Health Ministry adds steroid dexamethasone in COVID-19 treatment protocol

Dexamethasone, an inexpensive and widely used steroid, was included in treatment protocol for COVID-19 patients in moderate to severe sts of illness by Union health ministry on Saturday.

updated 'Clinical Manment Protocols for COVID-19' vises use of dexamethasone, which is alrey used in a wide range of conditions for its anti-inflammatory and immusuppressant effects, as an alternative choice to methylprednisolone for managing moderate to severe cases of COVID-19.

Keeping pace with evolving kwledge about COVID-19, especially in terms of effective drugs, change has been me after considering latest available evidence and expert consultation, health ministry said.

Union Health Secretary Preeti Sudan has also forwarded updated protocol to all states and Union Territories to make necessary arrangements for availability and use of new protocols and dexamethasone at institutional level also, it said.

health ministry h on June 13 also allowed use of antiviral drug remdesivir for restricted emergency use and off-label application of tocilizumab, a drug that modifies immune system or its functioning, and convalescent plasma for treating COVID-19 patients in moderate st of illness as an 'investigational rapy'.

It also recommended hydroxychloroquine in patients during early course of disease and t on critically ill patients. use of se drugs continues to be included in 'Clinical Manment Protocols for COVID-19'  under 'investigational rapy'.

updated treatment protocols for moderate cases vised considering methylprednisolone 0.5 to 1 mg/kg or dexamethasone 0.1 to 0.2 mg/kg for three days, preferably within 48 hours of mission or if oxygen requirement is increasing and if inflammatory markers are increased.

duration of ministration should be reviewed as per clinical response, it said.

For patients having respiratory distress requiring mechanical ventilation, both n-invasive and invasive, ministry said methylprednisolone 1– 2mg/kg/day or dexamethasone 0.2 to 0.4 mg/kg per day should be considered for five to seven days in two divided doses, if t given alrey.

"te that a larger dose of glucocorticoid will delay removal of coronavirus due to immusuppressive effects," treatment protocols stated.

revised treatment protocols were issued as India's COVID-19 tally raced past five-lakh mark on Saturday with biggest single-day surge of 18,552 cases, while death toll climbed to 15,685 with 384 fatalities.

Dexamethasone is a corticosteroid drug used in a wide range of conditions for its anti-inflammatory and immusuppressant effects.

" drug has been tested in hospitalised patients with COVID-19 in recovery clinical trial and was found to have benefits for critically ill patients and has been shown to reduce mortality by about one third for patients on ventilators, and by about one fifth for patients being maintained on oxygen rapy," ministry said.

drug is also a part of National List of Essential Medicines (NLEM) and is widely available, it said.