Dexamethasone and COVID-19

By:  Natalia Loomis, PharmD Candidate c/o 2022

The World Health Organization announced the official name “COVID-19” on February 11, 2020 when the outbreak was first identified in Wuhan, China. ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease and 19 for the year the first case occurred.² The Center for Disease Control and Prevention and other public health agencies are learning more every day about this novel virus. For now, we know that it can spread from person to person via close contact and those who do not demonstrate symptoms can still be carriers and infect others. The virus has various symptoms and seems to be affecting different populations. For example, some patients could be carriers and experience no symptoms at all, while others can suffer from severe shortness of breath or clotting.  Some of the common symptoms which can show up between 2-14 days of contracting the virus include fever, chills, and shortness of breath, congestion, loss of taste or smell.⁵ (World Health Organization)

As of right now, no medication has been approved for the treatment of COVID-19. Scientists and pharmacists have been diligently researching treatments and ultimately a vaccine. Since the outbreak, medications such as remdesivir (Veklury®) hydroxychloroquine and azithromycin have been used to treat the symptoms associated with the disease. However, both medications are no longer endorsed by treatment strategies, due to the risk of hearth rhythm problems and other safety issues.¹

According to the University of Oxford, there might be a breakthrough in treatment for COVID: a recent trial involving dexamethasone. For patients who required ventilators, dexamethasone treatment reduced mortality by one third. Additionally, preliminary findings released by the World Health Organization showed that patients requiring supplemental oxygen, saw a one-fifth reduction in mortality. The medication benefit group only involved patients who contracted severe cases of COVID-19, requiring further investigation of other patient groups. Severe cases are those in which the virus settles in a patients lungs, causing a severe difficulty of breathing. These patients require hospitalization and support through a ventilator.⁴ There is currently a lack of data on patients who contracted milder cases.

We are hopeful that in the next couple of months, as data continues to be tracked, there will be a follow up on if dexamethasone is in fact a new reliable treatment.

Sources:

1. Center for Drug Evaluation and Research. FDA cautions use of hydroxychloroquine/chloroquine for COVID-19. U.S. Food and Drug Administration. https://www.fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or. Published July 1, 2020. Accessed July 19, 2020.
2. Coronavirus (COVID-19) frequently asked questions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/faq.html#Basics. Published July 15, 2020. Accessed July 19, 2020.
3. Horby P, Lim WS, Emberson J, et al. Effect of Dexamethasone in Hospitalized Patients with COVID-19: Preliminary Report. medRxiv. https://www.medrxiv.org/content/10.1101/2020.06.22.20137273v1. Published January 1, 2020. Accessed July 19, 2020.
4. Nania R. What Happens In a Severe Case of COVID-19. AARP. https://www.aarp.org/health/conditions-treatments/info-2020/serious-covid19-infections.html. Published April 7, 2020. Accessed July 19, 2020.
5. WHO welcomes preliminary results about dexamethasone use in treating critically ill COVID-19 patients. World Health Organization. https://www.who.int/news-room/detail/16-06-2020-who-welcomes-preliminary-results-about-dexamethasone-use-in-treating-critically-ill-covid-19-patients. Published June 16, 2020. Accessed July 19, 2020.