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The sickest patients hospitalized with COVID-19 who received dexamethasone, the low-cost steroid, had a significantly lower incidence of death versus patients receiving usual care, preliminary results from the U.K.-based RECOVERY trial found.

Incidence of death was significantly lower for patients in the dexamethasone group who received mechanical ventilation versus those receiving usual care (29.3% vs 41.4%, RR 0.64, 95% CI 0.51-0.81) and those receiving supplemental oxygen without mechanical ventilation (23.3% vs 26.2%, RR 0.82, 95% CI 0.72-0.94), reported Martin Landray, PhD, of the University of Oxford, on behalf of the RECOVERY Collaborative Group, and colleagues.

However, there was no significant difference in the incidence of death between groups among those patients who did not receive respiratory support (17.8% vs 14.4%, RR 1.19, 95% CI 0.91-1.55), Landray's group wrote in the New England Journal of Medicine.

Overall mortality at 28 days was significantly lower in the dexamethasone group versus usual care (22.9% vs 25.7%, RR 0.83, 95% CI 0.75-0.93, P<0.001), the researchers noted.

These are not new results, with the U.K.-based Randomised Evaluation of COVID-19 Therapy (RECOVERY) investigators releasing topline interim results via press release on June 16. Back in June, the investigators said they would be submitting their data for peer review.

Commenting on June's topline results at a press conference for the International AIDS Society's COVID-19 conference last week, National Institute of Allergy and Infectious Diseases (NIAID) Director Anthony Fauci, MD, characterized the topline results as "quite impressive" for individuals on ventilators requiring oxygen.

"That is very important, because it goes along exactly with what we know about pathogenic mechanisms, mainly that early on, you really want to block the virus, but keep the immune system intact, and later on, when you have aberrant inflammation, you want to dampen it," he said.

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Drug that calms ‘cytokine storm’ may reduce COVID-19 mortality

An observational study finds that patients on ventilators who received a drug that dampens excessive immune responses had a 45% lower risk of dying compared with controls.

Despite being twice as likely to develop secondary infections, patients who received a single dose of the immune suppressing drug appeared to have a better chance of survival, researchers at the University of Michigan discovered.