COVID treatment: Govt issues revised guidelines on use of drugs, therapies

New Delhi: There is no evidence of injectable steroids benefitting Covid patients not requiring oxygen supplementation or in continuation after discharge, according to the revised ‘Clinical Guidance for Management of Adult COVID-19 Patients’.

The revised guidelines issued by AIIMS, ICMR-COVID-19 National Task Force and Joint Monitoring Group (DGHS) under the Union health ministry also stated that anti-inflammatory or immunomodulatory therapy, such as steroids, can have the risk of secondary infection like invasive mucormycosis, when used too early, at higher dose or for longer than required.

Injection methylprednisolone 0.5 to one mg/kg in two divided doses, or an equivalent dose of dexamethasone, can be given usually for a duration of five to 10 days in moderate cases, the guidelines stated. The same drug in two divided doses of one to two mg/kg can be given for same duration in severe cases.

“Inhalational budesonide (given via metered dose inhaler/dry powder inhaler) at a dose of 800 mcg BD for five days can be given in mild cases if symptoms (fever and/or cough) are persistent beyond five days of disease onset, it was stated in the guidelines.

If cough persists for more than two-three weeks, one should opt for investigation for tuberculosis and other conditions, they stated.

The revised guidelines continue to recommend emergency use authorization (EUA) or off-label use of remdesivir in patients with moderate to severe disease and those with no renal or hepatic dysfunction within 10 days of the onset of any symptom.

It warned against use of the drug for patients who are not on oxygen support or in home settings.