Corticosteroids reduce mortality in severe cases of covid-19, research says

A meta-analysis study, which gathered evidence from seven clinical trials conducted in 12 countries, including Brazil, confirmed that corticosteroid drugs reduce covid mortality in patients with critical conditions of the disease.
The research, published on Wednesday, 2, in the prestigious scientific journal Journal of the American Medical Association (Jama), evaluated the use of three drugs of this class: dhimhasone, hydrocortisone and methylprednisolone.
Corticosteroids are low-cost anti-inflammatory drugs used for decades primarily in the treatment of inflammatory, respiratory and allergic diseases such as asthma and arthritis.
The studies analyzed had the participation of 1,700 patients. All clinical trials were randomized, i.e., the participants of each group (the one who received the drug and the control group) were chosen by lot. In the group that took one of the corticosteroids, 32% of the patients had died after the 28-day follow-up period. Among patients who only received standard clinical support, mortality in the period was 40%, equivalent to a 20% lower risk of death among patients who received the medication.
Research also points out that corticosteroids have proven to be safe, with no increased risk of serious side effects. "Adverse events varied between studies, but there was no suggestion that the risk of serious adverse events was higher in patients treated with corticosteroids, except for the two smallest studies, in which the total number of serious adverse events was 1 and 3," the published paper points out.
The meta-analysis was performed by a working group formed by the World Health Organization (WHO) to provide rapid response on possible treatments for covid. The group has scientists from all over the world, including from Brazil.
Among the studies that were considered in this meta-analysis is a research coordinated by the main Brazilian private hospitals that showed that dmeshasone was able to reduce intubation time among critically ill patients.
Brazilian researchers warn that the benefit and safety of corticosteroids is valid for severe covid patients who need respiratory support. For mild or initial conditions, the drug has no proven benefit and may even worsen the condition.
"The corticosteroid will not cure the disease or fight the virus, it will modulate the inflammatory response of the body to combat an overreaction. Only that answer, at the beginning of the infection, is what fights the virus. It only becomes harmful if it becomes unrestrained. If you block it early on, it can increase the time of symptoms," explains Luciano Cesar Pontes Azevedo, superintendent of teaching at the Sírio-Libanês Hospital, a member of the executive committee of the Covid-19 Brazil Coalition and one of the authors of the study.
The new evidence reaffirms the findings of a study by the University of Oxford (UK) released in June in which dithasone was shown to be able to reduce by one-third the number of deaths among intubated patients. From the research released on Wednesday, new recommendations on the use of corticosteroids should be made.