An inexpensive and commonly used steroid can save the lives of people seriously ill with COVID, a randomized, controlled clinical trial in the United Kingdom has found. The drug, called dexamethasone, is the first shown to reduce deaths from the coronavirus that has killed more than , people globally. In the trial, it cut deaths by about one-third in patients who were on ventilators because of coronavirus infection.
How deadly is the coronavirus? Scientists are close to an answer. The dexamethasone arm enrolled 2, participants who received the drug at a low-to-moderate dose of 6 milligrams per day for 10 days, and compared how they fared against about 4, people who received standard care for coronavirus infection. The effect of dexamethasone was most striking among critically ill patients on ventilators. The steroid had no effect on people with less severe cases of COVID — those not receiving oxygen or ventilation.
Shortly after the results were released, the UK government announced that it had immediately authorized the use of dexamethasone for patients hospitalized with COVID who required oxygen, including those on ventilators. The researchers say that they are also sharing their findings with regulators in the United Kingdom and internationally.
Data from steroid trials during outbreaks of severe acute respiratory syndrome and Middle East respiratory syndrome caused by related coronaviruses were inconclusive, he says. Treatment guidelines from the World Health Organization and many countries have cautioned against treating people with coronavirus with steroids, and some investigators were concerned about anecdotal reports of widespread steroid treatment.
The drugs suppress the immune system, which could provide some relief for patients whose lungs are ravaged by an overactive immune response that sometimes manifests in severe cases of COVID But such patients may still need a fully functioning immune system to fend off the virus itself.
Dozens of coronavirus drugs are in development — what happens next? The study found no outstanding adverse events from the treatment, investigators said. And the pattern of response — with a greater impact on severe COVID and no effect on mild infections — matches the notion that a hyperactive immune response is more likely to be harmful in long-term, serious infections, says Anthony Fauci, head of the US National Institute of Allergy and Infectious Diseases. So far, the only other drug shown to benefit people with COVID in a large, randomized, controlled clinical trial is the antiviral drug remdesivir.
Remdesivir was shown to shorten the amount of time that patients might need to spend in hospital, but it did not have a statistically significant effect on deaths 2. Remdesivir is also in short supply. And remdesivir is complex to administer: it must be given by injection over the course of several days.
Dexamethasone, by contrast, is a medical staple found on pharmacy shelves worldwide and is available as a pill — a particular benefit as coronavirus infections continue to rise in countries with limited access to health care. The findings could also have implications for other severe respiratory illnesses, Baillie adds. For example, steroid treatments for a condition called acute respiratory distress syndrome are also controversial.
Horby, P. Beigel, J. Article Google Scholar. Download references. Both males and females have testosterone produced in their bodies: males in the testes, and females in the ovaries and other tissues. The full name for this class of drugs is androgenic promoting masculine characteristics anabolic tissue building steroids the class of drugs. The common street slang names for anabolic steroids include arnolds, gym candy, pumpers, roids, stackers, weight trainers, and juice.
Steroids are purported to increase lean body mass, strength and aggressiveness. Steroids are also believed to reduce recovery time between workouts, which makes it possible to train harder and thereby further improve strength and endurance. Some people who are not athletes also take steroids to increase their endurance, muscle size and strength, and reduce body fat which they believe improves personal appearance.
Doctors may prescribe steroids to patients for legitimate medical purposes such as loss of function of testicles, breast cancer, low red blood cell count, delayed puberty and debilitated states resulting from surgery or sickness. Veterinarians administer steroids to animals e. They are also used in veterinary practice to treat anemia and counteract tissue breakdown during illness and trauma. For purposes of illegal use there are several sources; the most common illegal source is from smuggling steroids into the United States from other countries such as Mexico and European countries.
Smuggling from these areas is easier because a prescription is not required for the purchase of steroids. Less often steroids found in the illicit market are diverted from legitimate sources e. Anabolic steroids dispensed for legitimate medical purposes are administered several ways including intramuscular or subcutaneous injection, by mouth, pellet implantation under the skin and by application to the skin e.
These same routes are used for purposes of abusing steroids, with injection and oral administration being the most common. People abusing steroids may take anywhere from 1 to upwards of a times normal therapeutic doses of anabolic steroids. This often includes taking two or more steroids concurrently, a practice called "stacking.
This practice is called "cycling. Doses of anabolic steroids used will depend on the particular objectives of the steroid user. Athletes middle or high school, college, professional, and Olympic usually take steroids for a limited period of time to achieve a particular goal. Others such as bodybuilders, law enforcement officers, fitness buffs, and body guards usually take steroids for extended periods of time.
The length of time that steroids stay in the body varies from a couple of days to more than 12 months. There is increasing concern regarding possible serious health problems that are associated with the abuse of steroids, including both short-term and long-term side effects. The short-term adverse physical effects of anabolic steroid abuse are fairly well known. Short-term side effects may include sexual and reproductive disorders, fluid retention, and severe acne. The short-term side effects in men are reversible with discontinuation of steroid use.
Masculinizing effects seen in women, such as deepening of the voice, body and facial hair growth, enlarged clitoris, and baldness are not reversible. The long-term adverse physical effects of anabolic steroid abuse in men and in women, other than masculinizing effects, have not been studied, and as such, are not known.
However, it is speculated that possible long-term effects may include adverse cardiovascular effects such as heart damage and stroke. Under this legislation, anabolic steroids are defined as any drug or hormonal substance chemically and pharmacologically related to testosterone other than estrogens, progestins, and corticosteroids that promotes muscle growth. The possession or sale of anabolic steroids without a valid prescription is illegal. If this is the second felony drug offense, the maximum period of imprisonment and the maximum fine both double.
While the above listed penalties are for federal offenses, individual states have also implemented fines and penalties for illegal use of anabolic steroids. Major League Baseball, National Basketball Association, National Football League NFL , and National Hockey League have banned the use of steroids by athletes, both because of their potential dangerous side effects and because they give the user an unfair advantage.
This Act identified anabolic steroids as a separate drug class and categorized over two dozen drugs as controlled substances. The Act also gave a four-part definition of this drug class, which allowed for flexibility in controlling new anabolic steroids as they were synthesized. In , Congress enacted the Anabolic Steroid Control Act of , which banned over-the-counter steroid precursors; increased penalties for making, selling, or possessing illegal steroid precursors; and provided funds for preventative educational efforts.
Other countries, such as Mexico and some European nations, where steroids are available without prescription, are the main sources of illegal steroids smuggled into the United States. Less common illicit sources include diversion from legitimate sources e. National Institutes of Health. Drug Topics. From the s into the s, both rumors and facts of performance-enhancing drug use combined to increase actual use.
Many athletes seemed to believe they had to use in order to remain competitive. Those athletes who require bulk and strength to be competitive, like bodybuilders, football players, and shotput throwers, were the first to abuse anabolic-androgenic steroids. During the 's demand for anabolic-androgenic steroids grew as athletes in speed-dependent sports discovered some of the potential benefits to using anabolic-androgenic steroids.
For one thing, the drugs allow athletes to train harder because muscle strains and tears repair themselves faster. All of this "doping" was against the sports organizations' rules and against the law. In , the International Olympic Committee first published a list of banned drugs and practices for athletes, but the IOC did not ban steroids until In the 's, steroid use continued in a sort of "gray market" area. Some elite-level athletes continued to use. Many non-competitive athletes and bodybuilders began to use steroids during this period, as well.
The first known case of a bodybuilder contracting AIDS from sharing a needle for steroid use was reported in In the sale of anabolic-androgenic steroids for non-medical purposes was illegal under the Anti-Drug Abuse Act of In , possession of anabolic-androgenic steroids without a prescription was made illegal in the U.
Home Mental Health Topics. History of Steroid Use.
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