Nati Harnik / AP
President Trump told Fox Business Network Thursday that he would be taking a steroid for COVID-19 “a little longer”. As his doctors told reporters last weekend, Trump started taking the drug on Saturday while he was still at Walter Reed National Military Medical Center.
The steroid dexamethasone is now part of the “standard of care” for COVID-19, said Dr. Celine Gounder, Assistant Professor of Medicine and Infectious Diseases at New York University School of Medicine.
“It’s an old drug, it’s cheap,” she said. “Of all the drugs we use for COVID, we have the most experience with them.”
Dexamethasone is an anti-inflammatory drug that is used for a number of diseases, including arthritis, kidney, blood, and thyroid disorders, and severe allergies. The drug is on the World Health Organization’s list of major drugs and is also used to treat certain types of cancer.
Earlier this year, a large clinical study in the UK found that giving dexamethasone to patients hospitalized with COVID-19 reduced the risk of death. Patients received 6 milligrams of the drug for 10 days.
The study, published in The New England Journal of Medicine In July, it was found that mortality was reduced by a third in seriously ill COVID-19 patients who received ventilators and a fifth in patients who received supplemental oxygen. It was found to be of no benefit to patients with mild illness and there was some evidence of possible harm.
Later in the course of the disease, COVID-19 can cause the immune system to go into high gear and damage the lungs and other organs. This can happen to people who are seriously ill. Dexamethasone helps these patients by suppressing the body’s immune response.
The Infectious Diseases Society of America now recommends that critically ill COVID-19 patients on ventilators and patients in need of oxygen be given 6 milligrams of the drug for 10 days. However, it is recommended not to use the drug on people with mild medical conditions who do not need supplemental oxygen.
While this commonly used drug is generally safe, there are a number of known side effects. “By far the most common is hyperglycemia. So that’s where your blood sugar rises,” said Gounder.
A number of psychiatric side effects are also common, especially in older patients, she added.
“Anything that makes you feel like you are on top of the world … your arthritic pains and aging symptoms just go away, you have a lot of energy,” she said. “There can be some grandiosity.”
The drug can also cause restlessness, insomnia, and even psychosis, Gounder said. “My own father was treated with high-dose steroids as part of his lymphoma regimen and developed acute psychosis that required a psychiatric hospital stay.”
All of these side effects suggest a need to carefully monitor the people taking these drugs, she added.
When the president’s doctors have prescribed the recommended dose for him, Trump will end his treatment early next week.