[EXPERT REACTION] Dexamethasone: Effective Treatment for COVID-19?

A research team at Oxford University has recently found a cheap and widely available drug called dexamethasone that can be used to effectively treat severe forms of COVID-19. The ‘breakthrough’ drug has shown to significantly reduce the number of deaths among those seriously ill with the coronavirus. However, Malaysian Health director-general Datuk Dr Noor Hisham Abdullah has cautioned against the misuse of the said drug. We asked experts to comment on the effectiveness of the drug in treating COVID-19.

EXPERT REACTION

Dr Lee Yeong Yeh, Professor of Medicine & Consultant Physician of Hospital Universiti Sains Malaysia, Kota Bharu, said:

“RECOVERY (Randomised Evaluation of COVID-19 therapy) is a UK-based research program to evaluate a range of potential treatments for COVID-19 using randomized clinical trial approach, of which Dexamethasone is one such treatment being evaluated. A total of 2014 patients were randomized to Dexamethasone 6 mg daily for 10 days and compared to 4321 patients with usual care. Dexamethasone was found to reduce one-third deaths in ventilated patients and one-fifth in patients receiving oxygen only. It must be mentioned that results of the full study have not been published but the study was terminated early because sufficient patients have been recruited to establish the effectiveness of the drug. 

“Dexamethasone contains steroid, which has anti-inflammatory and immunosuppressive properties, and is a widely used drug in conditions including allergy, brain swelling and part of a chemotherapy regime. This agent has been available since 1977, and since off-patent, Dexamethasone is a highly affordable and accessible in most countries. However, it is not without side-effects, among which include Cushing syndrome and possible risk of bacterial infections. It works in COVID-19 probably through its immunosuppressive effects thus reducing ‘cytokine storm’ but the actual mechanism remains elusive. 

“Despite the proclaimed effectiveness, it should not be considered the panacea for COVID-19. First, it is not effective for mild COVID-19. Second, it does not break transmission within the community. Vaccine is still needed for this purpose. Third, as mentioned above, the full results of the study have not been published yet. 

“Nevertheless, the results have confirmed that the drug does benefit a certain category of patients with COVID-19 and provide assurance to doctors who have been using Dexamethasone in their patients.” 

Associate Prof Dr Pang Yong Kek, Consultant Respiratory Physician & Lecturer at the University Malaya Medical Centre, said:

“There is a preliminary report on this trial performed by the Oxford group in UK on the use of dexamethasone 6 mg od X 10 days for COVID-19 patients compared to those in the usual care group. The study is not published or peer-reviewed yet.

“However, it is certainly exciting to know that there is some treatment that is effective for patients who have severe respiratory complications (those who require ventilators or oxygen therapy). However, the same study also shows that patients with mild illness of COVID-19 do not benefit from this treatment.

“Besides, we should be mindful of the potential risk of indiscriminate use of dexamethasone. The potential important side-effects of dexamethasone in this regard include hyperglycaemia and risk of secondary bacterial infection.”

Disclaimer: These comments were complied to provide journalists with a range of expert perspectives on the subject. The views expressed here are the personal opinions of the experts. They do not necessarily reflect the views of the Science Media Centre or any other organisation unless specifically stated.

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