Steroid use too early could also be inflicting drop in oxygen: AIIMS chief Randeep Guleria

With many sufferers within the present Covid-19 wave reporting a drop in oxygen saturation ranges, in flip requiring hospitalisation, AIIMS Director Dr Randeep Guleria on Monday warned in opposition to indiscriminate prescription of steroids, in addition to CT scans and checks, for these with delicate signs.
Talking about efficient medical administration, Guleria, a member of the nationwide process pressure on Covid-19, stated hospitals had been seeing delicate sufferers who had consumed steroids, triggering virus replication and inflicting a drop in oxygen ranges.
With a rush in sufferers in search of medical care, Prime Minister Narendra Modi held a overview assembly on Monday to spice up assets, together with making accessible providers of medical college students.
“We have to understand that taking steroids at the early stage can give more stimulus to virus replication. In many cases, mild cases are becoming severe and patients are reporting severe pneumonia. Steroids have no role in the first five days of illness,” Guleria stated.

For average illness, solely three particular remedies are efficient, he stated. “First is oxygen therapy; second, when the illness is moderate and oxygen saturation is low, then there is a role for steroids; third is anticoagulants, because we know Covid-19 pneumonia is a little different from viral pneumonia and promotes the clotting of blood. There could be blood clots in lungs resulting in a drop in blood saturation. Again, in mild illness, there is no role for anticoagulants,” Guleria stated.
The AIIMS Director additionally suggested in opposition to CT scans and biomarker checks in case of delicate signs. “Patients must undertake these tests only when they have moderate illness and on the basis of advice by doctors. There is a possibility of overtreatment due to unnecessary reliance on biomarkers,” Guleria stated.

“Many people are getting CT scans done on getting a positive report. We are also seeing people getting scans every three-four days. We are exposing the body to radiation. There is no benefit of CT scan in mild disease, or if you are in home isolation and have normal oxygen levels. Studies have shown that in 30-40% of asymptotic patients, some patches will show in CT reports, however they recover on their own without any treatment,” the physician stated.
Underlining different dangers of CT scans, Guleria stated, “One CT scan is equal to getting 300-400 chest X-rays. There is data from the International Atomic Energy, which deals with radiation protection and medicine, that conducting CT scan multiple times increases the risk of cancer in later life, especially in the younger age group.”
On biomarkers, the AIIMS Director stated, “Those testing positive are undergoing blood tests for C-reactive protein (CRP), complete blood count, D dimer. Again for mild illness and when oxygen saturation is under control, there is no requirement for these blood tests. These only cause a panic reaction. These biomarkers are for acute phase reactants, which means that whenever there is inflammation, these will increase. We don’t come to know if the infection is spreading. People think they should take steroids if CRP is more, this causes more damage.”
Following the overview assembly by Modi, the Centre introduced that the NEET-PG examination was being postponed for a minimum of 4 months. “This will make a large number of qualified doctors available for Covid duties,” it stated, including it had additionally determined to permit deployment of medical interns in Covid duties akin to tele-consultation, underneath the supervision of college.
The Centre additionally talked of “early signs” of a drop in circumstances within the final 72 hours. “There are early signs of plateauing in one or two states. However, many are still showing increase in daily cases,” it stated, noting that 22 states had a positivity fee of greater than 15%.