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Avoid steroids, get tested for TB if cough persists, says Centre in new Covid guidelines

The guidelines recommend testing for tuberculosis and other conditions if cough persists for more than 2-3 weeks.

Patients receive treatment inside a shehnai banquet hall, converted into Covid-19 isolation center, in New Delhi, on Wednesday. (Express Photo By Amit Mehra)

Doctors treating patients with coronavirus disease (Covid-19) should avoid prescribing steroids and get them tested for tuberculosis if severe cough persists, the Union Ministry of Health and Family Welfare has said in its updated set of guidelines.

According to the revised clinical guidelines for the management of adult Covid-19 patients issued by the health ministry on Monday, the use of steroids increases the risk of secondary infections, such as black fungus, and must thus, be avoided.

The guidelines recommend testing for tuberculosis and other conditions if the cough persists for more than two to three weeks.

Warning against the use of steroids in the early stages of clinical treatment, the guidelines stated: “Anti-inflammatory or immunomodulatory therapy (such as steroids) can have risk of secondary infection such as invasive mucormycosis when used too early, at higher dose or for longer than required.”

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The health ministry’s Covid National Task Force has also pointed out that there is no evidence to prove the benefits of injectable steroids in patients who do not require oxygen supplementation.

The task force laid down that while mild cases will be home isolated, severe patients will be admitted in the Intensive Care Units (ICUs). Patients with moderate symptoms, meanwhile, will have to be admitted to the Covid ward.

Based on oxygen levels and respiratory rates, the guidelines also defined who would fall under the mild, moderate and severe disease categories.

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Earlier this week, NITI Aayog Member (Health) Dr V K Paul warned against the “overuse and misuse” of Covid drugs, including steroids.

“There is a concern that whichever medicines we give it should be rationally used, there should not be any overuse. Last time, we saw a very scary situation when the contribution of medicine was to a very large extent responsible for mucormycosis,” he said in a press conference.

First published on: 18-01-2022 at 12:51 IST
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