"In India, we've been using steroids like dexamethasone since COVID-19 arrived," said Dr Behram Pardiwala, Internal Medicine Expert, Wockhardt Hospitals, in a discussion with BOOM about dexamethasone, the steroid that is now being hailed as the new wonder drug that can help treat COVID-19 patients.
A recent study by Oxford University found dexamethasone reduced deaths by up to one third in severely ill hospitalised patients, which created the hype around the steroid as a wonder drug.
But Dr Pardiwala reiterates that steroids have been used to treat COVID-19 in India since the start. "The press always seems to think that every next drug is a new discovery that is going to do wonders against COVID-19. Initially, Americans were extremely reluctant to use steroids. It was thought to cause harm, guidelines had banned it from use for treating COVID-19. But we've been using it since day one," added Dr Pardiwala.
He also said that variants of steroids can be interchangeable, like trying to use a generic version of antibiotics - the generic version of Terramycin or Tetracycline all differently.
"Prednisolone, dexamethasone, and methylprednisolone are steroids used in the treatment for COVID-19. 10 milligrams of prednisolone, will be equal to 4 milligrams of dexamethasone, will be equal to 2 milligrams of methylprednisolone," he said.
The Oxford University study also stated that dexamethasone reduced the number of deaths of patients who needed breathing machines by 35% and in patients who needed supplemental oxygen, death was reduced by 20%. The drug was either administered orally or given through IV.
Speaking about the use of the drug, Dr Pardiwala said, "The improvement of the patients who require high doses of oxygen is remarkable with dexamethasone. In fact, we try and give it earlier on. The earlier you give it the more effective it is like in any disease."
But doctors are also advising caution while using this drug if the patient has an existing infection.
"If the patient has a high level of procalcitonin which indicates infection we are a little cautious with administering dexamethasone, but if it is not so high, we go in with our guns blazing," he added.
Talking about the general trend of critically ill patients, Dr Pardiwala said, "With the help of drugs like dexamethasone, we have been able to prevent patients from going on the ventilator tends to have a fatal outcome. We've been able to pull out quite a few patients. We're getting quite a few older patients now, without remdesivir."
Remdesivir, an anti-viral medication developed by Gilead has shown great promise to treat coronavirus which has been in short supply in India. Gilead had stated on June 3 that there was a 'limited global supply' of remdesivir and that it anticipated new supply to become available only in July.
Dr Pardiwala has some advice for people who've started to venture out into the world since the lockdown has started lifting. "You're like a newborn baby now, take precautions like wearing a mask and carrying a hand sanitizer, and avoid going into crowds."
If you have COVID-19, then there's good news. A new antigen-based test that is based on a blood report can tell if you are COVID-19 positive or not in half an hour. This is, however, a pre-screening test. Dr Pardiwala said, "If you are negative on that, and the doctor's still suspicious, then they'll administer the traditional test."
But at what point should you get tested?
"A lot of people have hysteria, so it is better you consult a doctor who will judge whether you need to get a test done. if you have shortness of breath, a temperature, headache, and backache there's strong suspicion and you should get a test done," he said.
Catch the full interview on YouTube or watch the interview here.
