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Steroid improves survival chances of sickest Covid-19 patients, study involving Cambridge University Hospitals finds

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The survival chances for severely ill Covid-19 patients are improved by treating them with the steroid hydrocortisone, research involving Cambridge University Hospitals has shown.

Patients had up to a 93 per cent chance of a better outcome if given an intravenous seven-day dose of the drug, results from the REMAP-CAP study suggested.

Addenbrooke's Hospital. Picture: Keith Heppell
Addenbrooke's Hospital. Picture: Keith Heppell

Researchers and patients at Cambridge University Hospitals contributed to the international study, which was one of three papers exploring steroids published in the Journal of the American Medical Association this month.

The REMAP-CAP study was conducted across 15 countries around the world and led in the UK from the NIHR Imperial Biomedical Research Centre.

It was stopped early, however, after exciting findings from the RECOVERY trial emerged in June, which showed that another low-cost corticosteroid - dexamethasone - reduced the risk of death by up to one third among severely ill Covid-19 patients.

More severe cases of Covid-19 involve inflammation and an over-reaction from the immune system - problems that are tackled by steriods, which are man-made versions of hormones.

Dr Charlotte Summers, lead investigator for the REMAP-CAP trial at Cambridge University Hospitals and critical care lead for the NIHR Clinical Research Network Eastern, said: “This result from REMAP-CAP provides further support for the finding from the RECOVERY trial, suggesting that steroids improve survival for critically ill people with Covid-19.

“The breakthroughs we have made so far are testament to NHS teams’ unwavering determination to improve the outcomes of our patients by offering them the opportunity to participate in research.

“There are still more questions to be answered in relation to Covid-19, but with our country's unique NIHR community, along with those who participate in research, we're in the best possible position to succeed.”

Dexamethasone is now in use for treating severely ill Covid-19 patients (42223609)
Dexamethasone is now in use for treating severely ill Covid-19 patients (42223609)

Another of the papers published in the journal was a meta analysis, studying evidence from global steroid use across seven randomised controlled trials involving 1,703 patients in 12 countries.

The paper, co-ordinated by the World Health Organisation and led by researchers at the University of Bristol and the NIHR’s Bristol Biomedical Research Centre, concluded that corticosteroids, including dexamethasone, hydrocortisone or methylprednisolone, can reduce the risk of death in the most ill patients by up to 20 per cent.

This was the equivalent to about 68 per cent of patients surviving after treatment with corticosteroids, compared to around 60 per cent surviving without them.

NHS chief executive Sir Simon Stevens said: “One of the distinctive benefits of having our NHS is that we've been able to mobilise quickly and at scale to help researchers test and develop proven coronavirus treatments.

“Just as we did with dexamethasone, the NHS will now take immediate action to ensure that patients who could benefit from treatment with hydrocortisone do so, adding a further weapon in the armoury in the worldwide fight against Covid-19.”

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