Dexamethasone: what do we know about what, according to the University of Oxford, is the "first drug capable of reducing the number of deaths from COVID"

A cheap, accessible and well-known drug has just hit the treatment table against COVID19. According to the conclusions that the researchers from Oxford and the British NHS have made public, low-dose dexamethasone has managed to reduce deaths by one-third in patients with respiratory support. This would be a randomized trial with 11,500 patients and 175 linked hospitals. If confirmed, we would be talking about the first drug that would improve the chances of survival.

The 'randomized' thing is not just another piece of information. During these weeks, thousands of researchers have been in suspense while the real usefulness of hydroxychloroquine was worked out. All the studies with her had one thing in common: they were methodologically bad. The study has not yet been published, but preliminary data shows that the dexamethasone trial has chosen the most difficult route and appears to be quite robust.

Let us be cautious and do not launch the bells on the fly until we confirm it well: but if everything is as it seems, we are facing exceptional news that will help save many lives.

A medicine for the worst part of the disease

Until now, our best therapeutic option seemed to be remdesivir, a drug that seemed to block the replication of the coronavirus by inhibiting a specific enzyme known as RNA-dependent RNA polymerase. That is, it attacks the virus. The problem is that this drug was not only expensive and scarce, but simply reduced recovery time in the hospital. It's a lot in the middle of a pandemic, right. But dexamethasone is something else entirely.

It is a cheap and well-known corticosteroid that, according to the researchers, has managed to reduce the risk of death by 20% for patients with mechanical ventilation and 20% for those who have oxygen. It is very important to understand what is the logic of this and why it only works with very serious patients.

Unlike remdescivir, dexamethasone does not act on the virus, it acts on the immune system. It depresses it, to be more precise. Researchers have used it to mitigate the effects of the runaway immune response that appears in the later stages of the disease. However, there is no point in taking it preventively because it would have the opposite effect: it would leave us more defenseless against the virus.

I insist: we have to be very careful. During the coronavirus crisis we have seen how enormous studies that appeared in magazines of great prestige melted like sugar in hot water. And only in a matter of hours. It is true that, in this case, the data fits and the researchers behind it seem reliable. However, the current science situation requires us to be very rigorous, especially with the good news.

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