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Another corona drug pops up: Dexamethasone

The good old anti-inflammatory arthritic drug threatens to edge out Remdesivir and Trump-favourite hydroxychloroquine from the corona shelves. The Oxford University researchers found that it reduces mortality by one-third in critical coronavirus cases. The WHO described the finding as the "green shoots of hope." But how far is it true?

LONDON, June 17: British Health Minister Matt Hancock told Parliament on Wednesday that Oxford researchers had found dexamethasone useful in the treatment of critically ill covid patients. Dexamethasone is the first effective medicine found for the treatment of coronavirus, he claimed.

"It's the first time that anyone in the world has clinically proven that a drug can improve the survival chances of the most seriously ill coronavirus patients," Hancock explained.

The Oxford University researchers had announced on Tuesday that the first results of the trial found that the drug reduces mortality by one- third in critical coronavirus cases. The treatment is immediately available and is already in use in NHS (National Health Service), according to Hancock. The UK has 2,40,000 doses of dexamethasone in stocks.

It cut the risk of death by a third for patients on ventilators. For those on oxygen, it cut deaths by a fifth. Chief Medical Officer for England Prof Chris Whitty tweeted it would save lives around the world.

The risk of death was reduced from 40% to 28% in patients on ventilators and 25% to 20% in those on oxyden. About 2,000 hospital patients were given the trial medicine by the Oxford researchers. Their head Prof Martin Landray said the benefit is clear.

"This is the most important trial result for COVID-19 so far. Significiant reduction in mortality in those requiring oxygen or ventilation from a widely available, safe and well-known drug. Many thanks to those who took part and made it happen. It will save lives around the world," Prof Chris Whitty said.

The drug, used as anti-inflammatory in arthritis and asthma, is instantly available worldwide and is cheap and well-known. It is a common steriod used since 1960. It is administered intravenously in intensive care and in tablet form for less seriously ill patients. For a 10-day course it costs 5 pounds in the UK.

In fact it works like a drug against cytokine storm, which manifests in coronavirus patients in advanced stage, helping in recovery: Reason why it has been described as a life-saver in ventilator cases only. (Does it mean the drug is for cytokine storm and not for coronavirus as such?)

Cytokine storm is that state when the body's immune system goes into an overdrive to destroy foreign bodies or responds violently to mistaken signals, leading to damages like bleeding, clotting, strokes and abrasions to own organs. Here the lungs. Bleeding lungs then stop oxygen supplies and brings death. The drug's intervention is here, treating the cytokine storm.

Dexamethasone calms the immune system.

The only other drugs being tried for covid are comparatively new. Remdesivir developed for SARS and hydroxychloroquine which is a malaria drug also useful in arthritis and IBS. Both were included in the therapy protocol for coronavirus patients in India last week. Hydroxychloroquine, which has been promoted by US President Trump from the very beginning and has now been disapproved by the FDA, was a couple of days ago stopped by the WHO also from trial and use.

An optimistic Prime Minister Boris Johnson said dexamethasone is "a remarkable British scientific achievement" that can be celebrated. "We have taken steps to ensure we have enough supplies, even in the event of a second peak," he said.

The WHO has hailed the trial of the repurposed drug. Dexamethasone has "given signs of hope." However, intensive work should go on on the preventive side although the new drug is a "very welcome news" and it gives "green shoots of hope," the WHO Director-General Dr Tedros Adhanom Ghebreyesus said. It is a cheap and common steriod that can definitely help the critically ill. The medicine has been used since 1960 to reduce inflammation in arthritis and asthma and in some skin conditions. It cuts death rate by one-third, he elaborated.

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