The Union Health Ministry on Saturday included the use of a corticosteroid drug, dexamethasone, in the treatment protocols for coronavirus COVID-19 patients in moderate to severe cases. Keeping pace with evolving knowledge about COVID-19, the ministry released an updated clinical management protocol for managing COVID-19 cases.
The updated protocol included the advice to use dexamethasone as an alternative choice to methylprednisolone. The change has been made after considering the latest available evidence and expert consultation.
Dexamethasone is used in a wide range of conditions for its anti-inflammatory and immunosuppressant effects. The drug has been tested in hospitalized patients with COVID-19 in the recovery clinical trial and was found to have benefits for critically ill patients.
It 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 therapy. The drug is also a part of the National List of Essential Medicines (NLEM) and is widely available.
Union Health Secretary Preeti Sudan has forwarded the updated protocol with all states/UTs to make necessary arrangements for availability and use of the updated protocol and drug dexamethasone at the institutional level also. The guidance document has also been made available online on the website of the Health Ministry. The last update to the clinical management protocol was done on June 13.
The health ministry on June 13 had also allowed the use of antiviral drug remdesivir for restricted emergency use and off-label application of tocilizumab, a drug that modifies the immune system or its functioning, and convalescent plasma for treating COVID-19 patients in moderate stage of the illness as an investigational therapy, according to news agency PTI. It also recommended hydroxychloroquine in patients during the early course of the disease and not on critically ill patients.
The use of these drugs continues to be included in the revised treatment protocols under the ‘investigational therapy’. The revised treatment protocols for moderate cases advised 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 admission or if oxygen requirement is increasing and if inflammatory markers are increased.