Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what safeguards are in place to ensure that the (a) use and (b) withdrawal of steroids for patients with covid-19 is managed safely and effectively.

The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care, including guidance for use and withdrawal of steroids. NICE’s guideline NG159 recommendation 4.7 sets out the use of dexamethasone (a corticosteroid) in its COVID-19 rapid guideline, which is available at the following link:

https://www.nice.org.uk/guidance/ng159/chapter/4-Clinical-decision-making-and-management

The clinical guidance recommending corticosteroids followed the positive findings of the United Kingdom-based RECOVERY trial in June. As a result, dexamethasone or hydrocortisone are offered to patients with severe or critical COVID-19 which is in line with the World Health Organization’s guidance.

Steroids are now a standard of care in the National Health Service for hospitalised COVID-19 patients requiring oxygen therapy, non-invasive or mechanical ventilatory support. The recommended dose of dexamethasone is not sufficiently high, nor the course sufficiently long to require tapering of the dose or long-term monitoring. Some centres are using high dose steroids in selected ventilated patients. In these cases, local protocols are followed with specialist advice if necessary. The use and withdrawal of corticosteroids in COVID-19 treatment for the most severely ill patients is guided by evidence. We continue to undertake robust clinical trials to build an evidence base of what is and is not effective to treat COVID-19.