Dexamethasone, Explained

Here’s what to know about the president’s steroid treatment for Covid-19

Alexandra Sifferlin
Medium Coronavirus Blog
2 min readOct 5, 2020


Photo: John Phillips/Getty Images

White House physician Sean Conley, DO, said on Sunday that President Donald Trump is now taking the steroid dexamethasone as part of his treatment for Covid-19. Here’s what’s known about the drug.

How does it work?

Dexamethasone is a cheap and widely available steroid that’s given orally or intravenously to treat diseases such as arthritis, allergies, and asthma. It helps the body quell inflammation, Shin Jie Yong reports. It’s thought to be helpful for the Covid-19 by stopping the immune system from going into overdrive and attacking the body. Since it is a long-acting drug and has systemic effects, it is considered about 25 times more potent than other synthetic corticosteroids.

When is it recommended?

Dexamethasone has shown promise for treating severe forms of Covid-19.

In June, early results from a clinical trial of the drug showed it lowered the risk of death from 40% to 28% for people with Covid-19 on ventilators and from 25% to 20% for people requiring supplemental oxygen over 28 days. It did not appear to benefit people with milder cases of the disease.

Research has also suggested that the drug may actually be risky for people with milder cases. As the New York Times reported in September, people that were given the steroid who were not receiving respiratory support died at a slightly higher rate than similar patients who were not given the drug. It was not a statistically significant difference, but researchers noted it.

What are the side effects?

The drug can have a range of physical and mental side effects, including aggression, agitation, anxiety, dizziness, blurred vision, irritability, headaches, feelings of depression, mood changes, nervousness, swelling, trouble thinking, speaking, or walking, and weight gain.

What’s the expert reaction?

Experts have speculated that the use of dexamethasone suggests that Trump’s condition may be more severe than the White House has let on. There is confirmation that the president has had two episodes of low drops in oxygen levels. “The fact that he got the steroid sets up a bit of a red flag that there’s something going on here,” NBC News senior medical correspondent John Torres, MD, said on Sunday. “I think they might be painting a little bit of a rosy picture for everyone.”

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Alexandra Sifferlin
Medium Coronavirus Blog

Health and science journalist. Former editor of Medium’s Covid-19 Blog and deputy editor at Elemental. TIME Magazine writer before that