JUST IN: Dexamethasone proves first life-saving drug to use against Covid-19

It wasn't the first, nor is the usefulness of corticosteroids a new discovery. Dr. Ban already explained in what situations corticosteroids (like dexamethasone, prednisone or methylprednisolone; all immuno-suppressors) are warranted or needed as an escalation of care on March 25 (see after 3:29 in that video where he literally names the first 2). Corticosteroids are the focal point of the MATH+ protocol and the Covid-19 protocol of the Eastern Virginia Medical School (EVMS).

It is old news, but it's nice to see the media and others don't have such a big issue with it as with HCQ. And luckily, Trump didn't mention it. It would work even better if they added HCQ + quality care first (which includes corticosteroids as an escalation of care, because corticosteroids, immunosuppressors, are more invasive than HCQ + Azithromycin. I explained it in more detail in my response to the MATH+ protocol. A subsequent comment of mine there mentions in response to Willtell:

Methylprednisolone, the main ingredient in the MATH+ protocol, is not a "natural, non-pharmaceutical" cure. It's a synthetic (designer) drug. It's rather invasive as an immunosuppressor but it does do the trick (of dampening the cytokine storm). There are other less invasive options though, such as preventing the cytokine storm altogether with early treatment (outpatient, before they get to the hospital) with HCQ + Azithromycin + zinc + copper + vitC+D3 (+ melatonin, optional).

But it's pretty decent as part of a hospital protocol (but then again, if these patients have never been given HCQ, it's advisable to try that first to see if that's enough, in the outpatient setting it's almost always enough with the combination of substances earlier mentioned). Methylprednisolone is a way to take the treatment to the next level (in terms of taking more drastic measures to prevent further damage from the cytokine storm, should be determined on a patient by patient basis, not a rigorous protocol that people feel the need to follow to the letter, regardless of patient specifics, or whether or not the patient has already had HCQ + quality care, including those substances I mentioned).

It's nice to see they're finally coming around on the subject of corticosteroids (like dexamethasone, prednisone or methylprednisolone) though, it's a start. Cause earlier, as the EVMS mentions:

Note: Early termination of ascorbic acid and corticosteroids will likely result in a rebound effect with clinical deterioration (see Figure 3).
...
Scientific Rational for MATH+ Treatment Protocol
...
The above pathologies are not novel, although the combined severity in COVID-19 disease is considerable. Our long-standing and more recent experiences show consistently successful treatment if traditional therapeutic principles of early and aggressive intervention is achieved, before the onset of advanced organ failure. It is our collective opinion that the historically high levels of morbidity and mortality from COVID-19 is due to a single factor: the widespread and inappropriate reluctance amongst intensivists to employ anti-inflammatory and anticoagulant treatments, including corticosteroid therapy early in the course of a patient’s hospitalization. It is essential to recognize that it is not the virus that is killing the patient, rather it is the patient’s overactive immune system. [71] The flames of the “cytokine fire” are out of control and need to be extinguished. Providing supportive care (with ventilators that themselves stoke the fire) and waiting for the cytokine fire to burn itself out simply does not work... this approach has FAILED and has led to the death of tens of thousands of patients.

The systematic failure of critical care systems to adopt corticosteroid therapy resulted from the published recommendations against corticosteroids use by the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the American Thoracic Society (ATS), Infectious Diseases Association of America (IDSA) amongst others. A very recent publication by the Society of Critical Care Medicine and authored one of the members of the Front Line COVID-19 Critical Care (FLCCC) group (UM), identified the errors made by these organizations in their analyses of corticosteroid studies based on the findings of the SARS and H1N1 pandemics.[31,80] Their erroneous recommendation to avoid corticosteroids in the treatment of COVID-19 has led to the development of myriad organ failures which have overwhelmed critical care systems across the world.

Our treatment protocol targeting these key pathologies has achieved near uniform success, if begun within 6 hours of a COVID19 patient presenting with shortness of breath or needing ≥4L/min of oxygen. If such early initiation of treatment could be systematically achieved, the need for mechanical ventilators and ICU beds will decrease dramatically.

It is important to recognize that “COVID-19 pneumonia” does not cause ARDS. The initial phase of “oxygenation failure” is characterized by normal lung compliance, with poor recruitability and near normal lung water (as measured by transpulmonary thermodilution). This is the “L phenotype” as reported by Gattonini and colleagues. [81-84] Treating these patients with early intubation and the ARDNSnet treatment protocol will cause the disease you are trying to prevent i.e. ARDS. These patients tolerate hypoxia remarkable well, without an increase in blood lactate concentration nor a fall in central venous oxygen saturation. We therefore suggest the liberal use of HFNC, with frequent patient repositioning (proning) and the acceptance of “permissive hypoxemia”. However, this approach entails close patient observation.

Patients in whom the cytokine storm is not “dampened” will progress into the “H phenotype” characterized by poor lung compliance, severe oxygenation failure and PEEP recruitability (see Figure 7). Progression to this phase is exacerbated by ventilator induced lung injury (VILI). The histologic pattern of the “H Phenotype” is characterized by an acute fibrinous and organizing pneumonia (AFOP), with extensive intra-alveolar fibrin deposition called fibrin “balls” with absent hyaline membranes. Corticosteroids seem to be of little benefit in established AFOP. High dose methylprednisolone should be attempted in the “early phase” of AFOP, however many patients will progress to irreversible pulmonary fibrosis with prolonged ventilator dependency and ultimately death. [85,86]
...

Source: EVMS Critical Care COVID-19 Protocol.pdf

I also elaborated a bit on why corticosteroids (like dexamethasone) are more invasive than HCQ + quality care (which still includes an escalation with corticosteroids) in this comment:

(the term 'HCQ's effectiveness' is referring to using HCQ in the right way, Dr. Ban-style, so this includes vitamin C + D3 + Azithromycin with a possible escalation with corticosteroids like prednisone and its derivatives like "methylprednisolone", an immunosuppressor, if needed or warranted, patient specific, if we're talking about "dampening the storm", quoting the EVMS; it also includes 'avoiding intubation at all cost' as the EVMS puts it only to then include intubation into their protocols that have HCQ as an optional and go straight to the more invasive immunosuppressors that open up their patients to those nasty hospital bacteria, regardless of whether or not HCQ + quality care, Dr. Ban-style was tried first to avoid such drastic risky measures that can cause nasty bacterial infections especially in the hospital and especially if you go to intubation eventually anyway. C'mon man!!! What is wrong with these people?! Does nobody get it?)

a reply to: whereislogic
Oh, that information from the EVMS protocol about the behaviour of the WHO, CDC, ATS (no not this forum), IDSA amongst others, is also old news. April or something when they wrote that (the MATH+ protocol seems to have been published on April 24)? So probably somewhere in March or Feb when these organizations were discouraging the use of corticosteroids like dexamethasone, similar to their attitude against HCQ, discouraging physicians from using it and realizing that it works, saving lives in the process. Instead of causing, as the EVMS describes:

... this approach has FAILED and has led to the death of tens of thousands of patients.

Because of:
"The systematic failure of critical care systems to adopt corticosteroid therapy" and "providing supportive care (with ventilators that themselves stoke the fire) and waiting for the cytokine fire to burn itself out", which "simply does not work". All because of "the published recommendations against corticosteroids use by the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the American Thoracic Society (ATS), Infectious Diseases Association of America (IDSA) amongst others. ... Their erroneous recommendation to avoid corticosteroids in the treatment of COVID-19 has led to the development of myriad organ failures which have overwhelmed critical care systems across the world" "and has led to the death of tens of thousands of patients."

Nice that the mainstream media is doing a 180 on this one after staying utterly silent about it at first (for 3 months at least, 4 months perhaps), but it sadly won't bring back the dead.

Btw, dexamethasone has similar heart arrhythmia side effects as HCQ and Azithromycin; but seeing the nature of the media's articles about it, apparently they're not going to make as big an issue out of it, so we'll probably also not get such articles about it that the Lancet published regarding the heart arrhythmia issues of HCQ (+ Azithromycin*).

*: it's actually more azithromycin (brandname: zithromax) that creates the issue in some extremely rare cases, in which case you can switch to Doxycycline and fix the heart rythm issue, as Dr. Ban explains in his "case studies" series as well as the OAN interview (all in the earlier linked playlist, I actually prefer the way he says it in the OAN interview, you know what...)
It's at the end of this video (the question concerning cardiac arrhythmia and Qt prolongation is raised to him at 11:48, remember, he uses the brandname for HCQ, plaquenil):

And because I thought it was worth repeating, the beginning of this video:

Also, don't miss the key points regarding HCQ and dampening the cytokine storm I made in this comment referring to this article:

Cytokine storm and immunomodulatory therapy in COVID-19: Role of chloroquine and anti-IL-6 monoclonal antibodies (NCBI, April 16 2020)

... In addition to their antimalarial and antiviral effects, their anti-inflammatory properties have been demonstrated in the treatment of autoimmune diseases such as rheumatoid arthritis and lupus erythematosus. Chloroquine and hydroxychloroquine can inhibit major histocompatibility complex class II expression, antigen presentation and immune activation (reducing CD154 expression by T cells) via Toll-like receptor signalling and cGAS stimulation of interferon genes [11]. Thus, chloroquine and hydroxychloroquine can reduce the production of various pro-inflammatory cytokines, such as IL-1, IL-6, interferon-α and tumour necrosis factor, which are involved in the cytokine storm [11].
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Immunomodulatory agents that directly target the key cytokines involved in COVID-19 may also help alleviate hyperinflammation symptoms in severe cases [12]. [whereislogic: he can leave out the "may", it should be obvious that it helps] Elevated levels of the inflammatory indicator IL-6 in the blood have been reported to be predictive of a fatal outcome in patients with COVID-19 [13]. ...
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11. Schrezenmeier E, Dörner T. Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology. Nat Rev Rheumatol. 2020 Feb 7 doi: 10.1038/s41584-020-0372-x. [CrossRef] [Google Scholar]
12. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395:1033–1034. [PMC free article] [PubMed] [Google Scholar]
13. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020 Mar 3 doi: 10.1007/s00134-020-05991-x. [CrossRef] [Google Scholar]
...
Funding: None.

Author: Ming Zhao

a. Department of Pharmacy, Beijing Hospital, National Centre of Gerontology, Beijing, P.R. China

b. Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China

No funding is always a good sign. Just an honest guy doing his research properly, the right way. Note, this is called a "literature review", then he uses his common sense to draw rational conclusions based on the data already available. Here, I'll do the same based on the information highlighted above (just the first sentence, the rest is responding to what you said):

HCQ works great even at the latest stages of the disease during the cytokine storm. High dose vitamin C works pretty good at this stage as well, but not as effective at dampening the storm. ...

originally posted by: network dude
a reply to: shawmanfromny

I can only hope Trump doesn't say anything positive about this, or the MSM will kill it.

Lol, everyone, quick, send the shh emoji to Trump's Twitter account!

originally posted by: whereislogic
...Dr. Ban already explained in what situations corticosteroids (like dexamethasone, prednisone or methylprednisolone; all immuno-suppressors) are warranted or needed as an escalation of care on March 25 (see after 3:29 in that video where he literally names the first 2). Corticosteroids are the focal point of the MATH+ protocol and the Covid-19 protocol of the Eastern Virginia Medical School (EVMS).

Oops, Dr. Ban actually mentioned beclomethasone instead of dexamethasone, they sound very similar with his accent (had to hear that one again), but they're both corticosteroids, same idea, suppressing the immune system to dampen the cytokine storm. "Treatment with beclomethasone resulted in significantly improved pulmonary function of RAO-affected horses compared with placebo and dexamethasone treatments." Says the article "Effect of Beclomethasone Dipropionate and Dexamethasone Isonicotinate on Lung Function, Bronchoalveolar Lavage Fluid Cytology, and Transcription Factor Expression in Airways of Horses With Recurrent Airway Obstruction" (2006)

"Dexamethasone is a long-acting glucocorticoid with a half-life of 36 to 72 hours, and is 6 times more potent than prednisone." Says the article "Use of dexamethasone and prednisone in acute asthma exacerbations in pediatric patients" (2009) Sounds a bit more invasive as well like that, but hey, if it works...

originally posted by: Phage
a reply to: Violater1

He'll say that it's all anecdotal and should be studied for 10 months before trials.

Why would he say that? This is a controlled trial, part of a project which has been running since March.
www.recoverytrial.net...

A total of 2104 patients were randomised to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for ten days and were compared with 4321 patients randomised to usual care alone. Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).

Because he is a pompous ass.

a reply to: Violater1

Does that mean that he can't respect science?

My (ex) father-in-law is what some might consider to be a pompous ass, but he is a damned good scientist.

originally posted by: whereislogic
It wasn't the first, nor is the usefulness of corticosteroids a new discovery. ...

Context.

Note what the EVMS protocol now says about this particular study related to dexamethasone (a glucocorticoid, corticoid is short for corticosteroid):

...to receive dexamethasone 6 mg (equivalent to 32 mg methylprednisolone) once per day (either by mouth or by intravenous injection) for ten days... It should be noted that we would consider the non-titratable ‘fixed” dose of dexamethasone used in the RECOVERY-DEXAMETHASONE study to be very low. Furthermore, as indicated above, we consider methylprednisolone to be the corticosteroid of choice for the treatment of COVID-19 pulmonary disease.
...
[going back a little to compare the quantities mentioned above as "very low" with the quantities in the MATH+ protocol that the EVMS uses]
Essential Treatment (dampening the STORM); MATH +

1.Methylprednisolone 80 mg loading dose then 40 mg q 12 hourly for at least 7 days and until transferred out of ICU. In patients with an increasing CRP or worsening clinical status increase the dose to 80 mg q 12 hourly, then titrate down as appropriate. [48-54]
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16. Salvage Treatments
High dose corticosteroids; 120 -250 mg methylprednisolone q 6-8 hourly
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17.Treatment of Macrophage Activation Syndrome (MAS)
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“High dose corticosteroids.” Methylprednisolone 120 mg q 6-8 hourly for at least 3 days, ...

Compare what they said about the RECOVERY-DEXAMETHASONE study using a "very low" dose, with what the guy below says at 1:08 about "when people are not taking enough of those medications when they're on them, they actually are at risk for not being able to fight off those infections quite as well" (a video from before they did their 180 on corticosteroids, glucocorticoids like dexamethasone):

I think I also saw some media reports a couple of months ago that outright gave the false impression that "steroids" (they say it like that then) is like the 'bleach-thing' or 'drinking tonic'-idea (see end of this comment for an example), just some crackpot quackery (like they treated that video with that nurse or MD that was talking about drinking tonic that was removed from youtube early on; who they blasted with the whole 'factcheck' propaganda routine*. Of course as I explained in another thread, there isn't that much quinine in tonic water so it's not a great idea, and HCQ is still way more effective and thus less toxic).

*: here's an example of that, that responds to the video I was talking about (again, not particularly good advice cause HCQ is way more effective and less toxic, less invasive, and tonic water really doesn't have enough quinine in it for any strong beneficial results, it should never be prioritized over getting your hands on HCQ):

Note how fond they are of the word "cure", when the idea of taking quinine + zinc is not to cure, but to help out your immune system fight the virus and the disease, by slowing down viral entry into the cell and viral replication by reducing the function of particular enzymatic activity within the cell, lysosomes and endosomes that the virus uses, hijacks, so to speak. In that sense, it's the same idea with how quinine is used to treat malaria, only there it's the food vacuole of the single-celled bacteria that needs to be entered and then screwed around with by increasing the Ph there (to reduce particular enzymatic activity so it doesn't function correctly).

They did the same trick with HCQ, pointing out it isn't a "cure". Who cares man? Responding to it by pointing that out is like responding to a straw man argument, standard propaganda technique, which works even better if those on the pro-HCQ/CQ/Quinine side fall for it and also use the word "cure" (see edmc^2's thread title, which if you read the thread, Phage corrected him on by using the word "treatment" which he then subsequently agreed with), then it's sort of a straw man with some filling (as in not a pure straw man in the sense that the argument was never made like that, but a straw man that is actually believed or argued that distracts from the more accurate argument that it's a helpful beneficial treatment, so sort of a Don Quijote windmill giant to fight and defeat, like young earth creationism? A straw man if responded to or brought up in any debate with someone who believes in creation but not approx. 6,000 years ago, to ridicule their reasons for believing that; ah I don't know how to describe it, should be a separate terminology for it. Straw man argument is a bit inappropiate).

And besides, it's not even all that inappropiate to refer to HCQ as a "cure", given its highly effectiveness against the corona virus and Covid-19, the disease. In the end though, it's still your own immune system that is 'curing' you. HCQ just makes life hard enough for the virus to make it a little easier for your own immune system to finish it off without overreacting too much (vitamin C does actually 'kill' or destroy the virus though, as part of that immune system reaction; HCQ is more about hampering and slowing down the virus, as well as it's anti-inflammatory and immunomodulating functions in relation to the cytokine storm and most importantly the IL-6 protein).

Checkout below how they associate "steroids" with "swallowing or gargling with bleach" at 8:50 (no need to watch anything else, just the title there); note how they sneakily switched the subject of treating Covid-19 patients with steroids (to dampen the cytokine storm, the actual argument in favor of steroid use), to "protect yourself from Covid-19" (suggesting some prophylactic use), so they can avoid any accusation of actually lying about it, since technically they're right, steroids do not have any prophylactic value, but to associate it with "swallowing or gargling with bleach" by giving the false impression that anyone mentioning "steroids" is basically like those talking about "swallowing or gargling with bleach", is just as dishonest and misleading. Then when someone tries to explain the usefulness of steroids to someone who has read or seen such subtle propagandistic tricks of association, then that person will immediately not take the one arguing in favor of steroids seriously, cause they've already associated them with the 'bleach guy' stereotype which is already triggered upon hearing the term "steroids". Of course, if 2 months pass first, they might have forgotten all about it, especially when a pro-steroid message suddenly comes from what appears to be more legit and trustworthy sources, as is the case now with dexamethasone and all the media jumping on board the steroid bandwagon, doing a 180 in the process as explained before in my first comment in this thread.

If I dig a little deeper on youtube, I'd probably be able to find an actual example of the association-thingy (association with the bleach-idea, which is a very useful mental trigger word, "bleach") concerning treatment of Covid-19 rather than prevention (making it more an outright lie). But I'd rather not, cause things are hard to find on youtube.