The World Health Organization (WHO), has published guidance for clinicians and health care decision-makers on the use of corticosteroids in patients with Covid-19, based on new discoveries from some latest scientific studies.
The WHO recommended systemic corticosteroids for the treatment of patients with severe and critical Covid-19 cases. The UN health agency discouraged the use of the corticosteroids in the treatment of patients with non-severe Covid-19, as the treatment brought no benefits and could even prove harmful. The treatment should be under the supervision of a clinician.
According to an analysis of seven international trials published on Wednesday in the Journal of the American Medical Association, treating critically ill Covid-19 patients with corticosteroid drugs reduces the risk of death by 20% regardless of which steroid is used.
The analysis, which collected data from separate trials of low dose hydrocortisone, dexamethasone and methylprednisolone, revealed that they improve survival of Covid-19 patients in intensive care units.
The researchers, in a statement, said, “This is equivalent to around 68% of (these) patients surviving after treatment with corticosteroids, compared to around 60% surviving in the absence of corticosteroids.’’
The WHO representative, Janet Diaz, said the findings prompted the UN health agency to update its treatment advice to include a strong recommendation for steroid use in patients with severe COVID-19. The evidence shows that if you give corticosteroids, there will be 87 fewer deaths per 1,000 patients.
Anthony Gordon of Imperial College London, who also worked on the analysis said, “Impressive as these results are, this is not a cure. So it’s vital that we keep up all the prevention strategies.”
Corticosteroids are listed in the WHO model list of essential medicines, readily available globally at a low cost. WHO encourages countries to maintain sufficient stocks of corticosteroids to treat Covid-19 and the other diseases for which they are effective, while not maintaining excessive stocks which could deny other countries access.
This guidance was developed by the WHO in collaboration with the non-profit Magic Evidence Ecosystem Foundation (MAGIC), which provided methodologic support to develop and disseminate living guidance for Covid-19 drug treatments.
The WHO provides guidance that works across all contexts for all countries and health care systems.