CHENNAI: Steroids have been the last resort in Covid-19 treatment. However, there’s concern over the side-effects that they may cause, including immunosuppression and uncontrolled rise of blood sugar. To avoid these negative impacts, doctors in government hospitals across Chennai have proposed a different technique — administering these corticosteroids using nebulizers to mild and moderate-condition patients.
The difference is in the mode of consumption — instead of intravenous treatment, the medicine is inhaled directly into the lungs. Doctor A Ravi, nodal officer for Covid treatment at Stanley hospital, says the idea was proposed at a recent meeting. “This method is likely to have lesser side-effects as the steroids do not pass through the blood stream,” adds Ravi.
Though corticosteroids are being given in mild doses, they sometimes cause an increase in sugar levels.
“The new method of administering the steroids will avoid this complication.” In a study published in the European Respiratory Journal, doctors have said that the use of inhaled corticosteroids may be beneficial for treating viral infections.
However, the comorbid conditions of patients need to be taken into account before administering the steroids, says the study adding that the nebulized steroids may be used for those who have history of other respiratory illnesses.
Not life-saving: Experts
However, infectious diseases experts say that nebulized steroids have not shown evidence to save lives. “Inhaled or nebulized steroids may have fewer side-effects but they can’t be used on severe patients as the goal is to save lives,’’ says Dr Ram Gopalakrishnan, Infectious Diseases Specialist at Apollo Hospital. He said that moderate doses of steroids through intravenous injections are the standard form of use and is beneficial for patients with severe Covid.
Dr Subramanian Swaminathan, Infectious Diseases Specialist at Gleneagles Global Health City, says there is not enough data to back the use of nebulized or inhaler steroids as standard treatment for Covid-19.“In theory, they sound good as they may possibly reduce side effects but the inflammation caused by Covid is not just in the lungs,’’ he said. Dr Swaminathan said that nebulized steroids can be given based on various criteria including by observing recovery trials.
Pulmonologists say that nebulized steroids would address inflammation only in the airways and it could also have harmful side effects. “Nebulised steroids may increase fungal infections too and it is potentially harmful for a Covid patient,’’ said Pulmonologist Dr Raj B Singh.