The central government has made some changes in its guidelines related to the treatment of corona. In the new guidelines, doctors have been advised to avoid giving steroids to the patient. This increases the risk of getting other infections like black fungus. A few days ago, Dr. VK Paul, Chief of the National Covid Task Force, expressed remorse over the excessive use of these drugs in the second wave. According to the new guidelines, if steroids are given too quickly and in high doses or for a long time, it can also lead to other serious diseases in patients.
What are steroids?
Steroids are a type of chemical, which is made inside our body. This chemical is also made synthetically, which is used to treat a particular disease.
Apart from this, steroids are used to increase hormones in men, increase fertility, improve metabolism and immunity. Along with increasing strength in muscles and bones, it is used in the treatment of pain.
Experts believe that excessive use of steroids can lead to diseases like heart attack, liver problems, tumors, bone damage, stunted growth, infertility, hair loss, height increase, depression, etc. However, in many cases, doctors give steroid injections.
In the second wave, corona patients had problems with steroids
Steroids were used on patients during the second wave of corona in India. Due to its heavy dosage, many patients had black fungus infection and many people also lost their lives. Patients also had to face high sugar levels and heart-related ailments. In some cases, patients were also complaining of severe pain in the bones, difficulty in walking, standing, and lying down.
What do the new guidelines of the government say?
In the guidelines, dosages of different medicines have been given for mild, common, and severe infections of the corona.
According to the government, if a patient continues to cough for 2-3 weeks, then he should be tested for TB or other diseases.
If breathing is difficult, but there is no breathlessness and the oxygen level is not decreasing, then such patients are kept in the category of mild infection. They have been advised for home isolation.
Patients suffering from a mild covid infection, who have difficulty in breathing for more than 5 days, severe cough and fever, should go to the doctor immediately.
Such patients who have a lot of difficulty in breathing and their oxygen saturation is between 90-93, should be admitted to the hospital. Oxygen support should be given to such patients. They have been kept in the category of general patients.
If the respiratory rate is above 30 per minute, the patient is unable to breathe and the oxygen level is below 90%, then such patients will be considered serious. They should be immediately admitted to the ICU and given respiratory support.
Patients who are short of breath and need oxygen support should be given non-invasive ventilation (NIV) through a helmet or face mask.
Emergency or 'off label' use of Remdesivar has been approved for mild to severe symptoms. It will be used only on those patients who have not complained of 'renal' or 'hepatic dysfunction' within 10 days of symptom onset.
The drug Tocilizumab can be used in patients whose condition is not improving despite the use of steroids. They should not contain any active bacterial, fungal, or tubercular infections.
Those patients who are 60 years of age or above, who have heart disease, hypertension, diabetes, HIV, coronary artery disease, TB, lung, liver, kidney diseases, obesity, etc., are at the highest risk of corona infection.
Dr Randeep Guleria, Chairman of the Institute of Internal Medicine Respiratory and Sleep Medicine
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