The total number of coronavirus cases in the country has crossed the 2 crore mark.

The total number of coronavirus cases in the country has crossed the 2 crore mark. The increasing number of cases and shortage of medical care facilities is making the situation tense with each passing day.
While there is no decline in the number of overall cases, few people are still taking it lightly by not following all the COVID protocols and even by treating themselves on their own.
Talking about COVID treatment, we all have been hearing a lot about steroids. Steroids are being prescribed to many and some are even having it on their own. To clarify more on the consumption of steroids, we talked to a Senior Pulmonologist Dr. S K Katiyar, Former President, National College of Chest Physicians, India and Indian Chest Society. Here is all that he has to say.
What are steroids?’Steroids’, the short form of the term, ‘corticosteroids’, are a group of drugs with anti-inflammatory and immuno-suppressive effects that closely resemble ‘cortisol’, a hormone that is secreted by the adrenal glands in the body. This hormone regulates a wide range of processes throughout the body, including metabolism and the immune response.
Do all COVID patients need steroids?No, not at all. In fact, many patients will get okay even without any type of treatment. For people who are asymptomatic or have mild symptoms, whose oxygen levels do not dip, the symptoms start subsiding with the 6th-7th day and have minimal disease on HRCT, are the people who won’t need steroids.
Who needs steroids?The majority of people with mild symptoms and some even in the moderate category will not need steroids.
If the oxygen levels are falling (saturation below 94%), there is a downward trend of the disease along with other complications including severe involvement of lungs and throat, persistent high-grade fever for a week and over then steroids might be prescribed. All severe or critically ill patients will essentially need steroids.
If the patient’s X-ray has a lesion in the lungs which is deteriorating and the symptoms do not subside, instead show aggravation, he may be given steroids. There is not only one parameter that decides if a person should be given steroids or not. It varies from patient to patient. All those with a chance of developing post- COVID-19 fibrosis in the lungs need to be given steroids.
Steroids should be avoided the first five days…The body should be given the opportunity to fight the infection through its immune system. By giving steroids, the immune system gets suppressed and does not get a proper chance to fight the infection. Thus, steroids should be avoided during the first 4-5 days of the disease.
People should be made aware of COVID-19 disease and they should never ignore the symptoms, as every day counts in the management of this disease.
If the test reports are negative but the person has symptoms…If the RT-PCR test for SARS-CoV-2 is negative, and the person is symptomatic, which is likely to happen in about 30 per cent of the patients, they must get their X-ray and/or HRCT and other tests done for confirmation.
If it is ignored and not taken care of, it allows the disease to progress, develop complications, making it sometimes difficult to treat and control. Sometimes, one can go for a second CT scan too to see the current status of the disease and manage accordingly. Looking at the frequent use of CT scans during the present COVID pandemic, it is important to go for low dose CT scans to avoid cumulative hazards off radiation dose through the CT Scans.
Can steroids be taken without a doctor’s consultation?Never! One should never start the steroids without a doctor’s consultation even if they have similar symptoms to someone who has been prescribed steroids. The prescription of steroids depends on a lot of factors including age, comorbidities, weight and more.
After how many days one has recovered from the illness, one is safe?It is not the number of days, but perhaps the trend of disease as well which is important. If the symptoms are regressing and the patient’s overall health improves, the oxygen levels return to normal, they are on the recovery path. Usually, COVID-19 patient takes 10 to 14 days to get well but it may sometimes take longer if there are any complications.
If the person has a fever for 10 days accompanied by other features, they require more care. The milder and moderate group usually gets okay within 7-10 days of illness.