Early Use of Steroids Can Cause Drop in Oxygen Says AIIMS Chief Randeep Guleria

New Delhi- AIIMS chief Dr. Randeep Guleria on Monday warned that indiscriminate prescription of steroids for COVID-19 patients with mild symptoms can trigger virus replication and cause a drop in oxygen saturation levels. 

Dr. Randeep Guleria, who is a member of the national task force on Covid-19, said that viral replication and a drop in the level of oxygen saturation levels among COVID-19 patients with mild symptoms have been reported from hospitals across the country. 

"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," said Dr. Guleria. 

Dr. Guleria advised three specific treatments for a patient with mild COVID-19 symptoms. "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."

Dr. Randeep Guleria also warned against repeated CT scans in mild COVID-19 cases saying that it can end up doing more harm than good and that it has side effects. He also mentioned that people are going for a CT scan the moment they find out they are testing COVID-19 positive which may cause damage. 

"Exposing yourself to radiation, again and again, may cause damage. So, there is no point in doing a CT scan in mild COVID-19 if the oxygen saturation is normal," said Dr. Guleria. 

Underlying the potential danger of CT-scan, he said, "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." 

The PMO yesterday issued an order postponing the National Eligibility cum Entrance Test, NEET PG 2021 by at least 4 months in order to make the medical personnel available for COVID-19 as the healthcare infrastructure in the country is already overburdened with cases of the novel coronavirus skyrocketing and spiraling out of control with every passing day. 

The centre also said that in the last 72 hours there has been "early signs" of a drop in COVID-19 cases saying that there have been early signs of COVID cases plateauing in one or two states. However, 22 states still have a positivity rate of more than 15%. 

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