Dexamethasone and Covid-19: What need to know

What is dexamethasone

Dexamethasone is a steroid (Glucocorticosteroids or Corticosteroids), used as an anti-inflammatory drug for human. This steroid is also used to treat arthritis, Asthma, other allergic reactions, lupus, cancer, breathing disorder,  and so many diseases if doctor advise. 

This drug is not something new. In the early 1950's FDA approved the steroid as a drug for treatment. As this type of drug manipulate hormones  (sometimes itself works as hormone) in the body and they have a very close relationship with body immune system (most of the cases steroid suppress the immune cells), doctors advice is mandatory for taking these drugs. If doctor recommend, only after you can take this.

How steroid works in the body

Normally steroid decreasing inflammation and reducing the activity of immune cells. It has an inhibitory effect on broad range of immune response. Different steroid has different working principles in the body. Inflammation is one kind of immune response. 

Sometimes in our body, immune system is not work properly and might cause inflammation to work against the body tissue and cause damage. In that case steroid reduce the production of chemicals which causes inflammation and keep the cell or tissue damage as low as possible. Moreover it affects the function of white blood cells to manipulate immune system.

Dexamethasone and Covid 19

UK government, Oxford University along with 175 hospitals in UK started a recovery trial with more than 11,500 patient to test the efficacy of some  previously approved drug against Covid-19 and luckily found some positive results with small doses of dexamethasone in case of ventilated and oxygen receiving patients. 

In the trial, 2,104 patients were each given 6 milligrams of the dexamethasone daily for 10 days. For the test, 4321 patients were in control group .

For the study, 2,104 patients were each given 6 milligrams of the synthetic steroid daily for 10 days. The control group for the test comprised 4,321 people. Death rates among patients on ventilators dropped by one-third compared with the control group. The death rate among patients receiving oxygen but no artificial ventilation fell by one-fifth. Dexamethasone showed no effectiveness whatsoever when given to patients who did not require oxygen or normal covid-19 patients (not so severe).

This is certainly a hope in the treatment of critically ill Covid-19 patients who need ventilation support and oxygen. This development may help to reduce death rate no doubt.  World Health Organization welcome the preliminary results of dexamethasone trial to critically ill covid-19 patients. 

As dexamethasone is cheap and easily available drug, It can save millions of critically ill patients all over the world. But still we have to wait for more information. This results has not been published to any recognized journal nor has it been peer reviewed. Still we don't know the mechanism of dexamethasone in Covid-19 patient as well as the side effects.  

Immune system overeaction is play a major role in late stage Covid-19 patient and dexamethsone treatment approach to suppress the  immune system. The scientist community throughout the world are eagerly waiting for the publication of this amazing and outstanding results. Hope something better will come. Till then we have to wait and follow the doctors advice. 

Possible side effects of dexamethasone

There's a wide range of side effects of using these steroids. Associate diseases can also affect the functions of steroid. Weight gain, Diabetes, High blood pressure, organ failure, susceptible to infection, muscle weakness, Nervousness, Glaucoma, Swollen face, difficult sleeping, Osteoporosis, Heart burn, Edema are noted as side effects. These are common side effects though all patient will not develop the side effects. 

Side effects depends on the individuals. More side effects can be seen beside the above mentioned effects. That's why It is your doctor who only can prescribe you to take the steroid or not, after examining your medical conditions and history. Don't take it without the advice of your doctor. Please keep in mind, Life saving can also be life threatening. 

 Precautions during taking dexamethasone

• Tell your doctors about your other medicine you are taking now. Tell the doctor every single health problem you are facing right now.

• Don't take aspirin or other anti-inflammatory drug without the permission of your doctor

• Don't take any kind of immunization or vaccine during dexamethasone treatment without the permission of your doctor

• Don't stop it suddenly. This will also costs you a lot. Take advice from your doctor.

• Don't manipulate the dose by yourself

• Let the doctor know whether you are pregnant, breast feeding mother or taking any birth control pills. 

Hope this drug will work effectively against Covid-19 patient in further trial and we will get a clear recommendation soon. May Allah protect all of us. Stay safe. 

Nuronnabi Sagor