Dexamethasone
&
COVID-19
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Dexamethasone, a drug known to many of us, is basically known as Decadron. On June 16, 2020, a report from Oxford University in England found that the use of the drug Dexamethasone had significantly reduced the mortality rate of critical patients.
After administering the drug to about 2,000 patients, it was found that the mortality rate of critical patients on the ventilator could be reduced from 40% to about 28%. And it has been possible to reduce the mortality rate of patients who were completely dependent on oxygen support for about 20%.
The lead author of this study is Prof. Peter Horby says, "This is the only drug so far that has been shown to reduce mortality and and it reduces it significantly. It's a major breakthrough."
What is Dexamethasone??
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Dexamethasone is a type of corticosteroid drug that has been shown to benefit multiple diseases. Significant application of this drug is seen in the subsequent treatment of Allergy, Arthritis, various skin diseases, eye problems, stomach problems, major operations etc.
In another case dexamethasone has played an important role in treatments of respiratory problems. And right from the start of its application, dexamethasone has successfully become a life-saving drug for critically ill COVID-19 patients.
No role of this drug has been observed in infected patients except in critical patients.
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How does dexamethasone work?
COVID-19 disease actually causes inflammation of our airways and lungs. Once the inflammation becomes more severe, a condition called cytokine storm occurs in the body.
At very small doses dexamethasone can prevent this cytokine storm and become life-saving drug for the patient.
What is cytokine storm ??
The term was first mentioned by J L Ferrera in a 1993 magazine. The subject of his research was graft vs. Host disease.
Our body develops a normal immunity to any kind of disease. Cytokine is a special chemical that is identified as a signaling factor in this immune system.
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The presence of this cytokine in the body is at a very normal level. Cytokine is made to prevent any disease so that the body is always ready. If the level of this cytokine in the body is increased in any way, various organs of the body lose their ability to function and gradually a patient dies.
Relevance?
It has been found that the human body's immune system begins to weaken with age. This is called immune aging or immune senescence. Over time, interacting with various elements of the environment over a long period of time, the body is found to be in a chronic inflammatory state. This condition is called inflammaging.
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In most older patients, signaling factor cytokine is present in much higher levels than normal. The body can adapt to this condition. But in some physiological diseases, especially inflammation of the airways caused by infection with viruses, the levels of this cytokine begin to rise. Due to age, this cytokine remains unused most of the time because the immune system loses some of its ability to function. The presence of this excess amount of cytokine in the blood is called cytokine storm.
The importance of dexamethasone?
Infection with the H5N1 influenza virus, or SARS CoV-1, has been shown to cause cytokine storms. From that source, the incidence of cytokine storm was found during the examination of COVID-19 patients.
Dexamethasone can easily counteract this cytokine storm. In this way dexamethasone reduces the level of cytokine in the patient's body and saves the patient from multi-organ failure, and the patient can be brought back from the grip of death.
Is this system effective for all patients?
Absolutely not. According to the information available so far, it has been used in only 1/3 of the patients. Dexamethasone cannot be applied to any random patients.
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Any patient may have an allergy to this drug. Dexamethasone can make other physical problems worse. Many times a patient may react to dexamethasone with all the medications he takes regularly and push the patient towards death. So its use has to be done very carefully. This medicine should not be used without the advice of a doctor.
One more thing to note is that, according to Oxford experts, this drug is only effective for critical patients of COVID-19. It is not for normal healthy people or for patients with no symptoms.
Decamethasone is a very expensive drug ??
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Absolutely not. This drug is widely used all over the world and its cost is very low. In the case of one patient, the limit of application of this drug may be about 10-15 days.
Applying dexamethasone in the same amount for 10 days costs only ₹ 480 to ₹ 600 per patient. These costs may increase or decrease depending on the location and the need for ancillary components. Dexamethasone alone is not effective to control COVID-19.
What are the side effects of this medicine?
The list of side effects of dexamethasone is quite long. But at the most urgent moment, it is applied only after considering its side effects as a life-saving medicine. However, those side effects seem insignificant in the face of life and death. But if a healthy normal person starts applying it to his body unnecessarily and unknowingly, then more than one bad symptom can start, starting from nervous weakness.
This news is quite comforting in this crisis of corona infection.
Complete research on the application of this drug and its results has not yet been obtained. This discovery is truly exciting news in the absence of a comprehensive idea of any vaccine or proper treatment for COVID-19. Hopefully soon we will be able to overcome this crisis and get used to normal life again.
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Stay safe, stay well
Arka Bhattacharya
Kolkata
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