RECOVERY trial finds up to a third fewer deaths with dexamethasone

The national RECOVERY trial, led in Southampton by Dr Sophie Fletcher, has shown low-dose dexamethasone can save the lives of patients with serious COVID-19.

While most people with COVID-19 recover without needing to go to hospital, those with more serious infections often need oxygen or a mechanical ventilator.

Low-dose dexamethasone treatment reduced the deaths by up to a third for patients on ventilators, and a fifth for those on oxygen, the trial found.

The NHS is now working to quickly make this treatment available to these patients. It is already being used to treat COVID-19 patients at University Hospital Southampton.

National trial

The Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial, led by the University of Oxford, is the world's biggest trial testing existing treatments to see if they can treat COVID-19.

A total of 2104 patients had 6 mg of dexamethasone once a day (either by mouth or by intravenous injection) for ten days. Their results were compared to 4321 patients who had usual care.

Dexamethasone reduced deaths by a third in ventilated patients and by a fifth in patients receiving oxygen. The treatment did not help COVID-19 patients who were not on oxygen or a ventilator.

The trial continues to test multiple potential treatments in parallel for COVID-19 patients in NHS hospitals across the UK, adding new treatments and stopping others as new evidence emerges.

Worldwide benefit

Low-dose dexamethasone seems to help protect patients against the damage caused by a cytokine storm – a potentially deadly overreaction to the virus by the immune system.

It is a steroid already used to treat inflammation in other conditions, including arthritis, asthma and some skin conditions, so is widely available for use.

This means healthcare providers across the world will already have stocks of this drug available, and can quickly start using this treatment to treat patients with serious COVID-19.

“This is the first treatment for COVID-19 that can save lives. This is an enormous achievement, and proves the worth of using clinical trials to identify new COVID-19 treatments,” commented Dr Sophie Fletcher.

“I thank all of my colleagues who have worked so hard to get us to this point. It is not, however, a miracle cure and we will continue to test the most promising treatments.”

The RECOVERY trial still needs more hospitalised patients with COVID-19. If you are a healthcare professional working with COVID-19 patients at UHS, find out how to recruit patients.