The World Health Organisation (WHO) has released guidelines on the use of steroids which do not recommend the prescription of the drugs to non-severe Covid-19 cases.
The drugs, according to the document titled Corticosteroids for Covid-19, can be used in severe and critically-ill patients regardless of being hospitalised or not.
While studies that recommended the use of corticosteroids were based on hospitalised patients only, WHO, in the guidelines, has extended the use of these drugs to those, not in hospitals.
“In contrast, the panel concluded that the recommendation should definitely be applied to certain patients who were not included in the trials, such as patients with severe and critical Covid-19 who could not be hospitalised or receive oxygen because of resource limitations,” says WHO.
The guidelines dated September 2 were released the same day as a study that showed the efficacy of corticosteroids among severe and critical Covid-19 patients.
The above recommendation, however, does not apply for patients under corticosteroids for other illnesses like chronic autoimmune diseases, and obstructive pulmonary disease.
“If the clinical condition of patients with non-severe Covid-19 worsens (increase in respiratory rate, signs of respiratory distress or hypoxaemia), they should receive systemic corticosteroids,” read the guidelines.
WHO further recommended antenatal corticosteroids for pregnant women at risk of pre-term birth from 24 to 34 weeks when there is no clinical evidence of maternal infection and adequate childbirth and newborn care is available.
“However, in cases where the woman presents with mild or moderate Covid-19, the clinical benefits of antenatal corticosteroid might outweigh the risks of potential harm to the mother,” it adds.
WHO says in the above situation, the balance of benefits and harms for the woman and the preterm newborn should be discussed (with the woman) to ensure an informed decision, as this assessment may vary depending on the woman’s clinical condition.
WHO says corticosteroids, in cases of intestinal dysfunction, should be administered intravenously.
Hydrocortisone, prednisone and methylprednisolone are some of the corticosteroids.
“It would be prudent to monitor glucose levels in patients with severe and critical Covid-19,” adds WHO.