Steroid treatment should be reserved for sickest COVID-19 patients, say US scientists

Washington: Most adults with moderate-to-severe COVID-19 have a suppressed immune response towards the novel coronavirus moderately than life-threatening hyper-inflammation, in response to a research which suggests steroids corresponding to dexamethasone ought to be reserved for the sickest sufferers.

Scientists, together with these from St. Jude Kids’s Analysis Hospital within the US, assessed the degrees of the immune system protein cytokines, and different well being markers in 168 adults with COVID-19 , 26 adults with flu and 16 wholesome volunteers.

They stated greater than 90 p.c of the COVID-19 sufferers have been hospitalised, and about half within the intensive care unit (ICU), whereas greater than half of flu sufferers have been admitted for therapy, and 35 per cent have been within the ICU.

In accordance with the analysis, printed within the journal Science Advances, fewer than 5 p.c of the COVID-19 sufferers, together with a number of the sickest people, had the life-threatening, hyperinflammatory immune response often known as the cytokine storm syndrome.

The researchers defined that cytokine storms develop when extra or abnormally regulated ranges of cytokine proteins within the physique result in hyperinflammation and tissue harm.

Whereas dexamethasone and different steroids are prescribed to deal with cytokine storms, they stated these medicine can backfire in sufferers whose immune response is already suppressed.

“We did determine a subset of COVID-19 sufferers with the broadly upregulated array of cytokines. However, general, the typical particular person with COVID-19 had much less irritation than the typical particular person with flu,” stated research co-author Paul Thomas from St. Jude Kids’s Analysis Hospital.

Primarily based on the findings, the scientists stated therapy suppressing irritation would possibly solely be efficient in a minority of sufferers with the hyperinflammatory profile.

They consider the necessity of the hour is a quick, dependable, and cheap take a look at to measure cytokines and determine sufferers who’re most definitely to learn from dexamethasone therapy.

“Directing immunosuppressive therapies to the small subset of COVID-19 sufferers who’ve an overactive immune response is the one strategy to know if these approaches are in the end useful,” stated Philip Mudd, one other co-author of the research from the Washington College Faculty of Medication within the US.