‘Steroids Should Not be Taken in Mild COVID’: Dr Randeep Guleria

On 3 May, AIIMS issued new guidelines on the management of COVID infection in the different stages of the illness, with updates in the recommended treatments for mild and moderate cases.

Speaking at a press briefing, Dr. Randeep Guleria, Director, AIIMS, New Delhi, further explained how people with mild and moderate symptoms, isolating at home can manage the illness, and what treatments they should avoid.

'Take Steroids Only for Moderate Illness'

Dr Guleria emphasises that those with mild symptoms do not require any medication, and that the illness is likely to resolve itself in a few days.

Although Ivermectin or Hydroxychloroquine may be taken, he warns that there is limited data to prove their effectiveness.

Hydroxychloroquine has, however, been removed from the guidelines for the management of mild symptoms, months after several trials including the WHO led solidarity trials found the drug to be ineffective.

Dr Guleria follows this up by warning that taking steroids in the early stages (first four to five days) when the illness is mild can do more harm than good.

"Many people take high dose steroids in an early stage. This can lead to the virus replicating more rapidly. People with mild symptoms can end up developing severe viral pneumonia with the virus spreading in the lungs."

Dr. Randeep Guleria, Director, AIIMS, New Delhi

He reiterates that steroids should only be used in the case of moderate illness.

'Do Not Misuse CT Scans'

"CT scans are not required in case of mild covid where the patient is in home isolation and their saturation levels are normal," said Dr Guleria.

"CT scans should be done only in case of severe cases, and even then it is recommended that you do a chest xray before determining whether a CT scan is required."

Dr. Randeep Guleria, Director, AIIMS, New Delhi

Dr Guleria also talks of the harm that CT scans can do if they are misused or overused.

"One CT scan is equivalent to getting three hundred x-rays. And frequent exposure to this radiation is known to up the risk of cancer in the long run. This is another reason you should avoid getting CT scans unnecessarily," he said.

Things to Keep in Mind When Isolating at Home (Mild Illness)

According to Dr Guleria, those experiencing mild symptoms and are isolating at home, monitor their oxygen levels, and keep in constant contact with their doctors.

He also recommends getting immediate medical help in case you experience any of the following warning signs,

• If your oxygen saturation level dips below 93

• If you feel light-headed, dizzy or lethargic

• In case of chest pain

Recommended Treatment for Moderate Illness

Dr Guleria speaks of 3 types of treatments that are most effective in moderate COVID.

• Oxygen Treatment

"In case of low or dipping saturation, the main treatment is administering oxygen. "

Dr. Randeep Guleria, Director, AIIMS, New Delhi

• Steroids

"If low saturation is seen along with moderate illness, this is the stage when steroids may be taken," he adds.

• Anticoagulants

Anticoagulants or blood thinners can help combat dangerous blood clotting that may occur as a result of the COVID infection.

"In moderate to severe COVID blood clots can form in the blood vessels and can reduce oxygen saturation. Clots can also travel to the heart or the brain and prove fatal. In such cases anticoagulants may be used to prevent clotting."

Dr. Randeep Guleria, Director, AIIMS, New Delhi

However, he goes on to warn, "this, again, can prove harmful if taken in mild cases, or when it isn't required."

According to Dr Guleria, "there is strong Data backing the effectiveness of these three treatments in reducing the risk of severe COVID. But the timing of the drugs is very important."

"If a patient with moderate illness is getting these three treatments, then rest assured he's getting the right treatment," said Dr Guleria.