THD NewsDesk, GENEVA: On the 2nd of September, the World Health Organisation released its guidance for clinicians and healthcare decision members proposing the systemic use of corticosteroids for coronavirus positive cases. Corticosteroids have proven to be beneficial in the treatment of patients suffering from a severe illness caused by Covid-19. However, WHO has advised against its use in non-severe cases. Corticosteroids dosage is inefficient in cases with mild symptoms and could even turn counter-productive, causing more harm than good.
Corticosteroids are mentioned in WHO’s model list of essential medicines and it’s therefore recommended that countries keep sufficient stocks for treatment. Although they are abundantly available in most countries at affordable costs, WHO has asked governments to refrain from hoarding it, denying its supply to economically weaker countries. It is to be noted however that the recommendation is backed by low certainty evidence.
WHO in collaboration with the non-profit Magic Evidence Ecosystem Foundation (MAGIC) commenced their work on this guidance on June 22. MAGIC provided methodologic support to develop and disseminate living guidance for COVID-19 drug treatments. WHO conducted eight randomized trials of systemic corticosteroids for Covid-19 on 7184 participants in order to rapidly provide additional evidence to build on RECOVERY data and inform guidance development.
The guideline panel culminated data from two meta-analyses and published its first preliminary report on the impact of corticosteroids. The resulting evidence summary indicated that 28-day mortality in patients with critical COVID-19 was relatively reduced by systemic administering of Corticosteroids (moderate certainty evidence).
Strangely enough, the same treatment when given to patients with non-severe COVID-19 could increase the risk of death (low certainty evidence). Moreover, the use of systemic corticosteroids could probably reduce the need for invasive mechanical ventilation which is a matter of relief for patients.