The default drug for severe covid-19 might only work in men

Beware a blanket approach to treatment.
Beware a blanket approach to treatment.
Image: Reuters
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Covid-19 is here to stay a while longer, and more treatments are being developed and adopted to prevent it from advancing to a severe state. For covid-19 patients with severe lung infections, so far the default treatment has been dexamethasone, a steroid used for a range of conditions including arthritis, severe allergies, inflammation, and asthma.

However, a new study published in Nature by a team of researchers at the University of Calgary found that while the drug might indeed have an effect in treating covid-19, it likely does so only in men.

According to guidelines from the US National Institute of Health’s (NIH), the use of dexamethasone in patients with severe covid-19 for hospitalized patients who require supplemental oxygen, as the drug helps reduce the inflammation often associated with the condition. The drug is administered intravenously once a day for up to 10 days.

The NIH recommends against using dexamethasone when the patient has no need for additional oxygen, as it did not observe significant benefits in such cases. Yet the research found another situation in which dexamethasone doesn’t appear to bring much benefits: When the patient is a woman.

Why dexamethasone might not work for women

The reason behind the different outcomes is a result of the way covid-19 develops in men and women. Researchers observed that interferon, a protein that typically works quickly to resolve viral infections, trickles along in severe covid-19 infections, staying in the system and causing severe inflammation in patients. It is during this inflammatory state that organ damage is more likely.

Dexamethasone reduces the body’s reaction to interferon, and as a consequence, it calms the inflammation. The research found however that male and female patients had different reactions to interferon, and men had a much stronger inflammatory reaction to it. In women, on the other hand, the inflammation was much lower, so dexamethasone had little effect in improving the overall clinical situation.

“Currently, it’s possible the mainstay therapy for severe COVID-19 that we’re giving everybody is only benefiting half the population. This is a big problem,” Bryan Yipp, a professor of pulmonary immunology at the University of Calgary, said in a statement.

According to Yipp, this finding should inform a more targeted approach to treatment and individualized therapies, rather than blanket approaches.