Steroid Use In Mild Symptoms Of COVID-19 Leads To Drop In Oxygen Level: AIIMS Chief Randeep Guleria

Taking steroids at the early stage can give more stimulus to virus replication, and steroids have no role in the first five days of illness, said AIIMS Director Dr Randeep Guleria

Dr Randeep Guleria | File Image

The fear factor around coronavirus has only worsened as the second wave turns out to be deadlier with the increase in positivity and death rates across the country forcing people to opt for preemptive measures to fight the disease.

Several patients are complaining of a drop in oxygen saturation levels and requiring hospitalization amid the crunch in medical supplies. Hospitals are witnessing mild patients who had consumed steroids, triggering virus replication and causing a drop in oxygen levels.

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In such desperate times, medical experts have warned against the indiscriminate prescription of steroids, as well as CT scans and tests, for those with mild symptoms. On effective clinical management, Guleria, a member of the national task force on Covid-19 have specified a few measures. Many people are getting CT scans done on getting a positive report, and scans every three-four days, highlighted Guleria.

It is important to understand the reason why a number of early ways of Covid-19 treatment can prove to be harmful.

Here are warnings from AIIMS Director Dr. Randeep Guleria for Covid-19 patients

Taking steroids at the early stage can give more stimulus to virus replication. As per the observation of the AIIMS chief, in many cases, patients with mild complications are becoming severe and reporting severe pneumonia. The AIIMS director said hospitals are witnessing mild patients who had consumed steroids, causing virus replication and leading to a drop in oxygen level.

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Steroids have no role in the first five days of illness. Drugs such as Remdesivir, Plasma, Tocilizumab are authorized only for emergency use since limited data is available on their benefits, besides that the timing of when these drugs is administered is also critical.

The chief warned against CT scans and biomarker tests in case of mild symptoms. Patients need to go through these tests only in case of a moderate illness and on the basis of advice by doctors. There is a possibility of over-treatment due to unnecessary reliance on biomarkers.

CT scan exposed the body to radiation. He stressed that there is no benefit of CT scan in mild disease, or if the patient is in home isolation and have normal oxygen levels. "Studies have shown that in 30-40 percent of asymptotic patients, some patches will show in CT reports, however, they recover on their own without any treatment."

One CT scan is equal to getting 300-400 chest X-rays. There is data from the International Atomic Energy, which deals with radiation protection and medicine, that conducting CT scans multiple times increases the risk of cancer in later life, especially in the younger age group.

How to combat moderate illness?

According to the AIIMs director, for moderate disease, only three specific treatments are effective. He mentions oxygen therapy; second, when the illness is moderate and oxygen saturation is low, then there is a role for steroids.

While the third effective treatment is anticoagulants. He said Covid-19 pneumonia is a little different from viral pneumonia and promotes the clotting of blood. “There could be blood clots in lungs resulting in a drop in blood saturation. Again, in mild illness, there is no role for anticoagulants,” he added.

Meanwhile, the government is trying to increase resources, including making available services for medical students.

As per the Guleria, those who have recovered from Covid should take both doses of vaccine. In scientific language, the first dose is priming while the second dose is a booster dose, he stated.