Covid treatment: BMC using dexamethasone

While initial results from a clinical study conducted in the United Kingdom (UK) has shown the steroid dexamethasone reduces mortality in patients severely afflicted

While initial results from a clinical study conducted in the United Kingdom (UK) has shown the steroid dexamethasone reduces mortality in patients severely afflicted by Covid-19, the Brihanmumbai Municipal Corporation (BMC) has recorded faster recovery by administering the drug along with another alternative steroid, methylprednisolone. However, doctors have cautioned there could be side effects to this treatment for those with comorbodity.

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“We are already administering methylprednisolone to Covid-19 patients since April and the response is quite promising. Along with it, we have recently started using dexamethasone but are yet to decide if we want to include it in the treatment protocol as mandatory medication,” said Dr Daksha Shah, deputy health officer, BMC.

Earlier this week, dexamethasone emerged as a potentially effective treatment for critically-ill patients of Covid-19 after a group of scientists from the UK reported that a trial conducted among 2,100 Covid-19 patients had shown the steroid reduced deaths of patients on ventilators by one-third and of patients on oxygen by one-fifth. On Wednesday, the World Health Organisation acknowledged these findings.

Some civic-run hospitals have already been administering steroids as treatment to Covid-19 patients. Dexamethasone belongs to the same group of steroids as methylprednisolone, which doctors at BYL Nair Hospital are using to treat to their Covid-19 patients. “We have around 1,000 patients and we administer around 2,000 injections every day. The result has been quite promising,” said Dr Mohan Joshi, in-charge of the civic-run BYL Nair Hospital. “Both drugs [dexamethasone and methylprednisolone] are effective in treating patients. But as the study has shown that dexamethasone is more effective, we will suggest that the steroid be included in treating critical patients,” he said.

Steroids have shown to be effective medication to tackle Covid-19 and reduce complications and severity in critically-ill patients. “We already have methylprednisolone in the Covid-19 treatment guidelines. The drugs are readily usable and cheap. In India, we use them in pneumonia cases. Dexamethasone may be a good choice as it is supported by a large trial and is a cost-effective drug,” said Dr Avinash Supe, former dean of King Edward Memorial (KEM) Hospital and part of BMC’s Covid-19 death committee.

However, doctors have warned against unregulated usage of steroids among patients with Covid-19, especially those who are diabetic. Dexamethasone and methylprednisolone come under the type of steroids that significantly increase blood glucose levels in those with diabetes. “Patients should never consume these steroids without the supervision of doctors. It can be life threatening and cause severe damage,” said Dr Joshi.