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Corticosteroid drugs should only be used with doctor's prescription in COVID-19 treatment

Medical experts have warned the self-administration of corticosteroid drugs during home treatment of COVID-19 cases without a doctor’s input could worsen the disease. With the COVID-19 caseload skyrocketing throughout Vietnam, and home-based treatment becoming the norm as the majority suffer only asymptomatic to mild cases thanks to a very high vaccination rate, many overly worried patients have resorted to word of mouth treatments.

Some corticosteroid drugs circulating online are dexamethasone and methylprednisolone, which should only be prescribed by doctors for COVID-19 patients in mild or serious cases since their hyperactive immunity might be causing damage to their own organs.

While corticosteroids – strong hormone-related drugs even at lower dosages with wide-ranging effects throughout the body – are a very familiar group of anti-inflammatory drugs used in the treatment of many diseases from inhibiting inflammatory disorders and allergic reactions, these drugs should only be used after very careful benefit/risk considerations and only when absolutely necessary, said Dr Nguyen Thi Lien Huong from the University of Pharmacy Hanoi.

The drugs can inhibit immune response, lessening the severity of the assaults on the body during COVID-19 infection, which could lead to reduced hospitalisation time and cut mortality risks, according to clinical studies.

However, Dr Huong said that only a small fraction of COVID-19 patients suffer from this condition, and in most cases, especially among the vaccinated/boosted, the immune system was activated at an adequate level to fight off the virus without causing unintended damage.

This means if the corticosteroid drugs are used on unsuitable patients during COVID-19 treatment, the immune system might be unduly suppressed and no longer as effective in battling coronavirus as it should have been and causing the disease to progress further.

Early use of corticosteroids – when the patient has not required oxygen masks and saturation of peripheral oxygen (SpO2) is over 95 per cent – might lead to higher severe disease and fatality rates compared to non-use, according to Dr Nguyen Huy Hoang from the Vietnam-Russia Hyperbaric Oxygen Centre.

This is not to mention other opportunistic infections – including from bacteria and fungi – that could take hold when the body’s protection is lowered.

Taking corticosteroids even in the short term could also have various side effects like hyperglycemia, glaucoma, psychosis, peptic ulcers, etc. while long-term use can cause inhibition of the hypothalamic-pituitary-adrenal axis, acute adrenal insufficiency, osteoporosis, and endocrine disorders./.