The Post Graduate Institute of Medical Education and Research has cautioned against the “indiscriminate” use of steroids for the management of Covid-19 patients.
The premier institute in Chandigarh, which also receives patients from the neighbouring states of Punjab and Haryana, in a release stated that it has been seen recently that the “seriousness” of Covid patients coming to the hospitals has increased majorly due to the use of steroids, which needs to be regulated.
“We are facing this issue from a number of patients who are being admitted to our facility. It has become a trend that the patients are taking or given steroids, which can be harmful as the recent scientific evidence is showing,” said Dr GD Puri, dean (academics) and head of the anaesthesia and intensive care department, PGIMER.
The institute, in the release, said that steroids are not recommended for patients who do not require oxygen therapy. These include initial, mild or asymptomatic patients.
Citing the Recovery clinical trial published from England as well as observations made by experts at the institute, the release said it has been seen that steroids given in early stages of Covid-19, when a patient is not requiring oxygen, can increase severity of the disease along with mortality and morbidity.
“Steroids should be started in Covid patients only when they are requiring oxygen therapy and that also preferably after admission to the hospital under the supervision of an experienced physician,” the institute said.
{{/usCountry}}“Steroids should be started in Covid patients only when they are requiring oxygen therapy and that also preferably after admission to the hospital under the supervision of an experienced physician,” the institute said.
{{/usCountry}}‘Inhibits body defences’
Throwing more light on the issue, Dr Puri said steroids (such as dexamethasone) if given in the early phase of the infection, when virus replication is occurring and there is no secondary effect on the lungs, inhibit body defences against the virus and this increases the severity of the infection.
“Only when body defence mechanisms are failing and have started becoming self-destructive, it is the proper time for inhibiting inflammatory response (through steroids), which helps to limit the damage,” he said.
Dexamethasone is a corticosteroid drug used in a wide range of conditions for its anti-inflammatory and immunosuppressant effects. The drug has been tested in hospitalised patients with Covid-19 in the Recovery clinical trial and was found to have benefits for critically ill patients and has been shown to reduce mortality by about one-third for patients on ventilators, and by about one-fifth for patients being maintained on oxygen therapy.