当世界等待着新冠肺炎疫苗，研究可能的治疗方法的研究人员发现了一种被称为地塞米松的常用类固醇，它可能有助于挽救三分之一最终使用呼吸机的患者。
虽然另一种药物remdesivir已被证明能帮助患有COVID-19的重症患者更快康复，但这是首次有任何药物被证明能显著提高呼吸机患者的存活率。
“这是一项激动人心的临床试验——这是第一项如此大规模的研究，显示死亡率显著下降，”南岸健康中心感染预防主任托德·埃勒林博士说。
这项研究是在联合王国，包括来自175家医院的近6500名患者。结果尚未通过传统的同行审查程序进行审查。
2020年6月16日，英国加的夫，一家药店里一盒地塞米松片的特写镜头。今天宣布的一项试验结果显示，地塞米松，一种用于减轻炎症的廉价且广泛使用的类固醇药物，在住院的病情最严重的COVID-19患者中降低了约三分之一的死亡率。
研究人员发现，接受低剂量类固醇机械通气的患者比接受标准护理的患者更有可能康复。
与此同时，这种药物似乎也有益于那些需要氧气辅助而不需要机械通气的患者，将这一组的死亡率降低了约20%。
这种药物似乎并不能帮助COVID-19症状较轻、能够自主呼吸的患者。
地塞米松是一种低成本、广泛使用的抗炎药物，已经存在了近65年。这种药物非常有效，以至于一个独立的监测委员会建议研究的这一部分尽早结束，这样公众就可以看到结果。
范德比尔特大学医学中心的预防医学和传染病教授威廉·沙夫纳博士说:“这项研究似乎表明，与需要通气或氧疗的病人相关的死亡人数可以减少，而且他们在重症监护室的时间也可能缩短。”。
此前一直有关于使用类固醇的争论，因为一些研究显示效果不佳。
“COVID-19有两部分，病毒和炎症，”埃勒林说。“类固醇具有抗炎作用，可以减轻炎症，或肺部的免疫反应，甚至肺部周围的血管和其他器官，包括心脏、肾脏和肝脏，这些都是病毒常见的部位。然而，类固醇可能会增加病毒的数量。”
这种药物和类似的类固醇正在美国即将进行的临床试验中进行研究。
“我并不是说地塞米松对每个人都适用，”埃勒林补充道，“但现在我们需要强烈考虑对COVID-19严重或危重患者使用它。”
2020年4月8日，在德国汉堡大学医院的新闻发布会上，一瓶抗病毒药物remdesivir的照片。
专家强调，病情较轻的人可能不会受益于地塞米松，并恳求美国公众坚持采取预防措施，包括社交距离、戴口罩和手部卫生。
沙夫纳补充道:“研究表明，处于最严重的晚期阶段的人会受益，而不是早期阶段的病人。”。“这并不能阻止他们发展成重病，但一旦你到了那里，就可以给他们药物，这样你就有可能降低死亡率。”
对冠状病毒了解多少:
耶鲁大学儿童和青少年精神病学研究员，医学博士阿约德拉·阿迪根是美国广播公司新闻医学组的撰稿人。
它是如何开始的以及如何保护自己:冠状病毒解释
如果你有症状怎么办:冠状病毒症状
跟踪在美国和全球的传播:冠状病毒图谱
Steroids reduce COVID-19 deaths among seriously ill patients, UK study suggests
As the world awaits aCOVID-19vaccine, researchers studying possible treatments have found a commonly used steroid called dexamethasone that might help save one-third of patients who end up on ventilators.
While another drug, remdesivir, has been shown to help people severely ill with COVID-19 recover more quickly, this is the first time any drug has been shown to significantly boost the survival rate of patients on ventilators.
"This is an exciting clinical trial -- it is the first study of this magnitude that has shown a significant decrease in mortality," said Dr. Todd Ellerin, chief of infection prevention at South Shore Health.
The study, conducted in theUnited Kingdom, included almost 6,500 patients from 175 hospitals. The results have not yet been vetted through the traditional peer review process.
A close-up of a box of Dexamethasone tablets in a pharmacy on June 16, 2020, in Cardiff, United Kingdom. Results of a trial announced today have shown that Dexamethasone, a cheap and widely used steroid drug which is used to reduce inflammation, reduced death rates by around a third in the most severely ill COVID-19 patients who were admitted to the hospital.
Researchers found that patients on mechanical ventilators who were given a low dose of the steroid were more likely to recover than those who received standard care.
Meanwhile, the drug also seemed to benefit patients who required oxygen assistance without mechanical ventilation, reducing deaths in this group by about 20%.
The drug did not seem to help patients with milder COVID-19 symptoms who were able to breathe on their own.
Dexamethasone is a low-cost, widely available anti-inflammatory drug that has been around for almost 65 years. The drug worked so well that an independent monitoring board recommended that this part of the study end early so the public could see the results.
"This study appears to indicate that the fatalities associated with patients who need ventilations or oxygen therapy can be reduced, and probably the duration they spend in the ICU can be reduced," said Dr. William Schaffner, a professor of preventive medicine and infectious diseases at the Vanderbilt University Medical Center.
There has previously been ongoing debate on the use of steroids, as some studies have shown poor outcomes.
"COVID-19 has two parts, the virus and the inflammation," Ellerin said. "Steroids are anti-inflammatory and can reduce inflammation, or the immune response in the lungs, or even the vessels around the lungs and other organs, including the heart, kidneys and liver, which is common with the virus. However, steroids can potentially increase the amount of the virus."
This drug and similar steroids are being studied in forthcoming clinical trials in the United States.
"I am not saying dexamethasone is for everyone," Ellerin added, "but right now we need to strongly consider it for patients who are severely or critically ill from COVID-19."
An ampule of the antiviral drug remdesivir is pictured during a news conference at the University Hospital Eppendorf (UKE) in Hamburg, Germany, on April 8, 2020.
Experts emphasized that people who are less sick may not benefit from dexamethasone, and implored the American public to adhere to preventative measures that include social distancing, mask wearing and hand hygiene.
"The study suggests that people in the latter, most severe stages will benefit, not patients from earlier stages," Schaffner added. "It won't prevent them from moving into serious sickness, but once you are there, the drug can be given and you can possibly reduce your chances for mortality."
What to know about the coronavirus:
Ayodola Adigun, M.D., M.S., a fellow in child and adolescent psychiatry at Yale University, is a contributor to the ABC News Medical Unit.
How it started and how to protect yourself:Coronavirus explained
What to do if you have symptoms:Coronavirus symptoms
Tracking the spread in the U.S. and worldwide:Coronavirus map
