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Should Steroids Be Used In COVID-19 Treatment? Top Medical Experts Answer FAQs

As steroids emerge as the strongest defence against COVID-19 in the second wave, top medical experts answer FAQs surrounding steroids & other drugs available

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1. Which drugs are commonly used for COVID treatment in serious cases? Dr Mukund Penurkar, Sanjeevan Hospital (Pune)

For those who are home quarantined, the approved drugs as of now are Ivermectin that can be given for five days. Otherwise, in the initial phase, only multi vitamins and some anti platelets maybe used for such patients. It is a very simple treatement. We have to observe if the patient is not developing any complications. If the patient needs hospitalization, then we can think of Remdesivir. The most important thing is we should not use steroids for those patients who are in home quarantine. Mucormycosis is one such factor that is developing. 

2. What are the possible long-lasting side effects of steroids used? Dr Alok Roy answers 

Only three things work in COVID treatment. One is Oxygen, second is steroids and third is injectable blood thinners.These three are sure-shot helpful, everything else is just supportive or not very useful, including Remdesivir. Steroids must not be taken at home. In case if you require steriods, it is better that you are under medical supervision in an institution. The second wave, the trends are not orderly as we have experienced last time. Last year, it was very well ordained. We knew everything that would happen. This is not the case this time. The constant supervision by a physician is a must. 

3.  If I am asymptomatic/mildly symptomatic, what SOS medicines should I have? Dr BS Ajai Kumar answers

One of the things that we do is, as soon as the first symptoms are observed, we put the patient on a protocol and monitor them on a daily basis. Patients call me almost twice a day and give me a report. The best way to control is early detection. People often ignore symptoms in the first two-three days and that is where the problem intensifies. If their RT-PCR count is very high, they immediately need to be given Remdesivir. Not all of them are eligible. Another thing that we are beginning to do is use home care and oxygen concentrators. This is another step in the right direction. 

4. Does every COVID-19 patient need to have access to Remdesivir? Who really needs it? Dr Mukund Penurkar, Sanjeevan Hospital

Generally, Remdesivir is required for hospitalized patients. We should use it at right place and at the right time. Those patients who are experiencing fever for more than 72 hours and if the oxygen level is coming down, then we should think of it. If we use it properly, then there will be no black marketing. Remdesivir shows good results, patients may not need ICU treatment and may also recover early. As of now, there are no anti-viral drugs as effective as Remdesivir. Otherwise, steroids are the next line of treatment. 

5. Steriods to treat COVID: In what cases and what point does it become necessary? Dr Alok Roy answers 

Steroids are not the first line of defence, we have other medicines which we use. Once we feel that the anti-inflammatory markers are high then we introduce steroids. In this wave, the use of steroids is much more than what it was in the previous wave last year. We are also using nasal steroids. Steroids are certainly the backbone of treatment of COVID. 

6. Why is it that patients in the second wave are needing more extensive treatment compared to first wave? Dr BS Ajai Kumar answers

The second wave has been much more significant, when it comes to the numbers. It is affecting the inner population. One of the things we are beginning to see is that the number of patients who are vaccinated, we are not seeing a significant amount of hospitalization. This is another change we are beginning to observe. I see some early signs of improvement. The number of drugs available and medical oxygen is increasing. Hopefully, this is the beginning of the end. The second wave has taught us immense lessons. 


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