Breakthrough drug dexamethasone is being strongly considered for use in the Western Cape, said Premier Alan Winde. This comes after researchers in the United Kingdom released positive initial findings on the use of the steroid in COVID-19 patients who are critically ill.
“These preliminary findings have shown a reduction in mortality in patients who are being ventilated and to a lesser degree, in those who require oxygen support. The drug has been in use since the 1960s, and is widely available with several generic versions in production, making it affordable too,” Winde said in a statement.
“On Tuesday [June 16], Minister Zweli Mkhize indicated that while we wait for the results of the full study to be made available, the use of the drug could be considered for COVID-19 positive patients who are being mechanically ventilated, and patients who require oxygen support,” he said.
Dexamethasone is a cheap and widely-used steroid. Thus far, it has become the first drug to make a significant difference in patients with COVID-19. Preliminary trials carried out by scientists at the University of Oxford show dexamethasone reduced death rates by a third in seriously ill patients. Researchers are recommending it should immediately become standard care for such cases.
A RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial was established in March as a randomised clinical trial to test a range of potential treatments for COVID-19. These treatments included low-dose dexamethasone. Over 11 500 patients were enrolled from over 175 National Health Service (NHS) hospitals in the UK.
A total of 2 104 patients randomly received six mg of dexamethasone once per day – either by mouth or by intravenous injection – for ten days and were compared with 4 321 patients randomised to usual care alone.
Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).
“Since the appearance of COVID-19 six months ago, the search has been on for treatments that can improve survival, particularly in the sickest patients. These preliminary results from the RECOVERY trial are very clear – dexamethasone reduces the risk of death among patients with severe respiratory complications. COVID-19 is a global disease – it is fantastic that the first treatment demonstrated to reduce mortality is one that is instantly available and affordable worldwide,” said Martin Landray, professor of medicine and epidemiology at the Nuffield department of population health at University of Oxford, and one of the chief investigators of the trial.
“We are however encouraged that it has the potential to be life-saving for some of the people most severely impacted by this disease,” Winde said.
The Western Cape is the epicentre of the COVID-19 pandemic in South Africa, and 49 more deaths were recorded in the past 24 hours, Winde said when he released the latest figures on Wednesday. There are 12 738 active Covid-19 cases, 45 767 confirmed cases and 31 824 recoveries. There are 1 419 patients in hospital, of which 243 are in ICU or high care.