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‘Don’t take dexamethasone without medical advice’

25 Aug 2021

  • Doctors warn public of dire consequences
  • Reports of home-based Covid-19 patients ingesting drug orally
BY Pamodi Waravita The Sri Lanka Medical Association (SLMA) yesterday (24) cautioned patients undergoing home treatment for Covid-19 and their caregivers against the medically unsupervised use of dexamethasone, as it could lead to severe health issues. The SLMA said that such medically unsupervised could lead to a worsened Covid-19 status, high sugar levels in the blood, and even the deadly “black fungus” Infection which was commonly seen amongst patients in India who had contracted Covid-19. “In the present Covid-19 context, the dexamethasone drug is only administered in hospitals, if the patient is suffering from severe pneumonia as a result of Covid-19. Since we started the round-the-clock ‘Doc Call 247’ hotline, we have noticed that some patients who are undergoing home treatment for Covid-19 are taking this drug at home, ingesting it orally without proper medical advice. This is extremely dangerous, especially for diabetic patients,” SLMA Vice President Dr. Manilka Sumanatilleke told The Morning. The SLMA has introduced the round-the-clock 247 hotline for those who are undergoing home treatment for Covid-19 and has urged everyone to contact doctors using the hotline at any time of the day. Dexamethasone is a glucocorticoid medication used to treat a variety of diseases and conditions as an anti-inflammatory and immunosuppressant agent (both glucocorticoid effects) and for palliative treatment due to its effect on the blood and lymphatic systems. Glucocorticoids are a class of corticosteroids, which are a class of steroid hormones that bind to the glucocorticoid receptor in cells. A glucocorticoid receptor is a chemical structure composed of protein that receives and converts signals that may be integrated into biological systems, with the signals being chemical messengers that bind to a receptor and cause some form of cellular or tissue based response. Dr. Sumanatilleke said that if dexamethasone is administered without medical supervision to diabetic patients who have contracted Covid-19, the latter disease condition could worsen, whilst the sugar levels in the blood could also increase. “Other than the usual vitamin D and vitamin C, we caution against using any medicine for the treatment of Covid-19, without prior consultation with a medical expert,” Dr. Sumanatilleke added. Furthermore, he cautioned that the unsupervised use of said drug could result in the black fungus disease, especially in diabetic patients, as was seen in India in the last few months. Consultant microbiologist Prof. Jennifer Perera, who spoke to The Morning earlier this year about the disease, said the black fungus or “mucormycosis” is usually caused by the environment and cannot be spread from person to person. She added that the cases being reported in India may be a result of the steroids that are being used to treat Covid-19 patients suffering from hypoxia – a very low saturation of oxygen in the body’s cells and tissues – and stressed that steroids must therefore only be used for a few days and in a very small dosage, merely to overcome the hypoxia period of the patient. The World Health Organisation (WHO) has stated that the Delta (B.1.617.2) Covid-19 variant of Indian origin is at least two times as transmissible as the original virus. Sri Lanka is currently facing a severe spread of the Delta variant in all districts. The Health Promotion Bureau (HPB) said that 4,355 new cases and 194 deaths were reported on 23 August due to the virus.


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