Coronavirus: Hydrocortisone the second drug proven to save lives

A cheap and widely available drug has been shown to cut the risk of death for those critically ill by about 20 per cent.

A cheap and widely available steroid was shown to cut the risk of death for those critically ill by about 20 per cent. Picture: istock

A study led by British researchers has found only the second drug proven to save the lives of seriously ill coronavirus patients.

Hydrocortisone, a cheap and widely available steroid, was shown to cut the risk of death for those critically ill by about 20 per cent. The results suggest that for every 12 people who were given the medicine, a life was saved.

Chris Whitty, the chief medical officer for England, is expected to urge NHS intensive care specialists to take note of the results and the World Health Organisation will update its guidelines. Hydrocortisone will cost between $3.60 and $7.30 a patient a day.

Chief Medical Adviser to the UK Government Chris Whitty, centre, looks on as UK PM Boris Johnson speaks to the media. Picture: AFP

The finding matches earlier results from another large study, the Recovery trial, which is being run from Oxford University and has enrolled thousands of NHS patients. In June it revealed that another steroid, dexamethasone, also boosted the survival chances of the sickest patients.

Both hydrocortisone and dexamethasone belong to a group of drugs known as corticosteroids. They are thought to work by suppressing the immune system, dampening a harmful over-reaction that leads to complications in coronavirus patients.

Martin Landray, professor of medicine and epidemiology at Oxford and a leader of the Recovery trial, said the evidence for corticosteroids was compelling. “At the point at which you reach for the oxygen cylinder for a patient with Covid, you probably should be reaching for the prescription for the corticosteroids,” he said.

The findings were a testament to the benefits of health systems holding their nerve to run randomised controlled trials, which are the only method of providing clear answers on whether treatments are effective, he added.

The researchers also urged caution, however. “As impressive as these results are, it’s not a cure,” Anthony Gordon, a professor of anaesthesia and critical care at Imperial College London, who led the work on hydrocortisone, said. Corticosteroids were not a substitute for containing the virus through measures such as social distancing and masks, he said.

The hydrocortisone study was one of three papers published in The Journal of the American Medical Association which suggest that steroids can improve survival. They include a so-called meta-analysis, which collated the results from seven individual trials. Overall, it suggests that hydrocortisone and dexamethasone cut the death rate of the most ill patients to 32 per cent, from 40 per cent - that equates to a 20 per cent decrease in risk.

“The overall result is entirely consistent with and supports the findings from Recovery; corticosteroids reduce mortality in the sickest patients with Covid-19,” Jonathan Sterne, a professor of medical statistics and epidemiology at the University of Bristol, said.

“The results were consistent across the trials and show benefit regardless of age or sex.”

The hydrocortisone study tracked 403 patients with suspected or confirmed Covid-19 who required respiratory or cardiovascular organ support, such as mechanical ventilation or drugs to support their blood pressure. They included patients in the UK, Ireland, Australia, the US, the Netherlands, New Zealand, Canada and France.

Professor Gordon said: “At the beginning of the year at times it felt almost hopeless, knowing that we had no specific treatments. It was a very worrying time. Yet less than six months later, we’ve found clear, reliable evidence in high-quality clinical trials of how we can tackle this devastating disease.”

He added: “We now have more than one choice of treatment for those who need it most. Steroids are not a cure but they help improve outcomes. Having a choice of different types of steroids, all of which seem to improve patient recovery, is great as it helps ease the problem of drug supply issues.”

Sir Simon Stevens, the NHS chief executive, said: “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.”

The Times