After
UK drug study, WHO to update treatment guidelines
The World Health Organization
(WHO) said it was on the verge of revising its guidelines for the treatment of
people who were beaten by Covid-19 to show the results of a clinical trial that
showed that cheap, standard steroids could help save critically ill patients.
Test results announced on Tuesday revealed dexamethasone, which has been used
since the 1960's dermatology for arthritis, reduced the death toll by about a
third among Covid-19 critically ill patients admitted to the hospital.
WHO's clinical guide in the
treatment of patients infected with the new coronavirus is aimed at doctors and
other medical professionals and is looking to use the latest data to inform
doctors how to cope with all stages of the disease, from diagnosis and
treatment. Although the results of the dexamethasone study were the first,
researchers supporting the project said it suggested that the drug should be
standardized care for patients with severe disabilities.
In patients who are ventilated,
treatment has been shown to reduce stroke by about one-third, and in patients
who require only oxygen, death was eliminated by about one-fifth, according to
a preliminary report shared with the WHO. Benefit was only seen in patients
with undwithCovid19 and was not observed in patients with pain. The good news
comes when coronavirus infection is accelerating in some areas including the
United States and when Beijing canceled many flights to help facilitate a new
outbreak in the Chinese capital.
Dexamethasone:
its use, action, and what Recovery Trial found
A low cost,widely used steroid, dexamethasone,has become the subject of discussion
after researchers from the Recovery Trial reported that it helps reduce death
rates in certain Covid-19 patients.
What
is dexamethasone?
It is an anti-inflammatory
drug, which often cures cases where the immune system is malfunctioning, and
causes inflammation and tissue damage. Dexamethasone reduces the production of
inflammatory chemicals and reduces the function of the immune system by
affecting how white blood cells work. Dexamethasone falls into a category
called corticosteroids, which mimic cortisol, a hormone naturally produced by
the adrenal gland in humans.
It is often used in the
treatment of rheuma in logical conditions of inflammation: muscular swelling,
inflammation of the blood vessels, chronic arthritis, and lupus. It is used in
lung diseases, kidney inflammation and eye inflammation as well as to reduce
the efficiency associated with motor brain and spinal cord disorders. In
patients with cancer, it is used to treat nausea and chemotherapy-induced
vomiting.
How
useful is it in Covid-19 treatment?
There is no specific proven
treatment for Covid-19 yet. Patients are being administered different drugs that are
approved for treating for other diseases. During the SARS outbreak in 2003,
corticosteroid therapy was used to reduce inflammatory-induced lung injury. In
Covid-19, too many countries are investigating the effectiveness of cortico steroid
therapy on patients with an acute respiratory infection. Also, the World Health
Organization (WHO) has prioritized the evaluation of corticosteroids in
clinical trials to assess safety and efficacy.
In interim guidelines on
Covid-19 treatment released on May 27, the WHO has recommended against the routine
of systematic corticosteroid” for treatment of viral pneumonia. It said a systematic
review and meta-analysis of the impact of corticosteroid therapy on persons with
SARS-CoV-2,SARS-CoV and MERS-CoV revealed corticosteroids did not significantly
reduce the risk of death, did not reduce hospitalization duration, ICU
admission rate and/or use of mechanical ventilation, and had several adverse effects.
So,
what has newly been reported?
The Return Test in the UK has
an arm investigating dexamethasone. Oxford researchers this week announced the
results of the dexamethasone trial, in which 2,104 enrolled patients were given
6mg of the drug for 10 days. The drug was found to reduce one-third of deaths
in ventilated patients and by one-fifth of patients receiving oxygen only.
"According to these results, 1 (one) death will be prevented by the
treatment of eight patients, or in 25 patients who need oxygen only," the
university said. We said the drug was found to reduce the 28-day mortality rate
by 17 percent, which is a “very important” tendency for patients who need less
air.
How
significant are these findings?
First, the study found no
evidence that it was beneficial for patients who did not need oxygen. A
professor of Developmental Disease at the Nuffield Department of Medicine,
Oxford University, agreed that the survival benefit is clear and is only great
for patients who are sick enough to need oxygen therapy. Also, the case did not
read to patients without hospital repairs. Therefore, this drug is not
recommended for most mild patients.
Does
India use corticosteroid therapy?
Yes. The Covid-19
administration protocol issued by the Department of Health allows the use of
corticosteroid methyl prednisolone. In severe cases, the rule is:
"Consider IV methylprednisolone 0.5 to 1 mg / kg for 3 days (preferably
within 48 hours of admission or if the demand for oxygen increases and symptoms
of inflammation increase)". And in larger cases: In patients with
progressive deterioration of oxygenation, increased cognitive function and
excessive inflammatory response, glucocorticoids may be used for short periods
of time (3 to 5 days). / day.
What
are the side effects?
The Department of Health's
agreement states that high doses of glucocorticoid will delay coronavirus
removal due to immune effects. On May 25, The Lancet published a letter saying
that "improper use of the steroid system may increase the risk of
osteonecrosis of the woman's head (ONFH)". Osteonecrosis means death of
bone tissue due to lack of blood. Also, the WHO states that "if there is a
reduction in lack of efficacy and potential harm", regular corticosteroids
should be avoided unless they are indicated for another reason. "Other
causes may include asthma or COPD, septic shock or ARDS, and risk / benefit
analysis should be performed on individual patients."