Health Minister Dr Zweli Mkhize said he was "extremely excited" that there has been an important breakthrough in one of the therapeutic trials for Covid-19 management.

"The RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial has published results on the therapeutic merits of low-dose dexamethasone, which are extremely promising and are easily implementable in our country," Mkhize said on Sunday as he announced South Africa's latest Covid-19 statistics.

On Tuesday, a statement was issued from the chief investigators of the RECOVERY trial, a UK-based adaptive trial of various potential treatments for Covid-19, one of which was a systemic corticosteroid (dexamethasone, prednisolone or hydrocortisone).

Mkhize said dexamethasone is a well-known and widely used steroid which has potent anti-inflammatory properties.

"It is used in allergic reactions, asthma and other conditions where the inflammatory component of the disease needs to be controlled for better outcomes."

Inexpensive, commonly used steroid

It is an inexpensive and commonly used steroid that can save the lives of people seriously ill with Covid-19. Dexamethasone has been shown to cut deaths by about one-third in patients who were on ventilators because of a novel coronavirus infection.

The Ministerial Advisory Committee (MAC) on Covid-19 issued an advisory pertaining to the clinical applications of these breaking study results. 

In terms of the advisory, the full publication of the RECOVERY trial is eagerly awaited. "There are important aspects of the results that will be needed to make a full assessment of the data," the MAC said.

"Data on the absolute risk reduction and the numbers of events per patient group will also be needed to fully interpret the evidence provided."

Not a miracle cure

It should be noted that patients admitted to hospital with a confirmed or suspected diagnosis of Covid-19, and who do not require oxygen support, should not receive dexamethasone or other corticosteroid, unless clinically indicated for a specific comorbidity.

By Tuesday, the country had recorded 76 334 positive cases. There had been 1 625 confirmed deaths to date.

The World Health Organisation (WHO) also welcomed the initial clinical trial results.

"This is the first treatment to be shown to reduce mortality in patients with Covid-19 requiring oxygen or ventilator support," said Dr Tedros Adhanom Ghebreyesus, WHO director general.

"This is great news and I congratulate the government of the UK, the University of Oxford, and the many hospitals and patients in the UK who have contributed to this life-saving scientific breakthrough."

This is not a miracle cure or a vaccine, however.

It has been shown to be effective in very serious cases only, such as in ventilated or oxygenated patients.

"The benefit was only seen in patients seriously ill with Covid-19, and was not observed in patients with milder disease," the WHO stated. 

The MAC noted: "Based on these results, one death would be prevented by treatment of around eight ventilated patients or around 25 patients requiring oxygen alone."

"It is a major breakthrough," said Dr Peter Horby, an infectious-disease specialist at the University of Oxford and a chief investigator on the trial.

The study found no outstanding adverse events from the treatment.

"This treatment can be given to pretty much anyone," said Horby. However, the investigators said they would await full publication before making their assessment.