New Delhi: Doctors should avoid giving steroids to COVID-19 patients and advise tuberculosis tests if their cough persists, the government has said in its revised clinical guidelines for coronavirus treatment, days after its task force chief expressed regret for the overuse of the drug during the second wave.
The revised guidelines said that drugs like steroids can increase the risk of a secondary infection like invasive mucormycosis or ‘black fungus’, when used too early, at a higher dose or for longer than required.
“There is no evidence for benefit for injectable steroids in those not requiring oxygen supplementation, or on continuation after discharge anti-inflammatory or immunomodulatory therapy (such as steroids) can have a risk of secondary infection such as invasive mucormycosis when used too early, at higher doses or for longer than required,” the guidelines stated.
Under the anti-inflammatory or immunomodulatory therapy, the guidelines say, “Injection Methylprednisolone 0.5 to 1 mg/kg in two divided doses or equivalent dose of dexamethasone can be given usually for a duration of 5 to 10 days” in Covid-19 patients. The medicine can be administered orally if the condition of the patient is stable and/or improving.
Adult Covid-19 patients have been divided into three categories of mild, moderate and severe disease based on upper respiratory tract symptoms and breathlessness. The government-recommended treatments do not include medicines like ivermectin, favipiravir and Doxycycline. Antivirals like Molnupiravir and monoclonal antibodies are also not included in the guidelines.
The government has advised people to investigate for tuberculosis and other conditions if cough persists for more than 2-3 weeks after testing positive for Covid-19.
According to the guidelines, people aged 60 and above with cardiovascular disease, hypertension, and CAD Diabetes mellitus and other immunocompromised states (such as HIV), active tuberculosis, chronic lung/kidney/liver disease, cerebrovascular disease, and obesity are at high risk for severe disease or mortality.