[JAMA] Can patients with severe COVID-19 really benefit from high-dose corticosteroids?

This article is original by Translational Medicine Network.
Please indicate the source for reprinting.
Author: Tiffany Guide: The raging new crown epidemic has prompted scientists and medical circles to set off a wave of research again and again
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Recently, a group of scientists made a new discovery.
Can this be the hope of treating severely ill patients? Recently, a large international study of hospitalized patients with severe COVID-19 showed that although higher doses of steroids did not significantly reduce the mortality rate, they have the tendency to help patients slow down the disease, and side effects will not increase
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The results of this research were published in an article titled "Effect of 12 mg vs 6 mg of Dexamethasone on the Number of Days Alive Without Life Support in Adults With COVID-19 and Severe Hypoxemia" in "JAMA" magazine: this group The scientists compared the standard dose of 6 mg of steroid dexamethasone with 12 mg of steroid dexamethasone in patients.
These patients need stronger support to maintain their oxygen levels
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This is the first COVID-19 trial to report long-term mortality and one of the only "blind" trials.
This "blind" trial is designed to prevent doctors from knowing which patient received which dose Experiment
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The co-author of the study, Professor Bala Venkatesh of the George Institute for Global Health, said: Although previous studies have shown that larger doses of dexamethasone may benefit patients with more severe COVID-19, people have always worried that there will be potential in this.
Adverse reactions: "Our study found that there was no difference in the incidence of adverse events between the two doses
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Although there are reports that COVID-19 patients with weaker immune systems are infected with the so-called'black fungus', our research has not found that higher doses of steroids increase the infection rate
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"Severe COVID-19 patients usually have severe lung inflammation and extremely low oxygen levels.
When this happens, they often need to increase their oxygen support, mechanical ventilation (ventilator assisted breathing), maintain blood pressure, and maintain kidney dialysis.
Support
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Dexamethasone is the main treatment for severe COVID-19
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Although it is recommended to take 6 mg per day for 10 days, there are signs that higher doses may be beneficial for those with more severe diseases
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Use steroids one potential side effect is inhibiting the body's immune system, reduce the ability to fight other types of infection
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there are some reports that: COVID-19 in patients treated with steroids is a serious fungal infection called slime mold disease or "black fungus"
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in For this study, researchers in the period August 2020 to May 2021 recruitment of 1000 adult patients diagnosed with the virus to infect new crown in 31 locations in Denmark, India, Sweden and Switzerland 26 hospitals
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patients were randomized to Two groups, one group of patients received intravenous dexamethasone 12 mg (n=503), and the other group of patients received dexamethasone 6 mg (n=497) for 10 days
.
The
results: 12 mg The proportion of patients who survived 28 days and did not require life support was 42.
6%, and that of the 6 mg group was 40.
2%; the mortality rate of the 12 mg group and the 6 mg group were 27.
1% and 32.
3%, respectively
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Vivek Jha, George Institute, India Together with Professor Venkatesh, the professor established and implemented this trial in 12 participating hospitals in India
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He said: "This study provides useful guidance for clinicians treating COVID-19 patients around the world
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" He also explained: "Although the data does not provide clear evidence that 12mg dexamethasone is better than 6mg, we Seeing a trend that higher doses of dexamethasone will reduce the need for life support and mortality without increasing the risk of serious infections
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Because dexamethasone is cheap, easily available, and suitable for treating oxygen levels Very low COVID-19 patients, even with small differences in mortality or health outcomes, may bring important clinical and health economic benefits at the population level
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"Reference: https://medicalxpress.
com/news/2021-10 -patients-severe-covid-benefit-higher.
html Note: This article aims to introduce the progress of medical research and cannot be used as a reference for treatment options
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If you need health guidance, please go to a regular hospital
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