Corticosteroids have effects on severe forms of Covid-19. The WHO states thatCorticosteroids save lives when used in patients on oxygen and on a ventilator. But they are not effective in patients with mild or moderate disease and can be harmful. Therefore, the WHO recommends the use of corticosteroids only in patients in severe or critical condition.
For Pr Djillali Annane, the proven effect of corticosteroids on severe forms of Covid-19 is “A spectacular turning point”, and this treatment “Will save lives” in poor countries as well as in rich countries.
Head of the intensive medicine-intensive care unit at Raymond Poincaré hospital in Garches (AP-HP), Prof. Annane is co-author of one of the 7 studies confirming the effectiveness of these drugs, published on September 2 in the American magazine Jama. It goes around the question in three points.
Why is the proven effectiveness of corticosteroids for some patients important for the future?
“It is a spectacular turning point, in several ways. First,
it is the first treatment for which a very favorable effect on survival has been demonstrated, with very high certainty and several clinical trials conducted on five continents.
this treatment is not only beneficial in severe forms in intensive care, but also for patients who are on oxygen without being in a sufficiently serious condition to go to a sheave. Treatment can prevent their condition from getting worse and keep them from going.
Third, in published clinical trials, there is no reason to worry about complications.
The fourth element, and perhaps the best of the good news,
is that this treatment is not expensive.
It costs 10 to 40 euros to treat a patient and it is available all over the world, in the poorest countries as well as the richest. It is a treatment that will be able to save lives in Africa, Latin America as well as in New York, Paris or Tokyo. “
How do these drugs work?
“Cortisone has been used by millions of people for 70 years. It is a drug that works to decrease inflammation from whatever source. There are millions of people with asthma and rheumatic fever around the world who take corticosteroids every day.
Corticosteroids do not act directly on the coronavirus: they will prevent the inflammation produced by the virus
, or if this inflammation has already occurred, will decrease its intensity and shorten its duration. But it is absolutely not a preventive treatment, we should not take it if we have no symptoms. “
Dexamethasone has been mentioned a lot, but is it the only beneficial corticosteroid?
“No, it’s the class of corticosteroids that is interesting. Cortisone is a natural hormone that we all produce. Dexamethasone is a molecule made from this natural hormone. But there are other molecules: hydrocortisone, which is natural, methylprednisolone, betamethasone, etc.
This is important because the fact that there are several molecules will reduce the risk of a global shortage. If the effect only came from dexamethasone and not from the other corticosteroids, one might have feared that everyone would rush on it and that it would eventually run out. “