Navigating COVID-19 Treatment: CT Scans, Steroids, and Medical Practice Challenges in India

Jayanthi E ¹, C. Elayaraja ², Priyadharshini S ², Ashok kumar M ²

The review highlights India's struggle with COVID-19, emphasizing the need for tailored treatments amid rising cases, cautioning against unnecessary tests and misuse of medications.

Abstract

India is facing a severe challenge with the second wave of COVID-19, surpassing two crore cases. Individual treatment varies based on infection severity, with guidelines from the Indian Council for Medical Research (ICMR) advising against unnecessary RT-PCR testing, even for interstate travelers. However, the indiscriminate use of CT scans and steroids poses risks, cautioned by experts like Dr. Randeep Guleria. Overuse of CT scans, equivalent to 300 X-rays, leads to radiation exposure and potential cancer risks. Steroids, beneficial in severe cases, are misused in mild infections, increasing susceptibility to fungal infections. Balancing timely intervention and avoiding undue harm is crucial. Additionally, curbing reliance on costly and unnecessary tests like CT scans and IL-6 tests is essential to prevent patient confusion and long-term health risks.

Keywords: COVID-19, India, RT-PCR testing, CT scans, Steroids, Medical guidelines

References

Bani-Sadr et al (2020). Corticosteroid therapy for patients with COVID-19 pneumonia: a before–after study. International Journal of Antimicrobial Agents, 56(2), 106077.

Gong et al (2020). Effects of methylprednisolone use on viral genomic nucleic acid negative conversion and CT imaging lesion absorption in COVID-19 patients under 50 years old. Journal of medical virology, 92(11), 2551-2555.

https://www.thehindu.com/sci-tech/health/explained-why-have-doctors-cautioned-against-misuse-of-ct-scans-and-steroids-to-diagnose-and-treat-covid-19/article34516623.ece

https://www.thehindu.com/specials/explained-ip-rights-and-vaccines-use-of-ct-scans-and-steroids-for-covid-19-and-supreme-court-ruling-on-identifying-backward-classes/article34517428.ece

Hu et al (2020). Clinical use of short-course and low-dose corticosteroids in patients with non-severe COVID-19 during pneumonia progression. Frontiers in public health, 8, 355.

Li and Ma (2020). Acute respiratory failure in COVID-19: is it “typical” ARDS?. Critical Care, 24, 1-5.

Li et al (2020). Efficacy evaluation of early, low-dose, short-term corticosteroids in adults hospitalized with non-severe COVID-19 pneumonia: a retrospective cohort study. Infectious diseases and therapy, 9(4), 823-836.

Liu et al (2020). Risk factors associated with disease severity and length of hospital stay in COVID-19 patients. Journal of Infection, 81(1), e95-e97.

Mazza et al (2020). A fatal case of COVID-19 pneumonia occurring in a patient with severe acute ulcerative colitis. Gut, 69(6), 1148-1149.

Saghazadeh and Rezaei (2020). Towards treatment planning of COVID-19: rationale and hypothesis for the use of multiple immunosuppressive agents: anti-antibodies, immunoglobulins, and corticosteroids. International immunopharmacology, 106560.

Singh et al (2020). Role of corticosteroid in the management of COVID-19: A systemic review and a Clinician’s perspective. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(5), 971-978.

Su et al (2020). Tailoring steroids in the treatment of COVID-19 pneumonia assisted by CT scans: three case reports. Journal of X-ray science and technology, (Preprint), 1-8.

Wang et al (2020). Early, low-dose and short-term application of corticosteroid treatment in patients with severe COVID-19 pneumonia: single-center experience from Wuhan, China. MedRxiv.

Yuan et al (2020). Effects of corticosteroid treatment for non-severe COVID-19 pneumonia: a propensity score-based analysis. Shock, 54(5), 638-643.

Zha et al (2020). Corticosteroid treatment of patients with coronavirus disease 2019 (COVID-19). Medical Journal of Australia, 212(9), 416-420.

Zhai et al (2020). The epidemiology, diagnosis and treatment of COVID-19. International journal of antimicrobial agents, 55(5), 105955.