Nov 17, 2021
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Dexamethasone does not increase mortality in diabetics with COVID-19

Since people with diabetes are one of the main risk groups for coronavirus, the proportion of such patients in hospitals and intensive care units is very high. To assess the effect of dexamethasone on this group of patients, scientists from Imperial College London analyzed data from over 2.2 thousand patients hospitalized with COVID-19 during the first and second waves of morbidity in the UK.

From March to April 2020, 809 people were admitted to hospitals, and at that time, clinical trials of dexamethasone had not yet been completed, so it was not widely used. During the second wave from November 2020 to January 2021, when 1,372 people were hospitalized, the steroid was already included in the COVID-19 treatment protocols.

During the second wave, dexamethasone was prescribed to 68% of patients, 35% of them had diabetes. Hyperglycemia developed in 19%, which required additional treatment, and in most diabetics, symptoms of the disease worsened.

Another 12% of people were first diagnosed with diabetes during treatment, and the authors of the study explain this by the fact that some patients may not have known about their disease before hospitalization. In addition, 2% of patients developed so-called steroid-induced diabetes. Experts noted that in most cases this condition goes away after the completion of treatment.

At the same time, therapy with dexamethasone reduced the risk of mortality and severe complications by 56% in all patients, both with and without diabetes. Scientists consider these findings to be strong evidence that the benefits of corticosteroid treatment clearly outweigh the risks.

Dexamethasone is a corticosteroid that has been used since the 1960s to reduce inflammation in several conditions, including cancer. In June 2020, WHO announced the results of clinical trials of dexamethasone in the treatment of hospitalized patients with COVID-19 – the death rate of patients on mechanical ventilation is reduced by almost a third, on oxygen support by one-fifth. Today this drug is the standard of treatment for patients in the “red zones” around the world, including in Russia.

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