U.S. demand outstripping supply of steroid treatment for COVID

Grant Boone
June 28, 2020

Soaring hospital demand for the steroid dexamethasone, which British researchers say significantly reduces mortality among severely ill COVID-19 patients, is outstripping supply of the drug, but hospitals have so far been able to treat patients out of their inventories, according to Vizient Inc, a drug buyer for about half of USA hospitals.

For patients with progressive deterioration of oxygenation indicators, rapid worsening of imaging and excessive activation of the body's inflammatory response, glucocorticoids can be used for a short period of time (three to five days), the protocol reads. It is recommended that dose should not exceed the equivalent of Methylprednisolone 1 - 2mg/kg/day OR Dexamethasone 0.2-0.4 mg/kg/day. The development was considered one of the biggest breakthroughs in the COVID-19 fight. It is particularly exciting as this is an low-cost widely available medicine.

The guidelines add a note of caution: "A larger dose of glucocorticoid will delay the removal of coronavirus due to immunosuppressive effects".

The Union Health Ministry has put a revised version of "Clinical Management Protocol: COVID-19" - a document published for use by health professionals as a reference.

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Dexamethasone is the first drug proven to treat COVID-19. For pregnant severe cases, consultations with obstetric, neonatal, and intensive care specialists (depending on the condition of the mother) are essential. It has been tested on COVID-19 patients in clinical trial and was found to be effective on those who are critically ill.

The steroid did not reduce deaths in patients not receiving respiratory support. Older people and those with low immunity may present with atypical symptoms like fatigue, reduced alertness, reduced mobility, diarrhoea, loss of appetite, delirium, and absence of fever, the protocol mentions.

Eight states - Maharashtra, Tamil Nadu, Delhi, Telangana, Gujarat, Uttar Pradesh, Andhra Pradesh and Bengal - now account for 85 per cent of the active patients and 87 per cent of the deaths, health officials told a group of ministers meeting on Covid-19 on Saturday.

While using ventilators was helpful as a last resort for Covid-19 patients, doctors said that some 42 percent of the patients on the machines have so far succumbed to the disease.

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