No, you should not use cortisone without medical advice if you are positive for coronavirus

No

This is one of the indications that the Ministry of Health has released in the new protocol for the home management of patients with Covid-19: no to antibiotics, early corticosteroids or mild forms, and heparin; yes to paracetamol, ibuprofen and continuous monitoring

Fatigue is among the three most common symptoms of Covid-19 reported by the WHO, along with fever and dry cough (photo: LaylaBird via Getty Images) After the controversy over hydroxychloroquine , on vitamin D and so on and so forth, the Ministry of Health publishes a new protocol for the home management of patients with Covid-19, drawing up a list of remedies and conditions for their prescription, from paracetamol to antibodies monoclonal. The information provided, the ministry specifies, was produced on the basis of the scientific evidence available so far. Here are some of the top tips for treating asymptomatic and paucisymptomatic Sars-Cov-2 infections.

Watchful waiting

Faced with a patient who tested positive for Sars-Cov infection -2 the attending physician must arrange for constant monitoring of vital parameters and clinical conditions, so as to promptly detect the evolution of the infection. The periodic measurement of oxygen saturation by pulse oximetry is important, a parameter that can indicate progression towards pneumonia.

Symptomatic treatments

If mild symptoms such as fever or muscle / joint pain appear, these can be treated with acetaminophen or NSAIDs (non-steroidal anti-inflammatory drugs, for example ibuprofen). Other symptomatic medications may be prescribed at the discretion of the practitioner.

Correct hydration, nutrition and physical exercise at home (compatible with the patient's conditions) are supportive, also to limit the consequences of bed rest, especially in the elderly.

Cortisone and corticosteroids

The circular emphasizes that steroidal anti-inflammatories are not to be used routinely for home care: no to taking them in the case of asymptomatic or symptomatic forms from the beginning. "The use of corticosteroids - reads the document - is recommended only in people with severe Covid-19 disease who need oxygen supplementation. The use of these drugs at home can only be considered in patients with risk factors for disease progression to severe forms, in the presence of a worsening of pulse oximetry parameters requiring oxygen therapy where immediate hospitalization due to overload is not possible. of hospitals ".

The reason is soon said:" The use of early steroid therapy has proved useless if not harmful as it can affect the development of an adequate immune response ".

In other words, cortisone and the like taken early put a brake on the immune system in the phase in which it has just waged battle against the coronavirus, decreasing the chances of containing the infection.

Another matter is use in hospitalized patients with severe disease requiring oxygen therapy. In these cases, corticosteroids such as dexamethasone have shown evidence of decreasing the mortality rate.

Heparin

Heparin should also not be used for home management, unless the patient is immobilized.

Monoclonal antibodies

For the ministry the doctor has the possibility to evaluate the early treatment with monoclonal antibodies by the structures authorized to prescribe in case of patients at risk of progression of disease . As per Aifa indications, monoclonal antibodies can be considered for patients over 12 years of age, positive for Sars-Cov-2 but not hospitalized, with mild / moderate symptoms occurring no more than 10 days and with at least one factor risk for progression to severe Covid-19.

Not recommended: antibiotics

If there is no evidence of other infections other than Sars-Cov-2, use of antibiotics it is not recommended. "An unjustified use of antibiotics can also determine the onset and spread of bacterial resistance that could compromise the response to future antibiotic therapies".

Not recommended: hydroxychloroquine

L 'hydroxychloroquine is not considered a treatment for Covid-19: the randomized controlled trials conducted so far have not demonstrated its efficacy.

Not recommended: antivirals

"The use of lopinavir / ritonavir or darunavir / ritonavir or cobicistat is not recommended for either the purpose of preventing or treating the infection. The randomized clinical trials published to date all conclude for an ineffectiveness of these pharmacological approaches ".


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Coronavirus Italy Health Covid-19 therapies globalData.fldTopic = "Coronavirus, Italy, Health, Covid-19 therapies"

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