AIIMS Director Dr Randeep Guleria on Monday warned against the indiscriminate use of steroids, as well as CT scans and tests, to treat COVID-19 patients with mild symptoms. As per Dr Guleria, hospitals were seeing mild patients who had consumed steroids, triggering virus replication and causing a drop in oxygen levels.
“We have to understand that taking steroids at the early stage can give more stimulus to virus replication. In many cases, mild cases are becoming severe, and patients are reporting severe pneumonia. Steroids have no role in the first five days of illness,” Guleria said.
He further said that drugs like Remdesivir, Plasma therapy, Tocilizumab are authorised only for emergency use as there are limited data on the benefits. Also, the timing of when these drugs are administered is very important.
AIIMS director also cautioning that CT scans and biomarker tests were not needed in mild COVID-19 cases. He said that one CT scan was equivalent to 300-400 chest Xrays and could pose a potential risk of cancer if the scans were overused. “If you are in home isolation with mild illness and oxygen saturation is good, there is no point in doing a CT scan,” he said.
Dr Randeep Guleria is a member of the national task force on COVID-19 formed by the Central government. As per him, for moderate disease, only three specific treatments are effective.
“First is oxygen therapy; second, when the illness is moderate and oxygen saturation is low, then there is a role for steroids; third is anticoagulants because we know COVID-19 pneumonia is a little different from viral pneumonia and promotes the clotting of blood. There could be blood clots in the lungs resulting in a drop in blood saturation. Again, in mild illness, there is no role for anticoagulants,” Dr Guleria said.
The Centre has also issued guidelines on the management of COVID-19 in children with rising infections being seen in those under 18 years.