Research has shown that dexamethasone, a widely available steroid, can significantly reduce the chance of death from COVID-19. However, because of the way dexamethasone is transmitted throughout the body, it may be less effective in patients with diabetes, new research suggests, according to press releases.
Based on their findings, the researchers said 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 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.
To better understand serum albumin’s role in COVID-19, the researchers analyzed data from 373 patients at a hospital in Wuhan, China. The scientists found that patients who died had lower albumin levels than those who survived. Those who died also had higher levels of blood sugar. That aligned with the researchers’ conclusion that high blood sugar could affect serum albumin’s ability to carry its cargo.
The team also used powerful X-rays from the Advanced Photon Source at Argonne National Laboratory to get a full picture of the structure of serum albumin combined with dexamethasone. Their work was published in the Journal of the International Union of Crystallography.
Low levels of albumin may already make it more difficult for some patients to get the benefits of dexamethasone. This research shows that patients with diabetes may experience the same difficulty, since high blood sugar changes the way albumin binds with dexamethasone.
