COVID-19: Ministerial Advisory Committee okays use of dexamethasone in SA

Zweli Mkhize. Image credit: Twitter/SA Gov News

The Ministerial Advisory Committee (MAC) on COVID-19 has said dexamethasone may be considered in South Africa for patients who are being mechanically ventilated or require oxygen support.

Trial results from a UK-based Randomised Evaluation of COVID-19 therapy (RECOVERY) has found that dexamethasone reduces mortality rates by a third in patients on ventilators and a fifth in patients on oxygen support. The University of Oxford announced the results on Tuesday.

In a statement on Tuesday evening, Health Minister Dr Zweli Mkhize hailed this as an “important breakthrough” and said the therapy is “easily implementable in our country.”

Dexamethasone ‘may be considered’

In its advisory, MAC said it is awaiting the full publication of the trial, but added, “In the interim, we believe that intravenous dexamethasone 6mg daily or an equivalent oral corticosteroid (such as prednisolone 40mg daily) for 10 days may be considered in patients with a confirmed diagnosis of COVID-19 who are being mechanically ventilated.

“Although a lesser effect on mortality was shown in those patients requiring oxygen but not being mechanically ventilated, we also advise that dexamethasone may be considered for patients admitted to hospital with COVID-19 who require oxygen support but are not mechanically ventilated, especially those requiring high flow nasal oxygen, CPAP, or non-invasive ventilation.”

It further said COVID-19 patients who do not require oxygen support should not receive dexamethasone “unless clinically indicated for a specific comorbidity.”

“It must be stressed that this advisory is based on a preliminary statement by the Chief Investigators of the RECOVERY Trial, and this advisory may be subject to change following review of the full publication,” the MAC added.

Dexamethasone available in SA

Dexamethasone is widely available in South Africa and is produced locally by pharmaceutical giant Aspen. It is usually used for breathing disorders such as asthma and other conditions such as arthritis.

Prices per injection range from R149 to R176, according to a Business Insider report. Commenting on dexamethasone’s availability in South Africa, Aspen CEO Stephen Saad said, “It all depends on where and when we get the surges. We should be fine for South Africa, (as) we make this in South Africa.”

As of Tuesday, 16 June, South Africa had 76,334 confirmed COVID-19 cases. 42,063 had recovered, a 55.1 percent recovery rate, while 1,625 had lost their lives, a mortality rate of 2.1 percent.

The country has seen a spike in cases in recent weeks as more economic activity resumes under alert level 3, which began on 1 June.

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