The top priority for all health authorities is to find a treatment to rescue patients with Covid-19, in particular those who develop a severe form of the disease, such as acute respiratory failure. The organizations guaranteeing our health seek “to improve the care and the vital prognosis” of these patients.
The CAPE-COVID study
The results of the CAPE-COVID study as well as of 3 other trials, including the administration of corticosteroids, were published on September 2, by the scientific team, in particular that of INSERM, in the JAMA (Journal of the American Medical Association). CAPE-COVID is managed by Prof. Pierre-François Dequin, head of the intensive medicine department of the Tours University Hospital and Prof. Djillali Annane, head of the intensive care and resuscitation department of the Raymond Poincaré hospital (Assistance Publique-Hôpitaux de Paris) . At the same time, 7 other studies on corticosteroid therapy were underway around the world. The first trial that demonstrated the beneficial effects of this treatment is the UK RECOVERY trial. Dexamethasone, a synthetic corticosteroid, reduced the mortality of patients in intensive care on oxygen by 11% and 30% for patients on ventilation. After this announcement, the most advanced studies ceased to be the subject of meta-analyzes.
Corticosteroid therapy, the hope of treatment for severe cases of COVID
It is the scientific data of several combined studies (CAPE-COVID, REMAP-CAP and RECOVERY) that lead to this conclusion. They concern 1,703 patients in 12 different countries. They received, by lot, either standard care, or a placebo combined with standard care, or a corticosteroid (dexamethasone, hydrocortisone or methylprednisolone). The statistics lead to the same conclusion: “treatment with corticosteroids would reduce the risk of death from severe forms of Covid-19 by 21%”. In fact, 3 to 4 weeks after starting treatment, patients who received a corticosteroid had “a relative risk of mortality of less than 21% compared to patients receiving only symptomatic treatment or symptomatic treatment combined with placebo. In addition, no side effects specific to treatment with corticosteroids have been demonstrated ”. It is a discovery that significantly advances the search for treatment for people with severe forms of Covid-19, in addition to increasing their chances of survival. Inserm is continuing its research into blood samples from these patients to “better understand the impact of corticosteroids on the immune defenses of patients with Covid-19”.
