E-Paper
Early-stage irrational use of steroids worsening Covid cases: PGI expert
Dr GD Puri, who is the head of the department of anaesthesiology and intensive care at PGIMER, said at least 80% of Covid patients in the ICU are on ventilators
At least 80% of the Covid-19 patients in the intensive care units (ICUs) of the Post Graduate Institute of Medical Education and Research (PGIMER) are on ventilators.
Administration of steroids at an early stage of treatment, which is “totally avoidable”, is one of the key reasons, said Dr GD Puri, who is the head of the department of anaesthesiology and intensive care at PGIMER.
Dr Puri on Monday shared with the UT administrator that the institute was getting most patients in critical condition, who were referred there from various district hospitals in the neighbouring states.
The expert, who also heads the Covid-19 management committee of the premier tertiary care institute, said: “Most patients in PGIMER are critical and the first reason could be that they are reaching here late. Second, they have already been given treatments in district hospitals or are left untreated.”
“The third reason, which we are observing, is the irrational use of steroids, which is proving fatal,” he said.
Steroids are medications which are used for reducing inflammation. Calling their use a “double-edged sword”, Dr Puri said: “We do not give steroids to treat viral cases. However, it was in September last year when the UK’s recovery trial showed benefits for Covid patients who were given steroids.”
But that does not mean that doctors can give steroids without using rationality, he said. “What’s happening is that local physicians are coming up with various theories; they think if there is shortage of oxygen beds or other medicines, then why not give steroids before the disease worsens,” said the expert.
Steroids can prove fatal
“What they don’t realise is that if given without hypoxia (a condition in which the body or a part of the body is deprived of adequate oxygen supply), it can be harmful or even fatal for a patient,” he said.
Dr Puri said that they do not give steroids in the first phase when viral replication is happening, because it may stimulate the virus and exaggerate its harmful effects, like dropping of oxygen and interference with the immune system.
He said that it’s in the later stages (second week) when a patient has hypoxia and there are after-effects of the infection like inflammation. At this stage, steroids are to be given but with proper caution.
“The dosage, timings and stage at which steroids have to be given is very crucial. One can not just advise steroids. Also, long-term usage of steroids in Covid-19 patients can also lead to secondary infections like black fungus,” Dr Puri said. He said that a team of PGIMER had been regularly educating physicians in the region on the judicious use of steroids.
Currently, there are 368 Covid cases at PGIMER, of which 95 belong to Chandigarh, 140 to Punjab, 62 to Haryana, 27 to Himachal Pradesh and 44 from other states. There are 78 ventilators in PGIMER, of which 67 were occupied till Monday evening.
