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A drug to treat Covid-19.

Posted on 21st June 2020

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UK Prime Minister Boris Johnson is celebrating "a remarkable British scientific achievement", a drug that has been shown to be effective in treating Covid-19, as reported by the BBC here.

The headline of this story, "Dexamethasone proves first life-saving drug", probably based on UK government a press release, is actually not true. Dexamethasone is not the first. Trials of remdesivir, a drug developed to treat ebola, have shown that it is effective in treating Covid-19, as reported here, by Ars Technica about a month ago. There have also been very hopeful animal trials of a new drug from Celltrion (it seems that this new drug does no yet have a name), as reported in this story on Fox News.

For most of us, however, the news about dexamethasone is not really relevant. Dexamethasone, a low-dose steroid medication has been shown to increase the survival rates of people with severe infections: patients on ventilators (survival rates increased by a third) and patients receiving oxygen (survival rates increased by a fifth).

The reason why it doesn't affect most of us? Dexamethasone does not seem to help people with milder symptoms of coronavirus: those who do not need help breathing. Given that around 95% patients who are infected with the coronavirus recover without even being admitted to hospital, and not all patients admitted to hospital need oxygen or a ventilator, most infections will not be helped by treatment with this drug.

There is something that worries me about this announcement. Several studies (reported, for example, here, here and here) have shown that SARS-CoV-2 (the coronavirus which causes Covid-19) is not in fact a kind of pneumonia, but a blood vessel disease. It damages the blood vessels, causing lots of small blood clots; these clots cause not only the symptoms in the lungs, but also the widespread organ damage that some patients suffer, and the side-effects such as strokes and heart attacks. As a result of these analyses.some of the researchers have recommended treatment with a combination of anti-inflammatories (e.g. steroids or ibuprofen), anti-coagulants, anti-virals (e.g. drugs like remdesivir) and antibiotics (to treat the bacterial opportunistic secondary infections that often occur with viral diseases). So, it really shouldn't come as a surprise that dexamethasone (a steroid) and remdesivir (an anti-viral) are effective treatments, but for many doctors it seems, nevertheless to be a surprise. It just confirms that many doctors are not paying attention to current research, and as a result are putting their patients at risk.