WATCH: Do COVID patients need steroids? If so, when?

Alarmed by the indiscriminate use of steroids by physicians to treat COVID patients, Dr Randeep Guleria, a member of the national COVID-19 task force and director of All India Institute of Medical Sciences (AIIMS), Delhi, has cautioned that it could lead to “faster viral replication and severe viral pneumonia.”

Health experts say they have come across the trend of prescribing steroids in the first few days of COVID symptoms becoming visible. Not just steroids, but antibiotics and antiviral drugs that cannot possibly treat COVID — a viral infection– are being used without giving adequate attention to their side-effects.

Cause of black fungus infection

Doctors say that use of steroids in COVID patients with diabetes has been the reason black fungus or mucormycosis cases are being reported in Delhi, Gujarat, Rajasthan and many other states. Black fungus is a serious but rare fungal infection caused by a group of molds called mucormycetes. It may result in loss of vision or even life if left untreated.

A 39-year-old man from Nagpur went to a local doctor after he developed COVID-like symptoms. He was prescribed antibiotics, antiviral drugs and steroids even before his test results came positive. Of course, he recovered fast, but within days he developed high fever and his oxygen saturation levels dropped, following which he had to be hospitalized.

There are cases when very young patients were put on high doses of steroids in the first few days of the infection even though they showed signs of recovery. A teenage girl was given steroids on the basis of a chest CT scan that showed some abnormality in her lungs. Within days she got high fever and had to be admitted to a hospital.

Also read: A 3rd COVID wave likely in India if virus evolves rapidly: AIIMS chief

‘The Recovery Trial’, conducted in the United Kingdom in June last year, shows that a 6mg dose of dexamethasone, an inexpensive steroid drug, once a day for 10 days decreased mortality in patients on respiratory support. Doctors in India were found to give three times the prescribed dose, which causes complications at times.

Steroids like dexamethasone are prescribed for COVID patients to prevent inflammation, but doctors say they may result in severe side-effects if not used thoughtfully.

How can steroids harm?

They lower the body’s immunity and can also cause viral replication. Doctors say the correct time to use steroids is when oxygen saturation is low.

A report released by the Maharashtra COVID-19 task force in April this year suggests steroid-injection dexamethasone in moderate patients with pneumonia and oxygen saturation below 94%.

See the video by Dr Randeep Guleria, a member of the national COVID-19 task force, to know the harms of indiscriminate use of steroids.

Should patients with mild symptoms take steroids at early stage?#PIBFactCheck
Taking steroids during early stage of #Covid19 can further replicate the #Virus.

Take a look at this #PIBFacTree and know what Dr Randeep Guleria (Director, AIIMS) has to say about this! pic.twitter.com/HMUxd66YAl

— PIB Fact Check (@PIBFactCheck) May 10, 2021

What is viral replication?

It is a process of multiplication of the virus in the body. Since steroids mask symptoms and suppress body’s immunity, patients could develop severe infection.

Excessive use of antibiotics

“Antibiotics like doxycycline and azithromycin are essential for treating typhoid, scrub typhus and pneumonia. With their unnecessary use, we are leading to a serious drug resistance,” said infectious disease expert Dr Tanu Singhal from Kokilaben Dhirubhai Ambani Hospital, while speaking to The Hindustan Times. Singhal also said that ivermectin and another antiviral called favipiravir should not be used because they do not play any role in treating COVID-19 contrary to popular belief.

Indiscriminate use of antimicrobial drugs is the most important reason for developing antimicrobial resistance. The World Health Organization (WHO) says that antimicrobial resistance as one among the 10 worst global public health threats facing mankind.