Dexamethasone Improves Outcomes For Severe COVID-19 Cases (Only Patients on Ventilators or Oxygen) in Oxford Study

Over 2100 very sick COVID-19 patients received dexamethasone at 6 mg once per day (by mouth or IV) for 10 days. Another 4321 patients were randomized to normal (respiratory) care. The researchers found that dexamethasone significantly reduced deaths in very ill COVID-19 patients and reduced deaths by a third compared to standard ventilator treatment. For patients who only recieved supplemental oxygen (but were not on ventilators), the steroid reduced the death rate by one fifth. Patients who were not that sick did not have any survival benefit from using dex. 

Myeloma patients are routinely prescribed dexamethasone as part of their combination therapies. It is known to enhance the effectivity of other myeloma treatments, kills myeloma on its own and reduces inflammation.

Peter Horby, Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine, University of Oxford, and one of the Chief Investigators for the trial, said:

Dexamethasone is the first drug to be shown to improve survival in COVID-19. 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.

Dr. Horby noted that dexamethasone is very inexpensive and widely available and can be given to most everyone. The study results have not yet been peer reviewed. 

For COVID patients taking dex at such a low dose for only 10 days, the side effect profile should be tolerable, but patients can expect the normal side effects of dex: irritability, insomnia, hyperactivity while on the drug and the dex crash once you come off. 

For myeloma patients who are on 20-40 mg doses for years at a time, they know that dexamethasone is the drug that makes everyone else stupid. One of drugs myeloma patients love to hate, Jenny Ahlstrom shares her "I Will Say Goodbye" breakup song about dexamethasone for your listening pleasure :) 

We are thrilled that dex has a positive use in COVID-19 cases!