Avoid indiscriminate use of steroids, says PGI Director

Naina Mishra

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Tribune News Service

Chandigarh, May 23

The indiscriminate use of steroids has given rise to a new challenge for the health authorities — black fungus.

Prof Jagat Ram, Director, PGI, says mucormycosis (commonly known as black fungus) can be prevented if we stop the indiscriminate use of steroids in Covid patients.

“The use of steroids in mild Covid-19 cases (without hypoxemia) or the utilisation of higher doses of glucocorticoids should be avoided. The development of mucormycosis can be attributed to the indiscriminate use of glucocorticoids and suggests a need for their judicious use,” he said.

“Steroids aggravate sugar levels in patients and those with uncontrolled diabetes are at a higher risk of developing the fungal infection. A lot of patients start self-medication with steroids even when it is not required. It has also been seen that some patients were given steroids in higher quantities that worsened their condition,” said Prof Jagat Ram.

Prof Arunaloke Chakrabarti, Professor and Head of the Department of Medical Microbiology, PGI, said: “As uncontrolled diabetes is the major issue, good glycemic control during the management of Covid patients is required. Systemic steroids should only be used in patients with hypoxemia and oral steroids are contraindicated in patients with normal oxygen saturation on room air.”

“If systemic steroids are used, blood sugar should be monitored. The dose and duration of steroid therapy should be limited to dexamethasone (0.1mg/kg/day) for 5-10 days,” Professor Chakrabarti said.

He said: “During the discharge of Covid-19 patients, they should be advised about the early symptoms or signs of mucormycosis (facial pain, nasal blockage and excessive discharge, loosening of teeth, chest pain and respiratory insufficiency).”

Professor Chakrabarti clarified that no anti-fungal prophylaxis is recommended as the incidence is not more than 10 per cent in any Covid-19 cohort.