Hydrocortisone and Acute Respiratory Failure Related to COVID-19
The use of hydrocortisone as a medical treatment has a proven record of successfully managing several diseases and contributing to the recovery in many cases of illness. It stands to reason, then, that it could be effective in aiding the treatment of patients with severe COVID-19, especially when it comes to acute respiratory failure.
This was the opinion of researchers who, in their search for more successful COVID-19 treatment methods, set out to determine whether low-dose hydrocortisone use could lead to a higher level of successful treatment of COVID-19 patients with acute respiratory failure.
The Approach
A total of 149 COVID-19 patients were included in a study that tested the use of low-dose hydrocortisone in patients with severe COVID-19, including related acute respiratory failure. The goal was to measure the rate of treatment failure on day 21 following ICU admission. The outcome was defined as death or the continuous dependency on outside breathing assistance, including high-flow oxygen therapy or mechanical ventilation.
Because COVID-19 can cause severe damage to the lungs, corticosteroids are, in theory, a viable therapeutic option to reduce the potential for damage.
Findings of the Study
Despite the hopefulness of doctors and researchers, no significant difference was found in the rate of treatment failure within the determined timeline between those in the low-dose hydrocortisone group and the placebo group.
In fact, the randomized clinical trial was stopped early at the recommendation of the board monitoring date and safety. At the time of the study’s termination, the rate of treatment failure on day 21 was 42.1% in the hydrocortisone group and 50.7% in the placebo group.
Why it Matters
While the initial reaction to this study may be to declare it a failure, this is far from the truth. No relevant difference between hydrocortisone treatment and placebo use was found, but these results are skewed by the narrowness of the study.
By this, we mean that the study was not comprehensive enough to provide a solid conclusion regarding the use of hydrocortisone in the treatment of severe COVID-19. More patients would need to be included in a similar study to find any clinical or statistical importance.
Adding to this hopeful note is the fact that no serious adverse events were noted during the study, meaning that the use of hydrocortisone for COVID-19 treatment is more than likely totally safe. The next step, then, is a larger, more comprehensive comparable study to more accurately determined the effectiveness of low-dose hydrocortisone in this application.
