DEAR DR. ROACH: Why would a chest illness specialist prescribe steroids for chest an infection from COVID if it suppresses the physique’s immune system? — A.Okay.
ANSWER: Harm to lung tissue can come instantly from an an infection with a micro organism, virus or different pathogen. Nonetheless, further harm might happen because of the physique’s overvigorous response to some particular infections. Through the use of steroids to barely scale back the physique’s inflammatory response, lung harm might be lessened. That is significantly essential when oxygen ranges are very low, as may be the case throughout extreme an infection. I perceive why you might be involved about potential suppression of the immune system, however there’s a confirmed profit in extreme infections with some particular organisms. COVID-19 is one instance, however there are others.
Within the case of COVID-19, steroids are useful when the an infection is sort of extreme, as evidenced by the necessity for supplemental oxygen. COVID sufferers who want oxygen and would profit from steroids must be within the hospital, if the group has hospital beds out there.
I wish to point out that for individuals with COVID-19 who’re in danger for extreme illness, however who don’t meet standards for hospital admission (say, these with low oxygen), there are remedies that scale back threat of hospitalization. Monoclonal antibody remedies have more and more been proven to be efficient and are rather more out there than they was once. They need to ideally be used inside three days of signs, however not more than 10.
Danger elements that warrant consideration of monoclonal antibody remedy are extreme obese or weight problems; power kidney illness; diabetes; immunosuppression by illness or remedy; being over 65; or being over 55 with coronary heart illness, hypertension or power obstructive pulmonary illness (or different power respiratory illness). Early research present that these remedies can dramatically scale back the danger of creating extreme illness.
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Dr. Roach regrets that he’s unable to reply particular person letters, however will incorporate them within the column at any time when doable. Readers might electronic mail inquiries to ToYourGoodHealth@med.cornell.edu or ship mail to 628 Virginia Dr., Orlando, FL 32803.
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