Nati Harnik / AP
President Trump told Fox Business Network today that he will be taking a steroid for COVID-19 for “a little longer”. As his doctors told reporters last weekend, Trump began taking the drug on Saturday while still at Walter Reed National Military Medical Center.
The steroid, dexamethasone, is now part of the “standard of care” for COVID-19, says Dr. Celine Gounder, assistant professor of medicine and infectious diseases at NYU School of Medicine.
“It’s an old drug, it’s cheap,” he says. “Of all the drugs we’re using for COVID, it’s the one we have the most experience with.”
Dexamethasone is an anti-inflammatory drug used for a number of ailments, including arthritis, kidney, blood and thyroid disorders, and severe allergies. The drug is on the World Health Organization’s list of essential drugs and is also used to treat some types of cancer.
Earlier this year, a large clinical trial in the UK found that administering dexamethasone to hospitalized patients with COVID-19 reduces the risk of death. Patients were given 6 milligrams of the drug for ten days.
The study, published in the New England Journal of Medicine in July, found that the drug reduced mortality by one-third among critically ill Covid patients who were on ventilation and by one-fifth for patients who received supplemental oxygen. It was found to have no benefit for patients with mild disease and some evidence of potential harm has emerged.
Later in the course of the disease, COVID-19 can cause the immune system to overdrive, damaging the lungs and other organs. This is what can happen to seriously ill people. Dexamethasone helps these patients by reducing the body’s immune response.
The Infectious Disease Society of America now recommends giving 6 milligrams of the drug for 10 days to critically ill COVID-19 patients on ventilators and those requiring oxygen support. But he recommends not using the drug on people with mild illnesses who do not require supplemental oxygen.
Although this commonly used drug is generally safe, there are a number of known side effects. “By far, the most common is hypoglycemia, so that’s where the blood sugars will rise,” Gounder says.
Also quite common, especially among older patients, are a number of psychiatric side effects, he adds.
“Anything from feeling like you are on top of the world … your arthritic aches and pains of age fade away, you have a lot of energy,” she says. “There may be some grandeur.”
The drug can also cause agitation, insomnia, and even psychosis, Gounder says. “My father was treated with high doses of steroids as part of his lymphoma regimen and developed acute psychosis which required psychiatric hospitalization.”
All of these side effects point to the need to closely monitor people taking these drugs, he adds.
If the president’s doctors prescribe the recommended dose, Trump will finish his course of treatment early next week.