In the first major breakthrough in therapeutics for COVID-19 infection, dexamethasone has been shown to have a statistically significant effect on mortality in the most seriously ill patients.

There was a one-third reduction in deaths in patients on ventilators, while in patients receiving oxygen therapy there was a 15% reduction in 28-day mortality, in the U.K. Recovery trial. No benefit was seen in patients who were sick enough to be in the hospital but did not need help breathing.

The steroid was delivered either orally or intravenously at a dose of 6 mg per day. In total, 2,100 patients were randomized to the active arm and 4,200 to standard of care. There were no serious adverse events.

Based on the results, the chief investigators said treatment with dexamethasone should become standard of care.

Peter Horby, professor of Emerging Infectious Diseases at Oxford University, and one of the chief investigators for the trial, said, “This is an extremely welcome result. The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.”

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