NEJM: Dexamethasone is beneficial for patients with COVID-19 medium/severe! Harmful to mild patients! Clinical trial results are officially published!

20 July 2020 /PRNewswire/USNewswire/ -- The results of a long-awaited British trial of the steroid dexamethasone, released on Friday, confirmed its life-saving effect on patients with COVID-19 using a ventilator, but suggested that using it too early could cause harmthe study, a total of 2,104 hospitalized patients were assigned 6 milligrams of the drug per day for 10 days, 4,321 received routine treatment, and compared their mortality rates after 28 daysamong patients who used a ventilator, the mortality rate was 29.3 percent for those who used the drug and 41.4 percent for those who did not use the drugin other words, the mortality rate for this group was reduced by 29 per centthe benefits were lower in those who gave oxygen through less invasive methods -- 23.3 percent of patients who used dexamethasone and 26.2 percent of those who did not use dexamethasonepicture source: However, the group of patients who did not receive any oxygenation at the start of the trial did not benefitin this study, the mortality rate for those who took steroids was 17.4 percent, compared with 14 percent for those who did not take steroids, suggesting that the drug increased their risk of deaththis is because the drug works by suppressing an abnormal immune response that destroys human organs, rather than attacking the virusAnthony Fauci, america's chief scientist, warned in an interview with AFP in June that Dexamethason should not be prescribed soon after a patient becomes infected"It won't have any impact, and it could even make things worse in the first place," he saidthis is exactly what we know is that we need an immune system to suppress the virus in the early stages of infectionthe authors of the paper, published in the New England Journal of Medicine, added that benefiting from the drug "depends on choosing the right dose at the right time in the right patient."" they also said that in the case of COVID-19 disease, abnormal immune responses appear to be more likely to cause harm in patients who need oxygen than viruses replicate in the body, but they warn that without further research, this hypothesis should not apply to other viral respiratory diseases such as SARS, MERS and influenza because they may have different effectsOn June 16,, the day the initial results were announced, Dexamethason was adopted in the UK and recommended by the National Institutes of Healththe U.SNational Institutes of Health warned on its website that it was unclear how effective the dessemin was being used in combination with the antiviral drug Redsiwe, which has been shown to be beneficial when used aloneit said patients taking the drug should be closely monitored for secondary infections and high blood sugarpeople are also known to use corticosteroids to reactivate previously dormant infections such as hepatitis B virus or tuberculosis() References: Dexamethasone trial results confirm COVID-19 benefits but also risk sers Dexamethasone in patients with Covid-19 - Preliminary Report New England Journal of Medicine 17, 2020 DOI: 10.1056/NEJMoa2021436.