{"id":21958,"date":"2020-09-07T23:05:54","date_gmt":"2020-09-07T23:05:54","guid":{"rendered":"https:\/\/www.lifeandnews.com\/articles\/?p=21958"},"modified":"2020-09-08T14:25:11","modified_gmt":"2020-09-08T14:25:11","slug":"steroids-cut-covid-19-death-rates-but-not-for-everyone-heres-who-benefits-and-who-doesnt","status":"publish","type":"post","link":"https:\/\/www.lifeandnews.com\/articles\/steroids-cut-covid-19-death-rates-but-not-for-everyone-heres-who-benefits-and-who-doesnt\/","title":{"rendered":"Steroids cut COVID-19 death rates, but not for everyone \u2013 here\u2019s who benefits and who doesn\u2019t"},"content":{"rendered":"

Bryan McVerry<\/a>, University of Pittsburgh<\/a><\/em><\/p>\n

New studies show that treating critically ill COVID-19 patients with inexpensive steroids can cut their risk of dying from the illness by a third. The results are so clear that the World Health Organization changed its advice on Sept. 2 and now strongly recommends<\/a> corticosteroids as a first-line treatment for the sickest patients.<\/p>\n

Steroids aren\u2019t risk-free, however. They can have side effects, and they could do more harm than good in patients with milder cases of COVID-19.<\/p>\n

I am a pulmonologist and critical care physician<\/a> and co-author of one of<\/a> three new studies<\/a> that analyzed data from clinical trials involving the effect of steroids on thousands of critically and severely ill COVID-19 patients. Here\u2019s what people need to understand about steroids as a treatment for COVID-19.<\/p>\n

Who benefits from taking steroids?<\/h2>\n

It\u2019s important to understand that steroids can benefit the sickest patients hospitalized with COVID-19, but they\u2019re not a treatment for relatively mild cases<\/a>.<\/p>\n

With COVID-19 and other infectious diseases, there are two key components: the infection itself and the body\u2019s response to that infection.<\/p>\n

In the sickest patients, the body\u2019s immune system response is so robust it can injure organs<\/a>. So, calming the immune response may be important. But someone who is less severely ill may need the body\u2019s immune response to prevent the infection from getting worse. You wouldn\u2019t want to interfere with the immune response unless it was harming the patient.<\/p>\n

How do corticosteroids help critically ill patients?<\/h2>\n

When an infection triggers an inflammatory response<\/a>, specialized white blood cells are activated to go find the virus or bacteria and destroy it. It\u2019s more of a bomb effect than a targeted missile strike \u2013 the immune cells attack broadly, and the inflammation created can damage other cells in the vicinity.<\/p>\n

That response can get out of control<\/a> and continue even after the infectious agent is gone. In a really exuberant immune response, the patient can have respiratory failure and end up on a ventilator, or have circulatory failure and end up in shock, or they could develop kidney failure from the shock.<\/p>\n

In patients with severe COVID-19, corticosteroids are likely able to calm that inflammatory response and prevent the progression of organ damage, potentially in the lungs.<\/p>\n

Scientist aren\u2019t yet certain that that is how steroids are working. What we do know from the new studies is that people with severe COVID-19, particularly those with respiratory complications, benefit from relatively low-dose courses of corticosteroids. A combined analysis of the recent studies found the death rate four weeks after infection was significantly lower<\/a> in patients with severe COVID-19 who received steroids than those who did not.<\/p>\n