The full results of a large randomized clinical trial in Britain, the gold standard of evidence, looking at the steroid dexamethasone confirm the benefits of its use in patients with COVID-19 that were hinted at in the first findings published last month. The results, published Friday in the New England Journal of Medicine, showed benefits for people with advanced or moderate disease.
Overall, 2,104 patients with COVID-19 were randomized to receive dexamethasone and 4,321 to receive usual care. Four weeks later, dexamethasone had reduced the risk of death by 36% among patients who needed mechanical ventilation when they entered the study, and by 18% among those who received oxygen without mechanical ventilation.
The drug did not improve survival among patients who did not use oxygen or mechanical ventilation.
In an editorial, Dr. H. Clifford Lane and Dr. Anthony Fauci of the US National Institute of Allergy and Infectious Diseases said the results show the crucial importance of carefully designed, large, randomized controlled trials. made.
Even during a pandemic, they said, when it might be tempting to simply "give all therapies a try," for patient outcomes to improve, "there will need to be fewer small or inconclusive studies and more studies like the dexamethasone trial."
Immune cells can recognize the coronavirus years later.
Researchers in Singapore are not concerned that antibodies to the new coronavirus are rapidly fading.
More importantly, they said, is that cells of the immune system called T cells and B cells "remember" the virus and can trigger an immune response. As reported in the journal Nature on Wednesday, the researchers looked for "memory" T cells in 36 survivors of COVID-19, 23 survivors of the 2003 coronavirus that caused SARS, and 37 people who never had any of the diseases.
All of the COVID-19 survivors had T cells that recognized the new coronavirus. All SARS survivors had T cells that remembered the 2003 virus, and their T cells also recognized the new coronavirus. Furthermore, more than half of those who were never infected with any of the coronaviruses had protective T cells, suggesting that they may have found other coronaviruses in the past, and there may be some pre-existing immunity to the new coronavirus in the general population.
"We found the current discussion about 'the antibodies are fading' a bit pointless," three of the researchers told Reuters in a joint email.
"The important thing is that a level of B and T cell memory remains to quickly start an effective immune response capable of stopping viral spread," said Anthony Tanoto Tan of the Duke-NUS School of Medicine, along with colleagues Nina Le Bert and Antonio Bertoletti. T cells can kill infected cells to slow down the virus, and they also help instruct B cells to make antibodies, the researchers said.
From NDTV News
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