Hydrocortisone, a common and widely-available anti-inflammatory steroid drug, has been found to reduce the mortality rate in patients in intensive care by 20%.
For the discovery, researchers conducted a meta-analysis of seven trials involving 1703 critically ill patients from 12 countries to investigate the effectiveness of three different types of common steroid treatments in treating COVID-19. Including hydrocortisone and methylprednisolone, they also analyzed the usage of dexamethasone, already approved for usage against COVID-19, to reduce mortality rates.
When compared to those on a placebo, those treated with dexamethasone and hydrocortisone were around a third less likely to die during COVID-19 treatment. The mortality rate for those receiving methylprednisolone saw a smaller reduction. Although dexamethasone was shown to be marginally more effective than hydrocortisone, the researchers say that having other treatment options available could help alleviate future supply chain issues, and ultimately allow clinicians to administer whichever drug they feel most comfortable with.
"The overall results support and are consistent with the findings from RECOVERY (a trial conducted by Oxford University investigating dexamethasone as a treatment for severely-ill COVID-19 patients) that corticosteroids reduce mortality in the sickest patients with COVID-19," says Jonathan Sterne, professor of medical statistics and epidemiology at the University of Bristol.
"What we add is that these are a diverse group of patients from a variety of countries, and we have a consistent message from all these trials. The effect of hydrocortisone is also consistent with the effect of dexamethasone."
Although promising results that have already gone on to inform treatment practice in the UK (hydrocortisone will now be used by the UK's National Healthcare System (NHS) to fight COVID-19), the researchers say that the research comes with limitations. Firstly, they say that some of the investigators present in the trails did not take part in the meta-analysis. Furthermore, only one trial assessed methylprednisolone with a very small sample size. Thus, results for this steroid may not be conclusive.
The researchers also say that although these treatments may be available over the counter, they should not be used as home remedies for COVID-19, nor as a preventative strategy. This comes as patients in the trials received the drugs via an intravenous drip, and not in the commonly available pill form.