Some Covid patients in the city have received a steroid called Dexamethasone in the home isolation medicine kit.
Dexamethasone can be given both as injection and as an oral medicine. While small doses of steroids given at home are an exception in the case of asthma and rheumatoid arthritis patients with inflammation, doctors say that the drug comes with risks such as high blood pressure and spike in sugar levels when administered at home.
Members of the state’s critical care support unit with expertise in Covid-19 treatment procedures say Dexamethasone can’t be used by all Covid patients. They say only those with high inflammatory markers or low saturation can actually use the steroid.
“It must be prescribed after proper examination by a physician,” said Dr S Sachchidanand, member of the committee that drafts the state Covid-19 treatment protocol. A member of State Critical Care Support Unit, Dr Sunil Karanth, said: “It must be given only to hospitalised patients, and only when oxygen levels dip below normal.”
State’s nodal officer for testing Dr C N Manjunath also noted that Dexamethasone is not for all. “If inflammatory markers are high or saturation is low, only then is it prescribed,” he said. He continued: “If the patient’s saturation is normal and is monitored on a daily basis, they can be in home isolation. If the saturation level dips below 93%, they need hospitalisation.”
Some asymptomatic home-isolated patients said they were prescribed a list of drugs following an audio call with a BBMP-deputed private doctor. A member of the Critical Care Support unit, requesting anonymity, said: “If the patient’s oxygen saturation is low and s/he requires additional oxygen, we give steroids in a clinical setting. We haven’t given steroids so far at home. Usually, steroids come into picture in moderate and severe Covid patients.”
But in the BBMP West Zone, a patient in home isolation has been prescribed Dexamethasone. The zone’s nodal officer for Covid-19, Ujjwal Ghosh, said home-isolated patients in the zone are first triaged by BBMP medical officers. He also insisted that medicines are prescribed based on their assessment. “We need to review this case,” he said.
When DH contacted BBMP West Zone Health Officer Dr Manoranjan Hegde for clarity on the issue, he did not respond. However, BBMP’s Chief Health Officer (Public Health) Dr B K Vijendra urged caution.
“Sometimes patients are given medicines arbitrarily. Let’s not think too much about this,” he said.