Irish medics likely to start treating Covid-19 patients with dexamethasone

Irish medical specialists treating severely ill Covid-19 patients are likely to immediately start administering the widely-available steroid drug shown in the UK to significantly reduce death rates, according to a leading intensive care specialist.

Prof John Laffey of NUI Galway school of medicine said this was possible because dexamethasone, an anti-inflammatory medication, had a proven safety record and inflammation was often associated with severe cases of Covid-19.

He was commenting after preliminary data from a clinical trial suggested the drug reduced the risk of dying in Covid-19 patients on ventilators by as much as 35 per cent and patients on oxygen by 20 per cent.

Prof Laffey said it was reassuring that “it’s a big study done by a high-end bunch of people. If it gets past peer review, it will change practice”.

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Its use could be scaled up quickly as it was common, inexpensive and widely deployed in hospitals, he said.

What was "really encouraging" was the fact that the drug was evaluated in a randomised control trial, which were the most robust, said infectious diseases consultant Prof Paddy Mallon of St Vincent's University Hospital Dublin.

In addition, it was focused on mortality and achieved a reduction in deaths, especially with severely ill people in ICU. With the first wave of the pandemic they were trying to dampen inflammation using steroids. “This confirms our clinical approach . . . but people now will be more likely to get steroids as a consequence.”

The downside was an absence of full results. While he could understand why preliminary findings were issued in a press release, the data was scant, he stressed.

‘Awaiting full details’

Speaking in the Dáil on Wednesday Minister for Health Simon Harris said he has asked public health experts to contact the HSE regarding plans to make the drug available to treat Covid-19 patients here. Mr Harris cautioned “we are awaiting full details of the study” .

The HSE “looks forward with interest to studying the completed, peer-reviewed report, and note the potential evident from this early report,” a spokeswoman said.

While the HSE is not currently advocating widespread use of steroids in the treatment of Covid-19, it is advising that clinicians be alert and aware of this latest information, and use steroids only where clinically indicated, she added.