KEY POINTS

  • Prolonged use of or using too much dexamethasone can cause gland problems and increase a patient’s risk of cancer
  • WHO revised its COVID-19 treatment guidelines, saying corticosteroids are effective in reducing the risk of death
  • Trump was given dexamethasone because his blood oxygen level dipped to 93%

President Donald Trump has been bragging about the medications he was given to treat his COVID-19 infection – two of which are still being evaluated for safety and efficacy. But the third drug he was given has been around a long time, and doctors are well aware of its side effects.

The drug is dexamethasone, a powerful anti-inflammatory steroid that is being used to treat lung problems in COVID-19 patients.

Trump was given the steroid after his blood oxygen levels dropped to 93% – healthy levels are 95% to 100% -- following his diagnosis. The use of dexamethasone indicates Trump’s condition may have been more serious than his doctors let on since researchers had been using it on only the most critically ill patients.

Research published in August by the Journal of Hospital Medicine found giving the steroid to patients who are not that sick can endanger their health further.

The Mayo Clinic lists 19 known side effects from dexamethasone, including aggression, irritability and trouble thinking. It also can lead to a “false or unusual sense of well-being.” (Trump has been tweeting and issuing statements saying he is feeling “great,” and in at least one instance said he was feeling better than he had been for years.)

House Speaker Nancy Pelosi said Thursday the president appeared to be in an “altered mental state,” and Democrats Friday introduced legislation to set up a commission on invoking the 25th Amendment, which can be used to remove a president who is judged unfit to perform his duties.

Mayo warns prolonged use of or using too much dexamethasone can cause gland problems and increase a patient’s risk of cancer. It also can lead to osteoporosis and weight gain.

Trump’s age, 74, and weight, as well as his sex, put him at higher risk of complications from COVID-19.

The World Health Organization this week revised COVID-19 treatment guidelines, promoting corticosteroids as an effective COVID-19 treatment. Five papers published by the Journal of the American Medical Association examined data from seven clinical trials involving three steroids – dexamethasone, hydrocortisone and methylprednisolone – given to 1,700 patients and concluded the drugs were effective in reducing the risk of death.