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Dexamethasone drug may not benefit COVID-19 patients with ...

the University of Virginia School of Medicine
the University of South Carolina
Study Lead
Department of Molecular Physiology and Biological Physics, University of VirginiaResearcher Ivan Shabalin
Virginia Health SystemShabalin
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Blood, Blood Sugar
Dexamethasone, Diabetes, Drug Discovery, Drugs
Immune Response, Laboratory
Low Testosterone
Medical Research, Medicine, Pandemic, Physiology
Protein, Research, Spectroscopy, Structural Biology, Testosterone
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Sartorius AG
EKF Diagnostics

Dariusz Brzezinski
I. G.
commentYinan Jiang
Yinang Jiang
vaccineDavid Apiyo
Rebekah Stibbs


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The New York Times
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A new discovery about how the body transports dexamethasone, a drug that can increase the survival chances of patients with severe COVID-19, suggests diabetes and other factors may reduce its potentially lifesaving effectiveness.Based on their findings, the researchers say doctors may need to rethink how they dose the drug for certain groups of patients.The team of scientists, based at the University of Virginia School of Medicine, the University of South Carolina, and in Poland, has determined how a protein in our blood called serum albumin picks up dexamethasone and takes it where it is needed.Low serum albumin levels are already considered a major risk factor for severe COVID-19, as is diabetes.The new research suggests diabetes or low albumin levels may make it difficult for patients to get the benefits of dexamethasone, a corticosteroid that calms the hyperactive immune response that can lead to death in severe COVID-19.Diabetes is associated with high blood sugar levels, which results in a modification of albumin that may alter the binding site for dexamethasone. More men die of COVID-19 than women, and low testosterone levels have already been associated with worse outcomes.The authors of the study hypothesized that high dexamethasone levels might affect testosterone transport by competing for the same drug site on albumin.Serum albumin also uses the same binding dock to pick up several common nonsteroidal anti-inflammatory drugs, so doctors may need to consider the potential for competition in deciding COVID-19 treatment plans, the research suggests.That said, it's not as simple as increasing the dexamethasone dose for patients with diabetes or low serum albumin.

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