Corticosteroids boost survival rates for COVID-19 patients

Four newly-published papers on the use of corticosteroids to treat COVID-19 back prior evidence that outcomes for patients severely affected by the virus can be significantly improved, with one suggesting the risk of death can be cut by up to 20%.

The papers – all published in the Journal of the American Medical Association (JAMA) – include findings of the REMAP-CAP study led in the UK by Professor Anthony Gordon from Imperial College London, which found that patients in intensive care treated with a regular fixed dose of the steroid hydrocortisone for seven days had a better chance of recovery.

A separate study led by researchers at the University of Bristol and the NIHR’s Bristol Biomedical Research Centre provides an evidence summary of global steroid use across seven randomly controlled trials (RCTs) in 12 different countries.

It included data drawn from REMAP-CAP and the NIHR-funded RECOVERY trial – which has already shown that the steroid dexamethasone can be successfully used to treat moderate to severe COVID-19 – and concluded that corticosteroids can slash the risk of death in the most ill patients by up to 20%.

“These findings offer further evidence that corticosteroids can be an important part of COVID-19 treatment for severe patients,” Professor Jonathan Van-Tam, deputy chief medical officer.

“At the beginning of the year at times it felt almost hopeless, knowing that we had no specific treatments. It was a very worrying time. Yet less than six months later, we've found clear, reliable evidence in high quality clinical trials of how we can tackle this devastating disease,” added Professor Gordon, chair in Anaesthesia and Critical Care at Imperial and a consultant in Intensive Care Medicine at Imperial College Healthcare NHS Trust.

“Steroids are not a cure, but they help improve outcomes. Having a choice of different types of steroids, all of which seem to improve patient recovery, is great as it helps ease the problem of drug supply issues.”

“One of the distinctive benefits of having our NHS is that we've been able to mobilise quickly and at scale to help researchers test and develop proven coronavirus treatments,” said NHS chief executive Simon Stevens. “Just as we did with dexamethasone, the NHS will now take immediate action to ensure that patients who could benefit from treatment with hydrocortisone do so, adding a further weapon in the armoury in the worldwide fight against COVID-19.”