Common steroid improves critically ill Covid-19 patients’ recovery, survival

The WHO says it will update its Covid-19 treatment guidance following the global study’s findings

A global study of more than 200 intensive care units (ICUs), including several in Ireland, has found that delivering intravenous hydrocortisone improves recovery and survival outcomes for critically ill Covid-19 patients.

The World Health Organization said it would update its Covid-19 treatment guidance as a result of findings reported in the September edition of the Journal of the American Medical Association (JAMA).

The Irish arm of the Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP CAP trial) was partly funded by the Health Research Board (HRB) and led by Prof Alistair Nichol, St Vincent’s University Hospital and University College Dublin.

Prof Nichol said the trial had been designed to be able to quickly recruit patients in response to emerging pandemics such as Covid-19.

“So, in March 2020, our team of investigators began randomising patients with Covid-19 to alternative hydrocortisone dosing strategies and compared their outcomes with patients who received no corticosteroid,” he added.

The study involved 384 adult participants globally, and the research found a 93 per cent probability that giving this common steroid to patients improved their recovery and survival.

The results were consistent across age, race and sex and build on existing evidence that another corticosteroid, dexamethasone, also improved outcomes for Covid-19 patients.

Researchers said their results indicated that this class of anti-inflammatory drugs could make a real difference when treating patients diagnosed with the virus.

Commenting on the findings, Dr Mairead O’Driscoll, Chief Executive at the HRB, said: “This rapid response to address critical cases of Covid-19 is possible as a result of long-term investment by the HRB in both the Irish Critical Care Clinical Trials Network at the UCD Clinical Research Centre, and in clinic research infrastructures across in Ireland.

“It is good to see that by having this infrastructure in place, we can help deliver such timely and relevant outcomes for patients with Covid-19.”

JAMA, published online.

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