronavirus. In the United kingdom, controlled randomized clinical trials are done. The drug dexamethasone is proven the first defense line drug for treating the COVID’19 patients. Dexamethasone also minimizes the death rate as previously COVID’19 killed more than 457,620 people globally.   

According to UK experts, low-dose of dexamethasone is a breakthrough coronavirus treatment against the deadly virus and it efficiently minimizes the death rate. The effect of this drug was most noticeable in the seriously ill patients and those who are on the ventilator. The COVID’19 patients who are not on the ventilator but are only receiving oxygen therapy also showed better improvement and the risk of dying factor reduced by 20-25%, while this recovery therapy is not suitable for those patients who are not critically ill and they are not receiving any ventilator strategy or oxygen therapy.  

Meticulous Study

  • Peter Horby- a specialist in infectious diseases at Oxford University, UK, is also a chief investigator on the recovery trial said, Dexamethasone is the major breakthrough. He used steroidal drugs to treat the COVID’19 – a viral respiratory infection but Horby notes it has been controversial. He said, during these major outbreaks, the data from the recovery trial of severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS) that are caused by COVID’19 were irrefutable. The investigator suggested dexamethasone giving promising results and for this promising result, it is important to test the treatment.
  • According to the World Health Organization, they have cautioned against treating the patient of coronavirus with steroidal drugs. This drug has the ability to suppress the immune system, providing some relief to the patients whose lungs devastate due to the overactive response of the immune system in COVID’19 cases.
  • The investigator suggested, the RANDOMIZED RECOVERY TRIAL specified the doses of this steroid drug to find no adverse type of effects on the treatment of patients. This drug is equalized or pretty much treated by everyone. 
  • Nick Cammack, head of COVID’19 said, you should find a treatment like this clinical trial because it will help to transform the impact of pandemic COVID’19.  

Survey Trial

As mentioned above, dexamethasone is the steroidal drug that is used to treat COVID’19 patients, this randomized recovery trial is based at Oxford University. In this research, the investigator put the patients into three groups 

  • The patients who needed ventilator (in which ventilator machine helps them to breath)
  • The patients who needed oxygen therapy (not required ventilator)
  • The patients who didn’t require a ventilator or any oxygen therapy to breathe (mild condition). 

The researchers give the dexamethasone to each patient of those three groups (6 mg once a day as a tablet or via intravenous), while 

  • The fourth group is known as a controlled group (not given the drug).

During this COVID’19 randomized trial, 2,105 patients received 6 mg dexamethasone (at once-per-day) by intravenous injection or mouth. Those drugs given to the patients for 10 days and then compared with 4,320 control group patients (randomized) for usual care purposes.

After 28-30 days mortality rate was seen higher among the control group patients, who required 40-45% ventilation, seen intermediate rate who required 20-25% oxygen only, and the lowest rate of 10-13% seen in those patients who did not require any respiratory interventions.

Conclusion of this randomized trial in COVID’19 patients recommended that dexamethasone decreases the death rate in ventilated patients by 30-35% (the ratio is 0.65 [as 90% confidence interval-0.48-0.8], and 20-25% seen in other patients who are receiving only oxygen (the ratio is 0.80 [as confidence interval 0.67-0.96], while there are no profitable symptoms shown in those patients who didn’t need any ventilator support or interventions (the ratio rate is 1.22 [as confidence interval-0.86-1.75].

According to this randomized control result, only 1 death prevented by the treatment of around 8-10 ventilated patients and approx. 25-30 ventilated patients need oxygen. 

The benefit of this survival is clear in those patients who are sick and require oxygen treatment. Dexamethasone became the first standard drug to improve the survival of patients in COVID’19. 

How dexamethasone works for COVID-19 patients?

  • The patient with severe coronavirus has an overacting of the immune system and they easily catch the virus in the lungs. 
  • In doing this the body of COVID’19 patient produces infections that are frightening with white blood cells (WBCs) and this may cause inflammation with build pressure in the lungs that create difficulty in taking a breath. As consequently, dexamethasone decreases the inflammation by reducing the pressure that is built in the patient’s lung.

What other treatment plans are being used to treat COVID’19 patients?

Other medications are also being used to treat coronavirus (such as the antiviral drug Favipilavir) used to treat COVUD’19 patients that are being exported from (the main producer of the drug), while the plasma therapy is also being used to treat coronavirus patients, as it has given promising results too. 

Besides this medication, China and Russia are those countries that are trying to invent another treatment by leading different clinical trials to plan other treatments for COVID’19 patients. 

Dexamethasone in Pakistan to treat COVID’19?

Pakistan also uses dexamethasone drug to treat critical novel patients of COVID’19. The researchers in the UK announced earlier about dexamethasone-the cheapest widely available drug to treat COVIS’19 patients by reducing the risk factor of death in critically ill patients. But now Pakistan is also hailed that dexamethasone is a lifesaving breakthrough for coronavirus. 

The minister of health, Zafar Mirza said, our country had ampules supply of this drug to use as a standard treatment for COVID’19 patients who needed a ventilator or required oxygen therapy. In a tweet, Zafar Mirza said, according to the World Health Organization who have a positive response to this recent research-Pakistan also considers it a major part to treat coronavirus. Further, he said, Dexamethasone is the cheapest anti-inflammatory steroidal drug and by the blessing of good deeds, we have largely multiple producers in Pakistan of this drug.

Mirza clarifies this drug strategy plan, as this medicine is not used to treat mild patients, while self-medication is prohibited. This medication has its side effects too that becomes life-threatening for you.

The statement of the health minister came in Pakistan about the dexamethasone when Pakistan reported the highest daily count of COVID’19 patient, more than 136 with a death rate of approx. 2,975. Further, he stated to the UK researcher, “That was a great news and I warmly congratulate the UK government, Oxford University, and all hospital workers, researchers, patients in the UK who take active contribution to this life-saving breakthrough”.

Benefits of using Dexamethasone

As we know dexamethasone is the cheapest worldwide medicine, now it becomes an easily available remedy for the coronavirus patients. If we compare this steroidal drug to the other medicines that are being used in COVID’19 patients, dexamethasone is the first choice of saving lives in this pandemic situation. While the use of hydroxychloroquine (HCQ), facing a shortage of stalk for COVID’19 patients who are suffering from severe autoimmune conditions, there are also controversies of using this drug. Because it may be seen that HCQ leads to cardiac problems in patients.

What are the downsides of dexamethasone?

  • There are possible complications with dexamethasone. Initially, the drug dexamethasone suppresses the immune system for reducing the inflammation. That’s the reason it is not recommended to the patients who are sick from the infection. Before the prescription of this drug, a doctor should be needed to ensure that the patients have no infection.
  • If the results of this clinical trial are good, it means the drugs do not seem to compromise the ability of patients to fight against the COVID’19, this steroidal drug is just to affect the ability of patients to fight off other diseases.
  • Secondly, the thing that is necessary to keep in mind is this steroidal drug is used for that type of patient who is facing difficulty in breathing and requires assistance through a ventilator in the hospitals or by oxygen therapy.
  • Their usage is not given any benefit for the patients who don’t require breathing support. That’s the reason doctors shouldn’t prescribe this medication to every patient whose tests are positive for the virus. 
  • The third and the last, just like all drugs, dexamethasone might be given side effects that needed to be monitored. This drug rarely gives severe stomach or intestinal pain, change in vision, psychiatric changes, severe vertigo, dizziness, chest pain with irregular heartbeat, swelling of mouth, lips, tongue, and throat that can cause difficulty in breathing and swallowing.

What happens next?

  • We should need to study the full data and review of scientific-peer for the best result of a recovery clinical trial before making any decision that dexamethasone treatment is valuable, worthwhile, or something else. The selection of your approach for treating the patients appropriately is always correct or proven beneficial for the patients without any harm.
  • One important thing you should keep in mind, before using this drug you should be concerned with your doctor. This drug-treated COVID’19 patients and now it is called a life-saving drug, in spite of dexamethasone having its own side effects that become life-threatening to the patient if it is used without any prescription or recommendation.

Before you leave!

Dexamethasone is a long-acting drug and gives systemic effects to the body. This drug is 25 times more strong or potent than other corticosteroid drugs. In COVID’19 patients, these drugs stop two stages of inflammation in the body and endeavor both immunosuppressive and anti-inflammatory effects. Dexamethasone gives trusting results on COVID’19 patients. Before you leave this content, you should read some more facts about dexamethasone-what is good, bad, and ugly about this drug.

The good part of the dexamethasone use is that it is the cheapest and inexpensive drug. The other good thing is that doctors are well aware of this drug’s effects as they were using this a long time ago. 

The bad part is-unlimited sales and stockpiles make this drug unavailable for those patients who are dependent on it already.

The ugly part of this usage is its side effects. As it might increase susceptibility to fungal infections, muscle weakness, increases in blood sugar, and so on.

Before using this drug you should consult a doctor as it will prevent life-threatening conditions.

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