Avoid steroids, test for TB if cough persists – Centre updates COVID guidelines

Doctors treating COVID-19 should avoid prescribing steroids and get them tested for tuberculosis if severe cough persists, the Ministry of Health and Family Welfare has said in an updated set of guidelines.

According to the revised clinical guidelines, the use of steroids increases the risk of secondary infections, such as black fungus, and must thus be avoided.

The guidelines recommend testing for TB and other conditions if the cough persists for more than two to three weeks.

Warning against the use of steroids in the early stages of clinical treatment, the guidelines said: “Anti-inflammatory or immunomodulatory therapy (such as steroids) can have risk of secondary infection such as invasive mucormycosis when used too early, at higher dose or for longer than required.”

The ministry’s COVID National Task Force also said there is no evidence to prove the benefits of injectable steroids in patients who do not require supplemental oxygen.

The task force said that while mild cases should be home isolated, severe patients need to be admitted in ICUs. Patients with moderate symptoms, meanwhile, have to be admitted to a COVID ward.

Earlier this week, NITI Aayog Member (Health) Dr V K Paul warned against the “overuse and misuse” of COVID drugs, including steroids.

“There is a concern that whichever medicines we give it should be rationally used, there should not be any overuse. Last time, we saw a very scary situation when the contribution of medicine was to a very large extent responsible for mucormycosis,” he said.