Is Hydrocortisone an Effective Treatment for Severe COVID-19?

With the emergence of COVID-19 as a worldwide pandemic that has deeply affected the lives of many and led to country-wide economic stalls, researchers have been scrambling to find effective treatments for the virus as a vaccine is developed. While several new drugs are being investigated, the use of treatments proven in other areas of the medical field is also being tested.

One such drug is hydrocortisone, which has been used effectively to treat many other health problems. Thanks to its proven record and the uncertainty associated with COVID-19, researchers determined that hydrocortisone would be a potentially useful drug in treating the emergent disease.

Testing the Effectiveness of Hydrocortisone in Patients with Severe COVID-19

Corticosteroid use in the treatment of severe COVID-19 has been severely lacking. This study, which included 403 ICU patients with confirmed or suspected COVID-19, aimed to shed some light on this possible treatment. These patients, who represented 8 countries and 121 treatment sites, were randomized into one of three groups—no hydrocortisone, shock-dependent treatment, and a seven-day fixed course of hydrocortisone.

The goal of the treatment, and thus, the study, was support-free days within 21 days of admittance to the ICU. Support-free days are defined as days in which the patient did not require respiratory or cardiovascular support.

Participants featured a mean age of 59.5 to 60.4 years old and were predominantly male (over 70%). Mean BMI was approximately 30, and over half of the patients were receiving mechanical ventilation (50% – 63.5%).

The Outcomes and What They Mean

379 of the participants completed the study, and of those, the patients receiving hydrocortisone showed higher probabilities of superiority. More specifically, those in the seven-day fixed-dose group showed a 93% probability of superiority compared to the group receiving no hydrocortisone, and those in the shock-depended group showed an 80% probability of superiority compared to the group receiving no hydrocortisone.

What does this mean, exactly?

Unfortunately, it does not mean much, as the study ended prematurely and none of the strategies met the required criteria for statistical superiority. In other words, though the groups receiving hydrocortisone did show promise in regard to support-free days within 21 days, no decisive conclusion was reached.

Now What?

Doctors and researchers will continue to press forward in the pursuit of effective, reliable treatment methods for COVID-19. This pursuit could include future studies involving hydrocortisone and will most certainly involve the testing of other proven medical treatments.

With the world’s greatest medical minds working around the clock to find the best possible treatment for this global pandemic, and a vaccine one the horizon, there are plenty of reasons to remain hopeful!