Physicians should avoid giving steroids to COVID-19 patients, and the government has revised clinical guidelines for the treatment of coronavirus, whose task force chief regrets drug abuse during the second wave. Said a few days after the announcement.
According to revised guidelines, drugs such as steroids may increase the risk of secondary infections such as invasive zygomycosis and “black fungi” if used too early, at high doses, or for longer than necessary. ..
The guidelines detail the dose of the drug if it is required for three types of infections, “mild, moderate and severe”, and if the cough lasts for more than 2 to 3 weeks, the patient for tuberculosis and other conditions. It states that it needs to be inspected.
At a press conference last week, NITI Aayog member (health) and Dr. VK Paul, chief of the Covid Task Force, expressed concern about the “abuse and misuse” of drugs such as steroids.
According to the revised guidance, upper respiratory tract symptoms without shortness of breath or hypoxia are classified as mild illnesses and are recommended for home isolation and care.
People suffering from mild Covid should see a doctor if they have difficulty breathing, a high fever, or a severe cough that lasts more than 5 days.
People with shortness of breath whose oxygen saturation fluctuates by 90-93% can be hospitalized and are considered moderate cases. Such patients should be given oxygen support.
Respiratory rates above 30 per minute, shortness of breath in the room air or oxygen saturation below 90% should be considered serious illness and such patients are admitted to the ICU as they require respiratory assistance. is needed.
Such patients should receive respiratory assistance. Non-invasive ventilation (NIV) (helmet or face mask interface depending on availability) may be considered for people with increased oxygen requirements if they have less breathing work.
The revised guidelines provide Emergency Use Authorization (EUA) or off-label use remdesivir for patients with “moderate to severe” disease and those without renal or hepatic dysfunction within 10 days of onset of symptoms. We continue to recommend it.
It warned against the use of drugs for patients who are not on oxygen support or at home.
According to the guidelines, EUA or off-label use of tocilizumab should also be considered for use in the presence of severe illness, preferably within 24-48 hours of admission to the severe illness or intensive care unit (ICU). I can do it.
Tocilizumab may be considered in patients with significantly elevated inflammatory markers and no improvement with steroid use, and there is no active bacterial, fungal, or tuberculosis infection, they said.
People over the age of 60, or suffering from cardiovascular disease, hypertension, coronary artery disease, true diabetes, or other immunodeficiency conditions (HIV, active tuberculosis, chronic lung, kidney, liver disease, cerebrovascular disease, obesity, etc.) Those who have an increased risk of severe illness. According to the guidelines, illness and mortality.
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