Does a COVID-19 patient without breathing difficulty need steroids?

Question

Hello doctor,

My sister-in-law is COVID-positive, detected yesterday by RT PCR. She is 35 years old. She has a mild dry cough and nasal congestion.

Today, she had an HRCT done that showed patchy ground-glass opacities in the superior and the posterior basal segment of the right lower lobe and the left lower lobe's posterior basal segment. The findings suggest focal infiltrate (viral etiology), Co-RADS 6. CT severity index 2/25.

She is non -diabetic and non-hypertensive. All other investigations are normal except for the mild increase in IL-6, LDL 144, and TGL 248.

Please suggest to us the further management. Few doctors have suggested steroids.

Does she need steroids?
What treatment does she need?

She does not have chest tightness or shortness of breath. Her vitals are stable.

Please let us know.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have read your query.

And I can understand your concern.

According to your statement, your sister-in-law has been suffering from a mild dry cough and nasal congestion. According to HRCT chest (high-resolution computed tomography), it suggested a focal infiltrate resulting from pneumonia due to COVID-19 infection or as a consequence of complications of COVID-19 infection. In other words, she may suffer from COVID pneumonia.

IL-6 (interleukin-6) is an acute marker, and its increase indicates the presence of infection or inflammation, such as COVID-19 infection.

TGL means Triglycerides- am I right?

Then she may need to take Fenofibrate to reduce TG and LDL (low-density lipoprotein).

As she has COVID pneumonia, a doctor has suggested a steroid to prevent pneumonia from becoming worse or severe. I think she needs to take antiviral medications too. Monitor her oxygen saturation level with a pulse oximeter.

I hope this helps.

Please let me know if I can assist you further.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I am trying to provide the prescription.

She can take the following medications:

Tablet Azithromycin 500 mg 1+0+1 for 10 days.
Tablet Fexofenadine 120 mg 0+0+1 for 10 days.
Tablet Favipiravir 200 mg 8+0+8, on day 1, then 3+0+3 from day 2 to day 5 (total five days).
Capsule Fenofibrate 200 mg 0+0+1 (after meal) to be continued.

Hopefully, the above-mentioned medications will help to lessen her present suffering. Give her the steroid according to her doctor's advice.

I hope it helps.

Please let me know if I can assist you further.

Thank you.