Higher steroid dose for severe Covid less beneficial for Indians than Europeans: Study

Higher doses of steroids (dexamethasone) had less benefits to patients with severe Covid-19 in India, according to a study published on Monday in the journal The Lancet Regional Health – Southeast Asia.

However, it had significant benefits for severe Covid patients in Europe, said a team of international researchers from India, the UK and Denmark.

The study was conducted in Europe and India to examine the effects of giving patients injectable 12 mg versus 6 mg of dexamethasone every day for a maximum of 10 days.

About 1,000 adult patients hospitalised with Covid-19 and severe hypoxaemia were enrolled from 26 hospitals in Denmark, India, Sweden and Switzerland between August 2020 and May 2021. Patients were randomised 1:1 to dexamethasone 12 mg or 6 mg intravenously (IV) once daily for up to 10 days.

On day 28, the higher-dose group’s risk of death was 8.3 per cent lower for patients in Europe, whereas there was essentially no difference (0.1 per cent) in India.

The mortality benefits continued to be reduced for patients enrolled in India on day 90 and day 180, fewer number of days alive without life support at day 90, and at 180 days.

But reassuringly, there did not appear to be an increase in the occurrence of serious adverse reactions at day 28 in Indian patients compared to Europeans.

“Variations in patient characteristics, healthcare infrastructure, resource availability, and comorbidity profiles may be the cause of the regional disparities in treatment effects,” said researchers including from the George Institute for Global Health, in the paper.

“The observed discrepancies could be explained by variables including different levels of healthcare-associated infections, a higher incidence of diabetes, and the use of other anti-inflammatory medications such IL-6 inhibitors,” they added