A Low-Cost Steroid Shows Promise for Treating COVID-19. But Take the News With a Grain of Salt

Encouraging results from researchers looking into potential COVID-19 treatments are being hailed as a “groundbreaking development”—but recent history shows it’s worth taking these promising findings with a grain of salt.

Investigators working on the U.K.-based RECOVERY trial announced today that dexamethasone, a low-cost and widely available steroid that lowers inflammation, improved patients’ chances of surviving severe COVID-19. During the study, about 2,100 COVID-19 patients were treated with dexamethasone for 10 days. Patients on mechanical ventilation who were given dexamethasone were 35% less likely to die compared to patients on ventilators who did not get the treatment. In patients on less invasive forms of breathing support, dexamethasone decreased the risk of death by 20%, while patients who did not require any respiratory help saw no improvements after taking the steroid.

Those are promising findings, and it makes sense that an anti-inflammatory drug would be effective against a disease that’s most harmful when it spurs excess inflammation in the body. But there’s a big caveat: the researchers released only a summary of the data, rather than a complete, peer-reviewed paper. (The researchers said in a statement they’ll publish their full findings soon.)

It’s understandable that these researchers would want to get the news out as soon as possible, given the possibility that dexamethasone could, based on the results, save lives immediately. But some health experts are warning the public to interpret the results with caution—especially in light of a recent scandal in which two prominent medical journals, the Lancet and the New England Journal of Medicine, had to retract high-profile studies on potential COVID-19 treatments due to suspect data.

“It will be great news if dexamethasone, a cheap steroid, really does cut deaths by 1/3 in ventilated patients with COVID-19, but after all the retractions and walk backs, it is unacceptable to tout study results by press release without releasing the paper,” influential surgeon and author Dr. Atul Gawande wrote on Twitter this morning.

The anti-malarial drug hydroxychloroquine serves as a cautionary tale. A small French study from March sparked a flurry of excitement (and glowing praise from President Donald Trump) over hydroxychloroquine’s potential to treat COVID-19. But as more robust studies came out, findings began to suggest the drug is at best ineffective, and at worst potentially harmful. Eventually, the growing body of research led the U.S. Food and Drug Administration to revoke the drug’s emergency use authorization.

The hope, of course, is that no such thing happens with dexamethasone. If the drug truly works as well as the early results suggest, it could revolutionize the way severe COVID-19 is treated. But the rapidly evolving COVID-19 pandemic, which has spurred scientists to produce a staggering amount of work in record time, has also exposed the drawbacks of accelerating past the traditionally slow-and-steady scientific review process. Mistakes happen, and conclusions change—especially when the whole world is impatient for answers.