Global hydrocortisone trial sees steroid reduce death in sickest COVID-19 patients

16th September 2020

An affordable and widely available steroid has been shown to reduce mortality in COVID-19 patients receiving intensive care, new research finds.

Hydrocortisone, an anti-inflammatory drug, was found to improve the recovery of patients following seven days of treatment in 93% of cases compared to those who were not treated with the steroid.

This is according to a worldwide trial, which was overseen in Ireland by Professor Alistair Nichol, Intensive Care Consultant at St. Vincent’s University Hospital and chair of critical care medicine at University College Dublin.

In a paper published in the Journal of the American Medical Association (JAMA), researchers demonstrated that delivering intravenous hydrocortisone, a corticosteroid, improved recovery and survival for critically ill COVID-19 patients.

The findings were made through the “Randomised Embedded Multifactorial Adaptive Platform-Community Acquired Pneumonia” (REMAP-CAP) trial.

This is really good news for patients who are unfortunate enough to get really unwell with COVID-19 and end up in intensive care units in Ireland,” said Professor Nichol

“Steroids are a really inexpensive drug… [and] the trial that we conducted… showed that if we gave this inexpensive drug to patients when they enter the ICU and are very unwell, it can actually reduce the mortality rate from 40% to 32%.

“So that’s a 20% reduction in mortality, and it can also reduce the need for the complex and expensive machines that people sometimes need to support organs when they’re unwell”.

He added: “I would not recommend to anyone who is listening to this to go out and take steroids if they were unwell, or thought they had symptoms of COVID.

“Steroids are a powerful drug that suppress the immune system, so we wouldn’t recommend people to make this decision themselves.

“This study that we did was very much confined to people who are critically unwell in the ICU.

The World Health Organisation is now updating its COVID-19 treatment guidance as a result.

Between March and June, the REMAP-CAP corticosteroid trial randomized 403 adult COVID-19 patients admitted to an intensive care unit to receive the steroid hydrocortisone or no steroids at all.