Coronavirus USA: Donald Trump is taking the steroid drug dexamethasone – what is it?
The US President has been using a drug with some potentially harmful side effects to help his fight against Covid-19.
Donald Trump’s personal physician Dr Sean Conley revealed in a speech on Saturday that the President has been taking dexamethasone, a steroid that has been shown to help Covid-19 patients with respiratory issues.
The 74-year-old announced that he had contracted the virus last week and information regarding the President’s condition have been the subject of much debate ever since. The President tweeted that his recovery was “Going well”, but Dr Conley has confirmed that Trump’s blood oxygen levels had fallen since receiving the diagnosis.
President Trump has taken two doses of a five-day course of the intravenous antiviral drug remdesivir for COVID-19, his doctors said, as well as the steroid dexamethasone, which is used in severe cases https://t.co/43VWTADh7l pic.twitter.com/rPwb5jIIPN— Reuters (@Reuters) October 5, 2020
After the positive test result was returned last week the President was admitted to the Walter Reed hospital in Bethesda, Maryland. Dr Conley insisted that Trump is doing well but admitted that he had required supplemental oxygen at some point in recent days.
What does dexamethasone do?
The first thing to draw from this news relates to the severity of the President’s condition. While the Trump team have maintained a positive attitude publically, the use of a drug usually reserved for patients with more developed infections is a concern.
Dexamethasone has been shown to reduce instances of respiratory failure in patients who have displayed symptoms for over a week. The UK’s Recovery trial (https://www.recoverytrial.net/news/low-cost-dexamethasone-reduces-death-by-up-to-one-third-in-hospitalised-patients-with-severe-respiratory-complications-of-covid-19 ) found that the steroid is most effective in those with severe respiratory conditions, which some have taken as a sign of the President’s worsening health.
The use of the drug in patients who have had the drug for less than a week is not recommended due to the potential for side effects, so some have speculated that the diagnosis may have been returned earlier than first thought. Just two days before the positive test result was announced, Trump was on stage with Democratic challenger Joe Bidden in the first of the live presidential debates.
📍DANGERS OF DEXAMETHASONE: when used too soon has no effect on #COVID19 mortality if <7 days *since symptom onset*. In fact, it can weaken innate immunity. So Trump either:— Eric Feigl-Ding (@DrEricDing) October 4, 2020
📌A. Illness moved REALLY damn fast
📌B. diagnosed much earlier
📌C. his doctors caved to his wishes pic.twitter.com/BNi18lEIIo
What are the side effects of dexamethasone?
The National Institute of Health and Care Excellence (NICE) have published extensive research on the drug dexamethasone and have highlighted a number of potential side effects that could hamper the President in the run up to the election.
Notably, a number of the most common side effects relate to mental impairments like anxiety; abnormal behaviour; cognitive impairment; mood alteration and psychotic disorder.
I was treated with Dexamethasone following brain surgery. It is (as my team told me) a drug that seriously messes with your mind. It is a bad drug. I could not wait to get off it. Unfortunately you have to wean off which takes time. Trump is incapacitated.— Michele Dauber (@mldauber) October 4, 2020
Given the President’s advanced age there are also concerns about the physical toll that an extended fight against the virus may have and dexamethasone is known to bring its own risks. The NICE lists fatigue, gastrointestinal discomfort; increased risk of infection and sleep disorders as commonly accompanying use of the drug.
Another major concern is the effect that the steroid can have on the patient’s immune system, a vital factor in the fight against a viral infection. Dr Nahid Bhadelia, the medical director of Boston Medical Center’s Special Pathogens Unit, spoke to health and medicine publication STAT about the drug’s use in Covid-19 patients and warned about the dangers of premature use:
“You don’t want to give it to a patient too early,” said Dr Bhadelia. “It’s a blunt instrument, so it may suppress a good immune response as well as a bad one.”
From the RECOVERY Trial:— C. Michael Gibson MD (@CMichaelGibson) October 4, 2020
"We found no benefit (and the possibility of harm) among patients who did not require oxygen."
Steroids may block the immune response the body needs to mount early on when the virus is still activebut may help tamp down an over exuberant response later. pic.twitter.com/DIJCJlcSX7
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