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Inhaled steroids may soon be part of ‘off-label’ Covid treatment | India News – Times of India


MUMBAI: Inhaled steroids, mainly used to treat asthma and other serious respiratory problems, may soon be added to the list of “off-label treatment” for Covid-19 patients in Maharashtra.
The Maharashtra government’s task force on Covid-19 is preparing guidelines for use of inhaled steroid budesonide for patients with mild to moderate symptoms. “We may announce this addition within the next few days,” said Dr Rahul Pandit, a member of the task force.
Two puffs of budesonide daily for 14 days could reduce the risk of hospitalization in mild to moderately ill Covid-19 patients by 91% (as compared to Covid-19 patients on regular treatment), according to a study published by Oxford university in The Lancet Respiratory Medicine earlier this month.
After the study was published, the UK National Health Service introduced inhaled steroid in the list of medicines used “off label” for Covid-19 patients. “Fewer participants on budesonide had persistent symptoms at day 14 and day 28 compared to participants receiving usual care,” said the Lancet study.
Doctors whom TOI spoke to said that inhaled steroids have been used by medical practitioners in Mumbai since May 2020. A doctor from a BMC hospital said that budesonide has a role to play in a certain subsection of Covid-19 patients. “It cannot be used for all Covid-19 patients. It is best to let the doctor decide instead of the patient deciding that they need inhaled steroids, ”said the doctor. Pulmonologist Dr Sujit Rajan from Tardeo’s Bhatia Hospital too treats mild to moderate Covid-19 patients with budesonide. “In September, my team called up all the 170 asthma patients in our care and found out that only one had got Covid. None of the patients with other lung diseases had caught the infection either, ”he said. This showed they had protection perhaps from the inhaled steroids they need to use daily.
Dr Sundeep Salvi of the Chest Research Foundation in Pune said budesonide could be the potential game changer in the pandemic. “The Oxford The study showed that if recently infected Covid-19 patients start taking inhaled steroids as soon as symptoms such as sore throat and cough start, they would benefit immensely, ”he said. On the plus side, budesonide has been used for children and pregnant women with asthma for around four decades. “It is mild, affordable and easily available Oral steroids given to severely ill Covid patients are 40 times the strength of inhaled steroids,” pointed out Dr Rajan. But several doctors are worried about the inadequate research and potential misuse. “Asthmatics are trained by counselors to use the inhaler properly. If the shot is not delivered properly, it could increase the risk of fungal infection, ”said a doctor. Another said that while treating Covid-19 patients with inhaled steroids, care must be taken to ensure the patients don’t have underlying disease such as tuberculosis. A doctor from a civic hospital said there is no “cellular level” proof that inhaled steroids work. “We know that it works at the cellular level for asthma patients, but there is no equivalent research for Covid-19,” said the doctor.

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