New studies clarify what drugs help, hurt for COVID-19
London: Fresh studies give more information about what treatments do or don't work for COVID-19, with high-quality methods that give reliable results.
British researchers on Friday published their research on the only drug shown to improve survival -- a cheap steroid called dexamethasone.
Two other studies found that the malaria drug hydroxychloroquine does not help people with only mild symptoms.
For months before studies like these, learning what helps or harms has been undermined by desperation science as doctors and patients tried therapies on their own or through a host of studies not strong enough to give clear answers.
For the field to move forward and for patients' outcomes to improve, there will need to be fewer small or inconclusive studies and more like the British one, Drs. Anthony Fauci and H. Clifford Lane of the National Institutes of Health wrote in the New England Journal of Medicine.
It's now time to do more studies comparing treatments and testing combinations, said Dr. Peter Bach, a health policy expert at Memorial Sloan Kettering Cancer Center in New York.
Here are highlights of recent treatment developments:
DEXAMETHASONE
The British study, led by the University of Oxford, tested a type of steroid widely used to tamp down inflammation, which can become severe and prove fatal in later stages of COVID-19.
About 2,104 patients given the drug were compared to 4,321 patients getting usual care.
It reduced deaths by 36% for patients sick enough to need breathing machines: 29% on the drug died versus 41% given usual care. It curbed the risk of death by 18% for patients needing just supplemental oxygen: 23% on the drug died versus 26% of the others.
However, it seemed harmful at earlier stages or milder cases of illness: 18% of those on the drug died versus 14% of those given usual care.
The clarity of who does and does not benefit probably will result in many lives saved, Fauci and Lane wrote.
HYDROXYCHLOROQUINE
The same Oxford study also tested hydroxychloroquine in a rigorous manner and researchers previously said it did not help hospitalized patients with COVID-19.
After 28 days, about 25.7% on hydroxychloroquine had died versus 23.5% given usual care -- a difference so small it could have occurred by chance Now, details published on a research site for scientists show that the drug may have done harm.
Patients given hydroxychloroquine were less likely to leave the hospital alive within 28 days -- 60% on the drug versus 63% given usual care. Those not needing breathing machines when they started treatment also were more likely to end up on one or to die.
Two other experiments found that early treatment with the drug did not help outpatients with mild COVID-19.
A study of 293 people from Spain published in the journal Clinical Infectious Diseases found no significant differences in reducing the amount of virus patients had, the risk of worsening and needing hospitalization, or the time until recovery.
A similar study by University of Minnesota doctors in Annals of Internal Medicine of 423 mildly ill COVID-19 patients found that hydroxychloroquine did not substantially reduce symptom severity and brought more side effects.
It is time to move on from treating patients with this drug, Dr. Neil Schluger from New York Medical College wrote in a commentary in the journal.
REMDESIVIR
The only other therapy that's been shown to help COVID-19 patients is remdesivir, an antiviral that shortens hospitalization by about four days on average.
The role of remdesivir in severe COVID is now what we need to figure out, Memorial Sloan Kettering's Bach wrote in an email, saying the drug needs to be tested in combination with dexamethasone now.
Details of the government-led remdesivir study have not yet been published, but researchers are eager to see how many patients received other drugs such as steroids and hydroxychloroquine.
Meanwhile, Gilead Sciences, the company that makes remdesivir, which is given as an IV now, has started testing an inhaled version that would allow it to be tried in less ill COVID-19 patients to try to keep them from getting sick enough to need hospitalisation.
Gilead also has started testing remdesivir in a small group of children.
Supplies are very limited, and the U.S. government is allocating doses to hospitals through September.
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Criticism of PM Modi, repeated mentions of guarantees to be highlights of K’taka Budget: LoP Ashoka
Bengaluru (PTI): Leader of Opposition in the Karnataka Assembly R Ashoka on Thursday took a dig at CM Siddaramaiah ahead of the state Budget presentation, claiming that the government is expected to borrow Rs 1.15 lakh crore and is likely to impose fresh taxes on the people.
He said the Budget would have nothing new, adding that its highlights would be criticism of Prime Minister Narendra Modi and repeated mentions of the five guarantee schemes ('Shakti', 'Gruha Lakshmi', 'Gruha Jyoti, 'Yuva Nidhi' and 'Anna Bhagya').
Chief Minister Siddaramaiah, who also holds the Finance portfolio, is scheduled to present the 2026–27 Budget on March 6. This will be his record 17th budget.
“Siddaramaiah-led Congress government’s budget will be presented tomorrow. While Finance Minister Nirmala Sitharaman reduced the tax burden in the Union Budget, Siddaramaiah is known for imposing taxes on people. He imposes about four taxes a month and has already introduced 36 taxes, and is now looking for ways to impose more,” Ashoka said.
Speaking to reporters, he said the Congress had promised people before coming to power that the guarantee schemes would be implemented without imposing any burden on them.
“By the end of the chief minister’s term, the state’s total debt will probably exceed Rs 6 lakh crore. The government has already breached financial discipline. Siddaramaiah and his government are somehow managing the situation,” Ashoka claimed, adding that his borrowings as CM equal those of 12 or 13 former chief ministers combined.
Stating that the Budget should create higher revenue sources, ensure that no burden is placed on people, and take the state away from debt, the opposition leader said this could be ensured only by a “clever and intelligent finance minister.”
“Anyone can run a government by pushing the state into debt,” he said, accusing Siddaramaiah of “increasing the state’s debt and failing to meet the expectations of the people.”
Highlighting that Siddaramaiah blames the previous BJP government for everything, Ashoka said Basavaraj Bommai, the chief minister during the previous BJP government, had presented a “surplus budget,” without excessive borrowings.
“Despite having the opportunity to borrow more while staying within the parameters of financial discipline, he (Bommai) did not do so, as it would burden the people,” he said, accusing Siddaramaiah of borrowing crores of rupees every year.
“I feel that this time too, he will take a loan of Rs 1.15 lakh crore,” he claimed.
The BJP leader said he had written to the CM requesting an allocation of Rs 15,000 crore annually for the development of backward taluks, as recommended by the High Power Committee on Redressal of Regional Imbalance (HPCRRI), chaired by economist Prof M Govinda Rao.
Claiming that the government appears “inactive” due to internal rifts, Ashoka pointed to an ongoing power struggle between factions led by Siddaramaiah and Deputy Chief Minister D K Shivakumar over the CM’s post.
“Amid all this, we cannot expect anything new from this Budget. The CM will repeatedly speak about the guarantee schemes and target the central government and PM Modi. Criticising Modi and repeated mentions of the five guarantee schemes will be the highlight of this Budget. Other than that, there will be nothing new,” he added.
He also dismissed the CM's claim that the government had achieved 90 per cent of the promises made in the previous Budget. “The fact is that not even 9 per cent has been achieved. I have evidence for it,” he said.
Ashoka further alleged that the government had also failed in tax collection, achieving only 48 per cent of the target, and had released less than 40 per cent of the allocated funds to some departments.
