Everyone is looking for some medication, vaccine, or magic pill to treat COVID. While we haven’t found it yet, there is evidence out of England that Dexamethasone can be helpful in preventing serious morbidity (injury) and even mortality (death) in a percentage of patients with COVID.
Steroids are a magnificent medication that works by decreasing the inflammatory response that the body uses as a defense mechanism. In some cases the body's response is more damaging than the disease itself.
It appears that COVID may be one of these. The “cytokine storm” you may have heard about is the body's way of mounting troops to fight off the infection - but with a significant risk of collateral damage. It is similar to a fever that the body creates in order to fight a cold, but far more severe and life-threatening. Steroids appear to limit the body's response, thereby minimizing one of the key challenges that patients with COVID have been facing.
In ENT, we use topical steroids sprays or drops frequently to treat local inflammation such as sinus disease and external ear infections. We also use systemic (ingested) steroids to help patients with difficulty breathing or with certain forms of sudden-onset hearing loss.
Steroids certainly have their share of risks and side effects and should never be taken without a physician's prescription and consideration of the risks and benefits. Generally speaking for an otherwise healthy patient, taking short term steroids is very well tolerated. The use of steroids in the fight against COVID is a welcome tool in an otherwise fairly limited armory.
We still need more research on the topic and certainly need continued public vigilance but it’s a step in the right direction.