COVID-19 treatment: a growing (anti)body of evidence

  • Kim Outhoff

Abstract

Our lives changed dramatically eight months ago when we went into a hard nationwide lockdown in a bid to limit the transmission of our new spiky foe, SARS-CoV-2. We endured the uncertainties of autumn, and then the winter and the cold July COVID-19 peak. At this time, Oxford University’s RECOVERY Collaborative group first reported on dexamethasone (6 mg daily for 10 days) significantly lowering the 28-day mortality in hospitalised COVID-19 patients on invasive mechanical ventilation or on oxygen alone, by as much as a third and a fifth, respectively.1 It was hypothesised that glucocorticoids modulate inflammation-mediated lung injury, thus reducing the likely progression to respiratory failure and death in patients with severe illness. This made us perk up because a couple of months earlier, the intravenous antiviral, remdesivir (100 mg), also administered for 10 days, had shown promise in shortening the time to recovery by a median of five days compared to placebo, but not in reducing death in hospitalised COVID-19 patients with lower respiratory tract involvement.2 The FDA granted remdesivir Emergency Use Authorization (EUA) in May for the treatment of adults and children hospitalised with suspected or laboratory-confirmed COVID-19 based on this meagre evidence, as there were no other treatment options at the time. Meanwhile, dexamethasone, which is relatively cheap, quickly became the standard care in patients requiring oxygen.

Author Biography

Kim Outhoff

Editor: SA General Practitioners Journal

Published
2020-11-27
Section
Editorial