Introduction

Apart from the research for Covid 19 vaccine, there are also developments in clinical trials for alternative effective treatments for the disease. Dexamethasone is a medication proved to be useful as the treatment for severe and critical coronavirus disease 2019 (COVID-19) patients. In this article, we will explore in detail on dexamethasone and its typical side effects as a treatment for COVID-19.

What is dexamethasone?

Dexamethasone is an anti-inflammatory medication, belonging to the family of corticosteroids. It works by suppressing inflammation and dampening the immune system of our body. It is used to treat a wide range of inflammatory conditions such as arthritis, skin diseases, asthma, immune diseases and many more.

Dexamethasone is a drug of wide availability which can be used in the form of oral medication, aerosol spray or injection.

What is the role of dexamethasone in COVID-19 treatment?

Virus infection in the lung might potentially trigger an immune response which indirectly damages the lung. A whole body inflammatory response will eventually lead to various organs injury and dysfunction.

Dexamethasone is used as one of the treatments for patients with severe and critical cases of COVID-19. Treatment is given in the form of oral medication or intravenously (infusion into vein). The treatment will last for 7-10 days. It is known to be safe for use in all age groups and recommended for pregnant women requiring oxygen therapy.

Lung injury in COVID-19 occurs much later compared with other respiratory illnesses. It happens when a specific antibody against the coronavirus starts to appear. This delay in lung injury of COVID-19 is unique which explains the reason dexamethasone is only useful in the late stage of the disease. Hence the World Health Organisation (WHO) does not recommend the use of dexamethasone in non-severe cases of COVID-19.

Effectiveness of dexamethasone as COVID-19 treatment

Dexamethasone was shown to be effective as one of the treatments for COVID-19 patients. It has shown to reduce mortality of patients on ventilators or supplemental oxygen.

It prevents one in three deaths in patients on ventilators and one fifth of patients requiring oxygen.

What are the typical side effects of dexamethasone during COVID-19 treatment?

A dexamethasone treatment for COVID-19 patients is only designated for a short period of time. Moreover, the dosage used in COVID-19 patients is low to prevent the serious side effects of corticosteroid.

A raise in blood glucose level is the side effect known for the short-term treatment for COVID-19 patients. In diabetic patients, it might worsen the disease. However, the side effect is temporary. Serious side effects of corticosteroid are not known for the short-term usage of dexamethasone.

The side effects of prolonged usage of dexamethasone are weight gain, fatigue, increased risk of infections, diabetes, increased risk of fracture, depression, anxiety, high blood pressure, menstrual irregularity in females and erectile dysfunction in male.

In pregnant patients receiving dexamethasone, a repetitive dose might lead to several side effects as dexamethasone can cross the placenta and reach the fetus. This can result in fetal growth restriction, smaller head circumference, neurological problems and low blood glucose in the newborn.

Conclusion

Dexamethasone is an immunosuppressive and anti-inflammatory medication. It is used in the treatment of COVID-19 for patients requiring mechanical ventilation and supplemental oxygen. The treatment is administered short term (7-10 days) in low dose with temporary high blood glucose as the only side effect of note. In conclusion, dexamethasone manages to reduce the mortality rate of patients suffering from severe and critical cases of COVID-19.

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