Due to psychological anxiety because of COVID-19, many patients treated at home have self-medicated, including corticosteroids (such as Medrol). There have been cases of gastrointestinal bleeding and more severe cases of COVID-19 due to self-medication.
1. Corticosteroid side effects
Corticosteroid anti-inflammatory drugs (dexamethasone, prednisone, methylprednisolone, hydrocortisone...), nature of the hormone group, with very strong biological properties even at very small doses and capable of affecting many organs and organizations in the body.
Corticosteroids are a very familiar group of anti-inflammatory drugs used in the treatment of many diseases: Inhibiting inflammatory disorders, anti-allergy and suppressing the immune system. However, these drugs should only be used after very careful benefit/risk considerations and only when absolutely necessary.
Corticosteroids have many other side effects, even when used in a short time, such as causing hyperglycemia, glaucoma, psychosis, peptic ulcers... long-term use can cause inhibition of the hypothalamic-pituitary-gonadal axis. adrenal gland, causing acute adrenal insufficiency, osteoporosis, endocrine disorders... and many other dangerous side effects.
2. When do covid patients need corticosteroids?
People with COVID-19 can have varying degrees of illness, from no symptoms, to mild, moderate, severe, and critical symptoms. With each level of disease, the pathogenesis is very different, requiring careful drug selection. If the medicine used for this disease level is mistaken for another disease level, not only is it not beneficial but also harmful, even seriously affecting the patient's health.
In the case of corticosteroids, two commonly mentioned drugs in the treatment of COVID-19 are dexamethasone and methylprednisolone (Medrol). This class of drugs is only used for people with moderate or higher levels of disease, mainly because in these patients, the immune system may be overactive and cause damage to various organs in the body. Dexamethasone or methylprednisolone is indicated because the drug has an immunosuppressive effect, which in the body will act to "suppress" the excessive effects of the immune system that is attacking and causing organ damage.
For these reasons, when using corticosteroids in treatment in general and in the treatment of COVID-19 in particular, it is necessary to be very cautious, carefully weighing the benefits and risks.
In accordance with the treatment guidelines of the Ministry of Health, corticosteroids are NOT allowed to be used for asymptomatic COVID-19 patients or with only mild symptoms. The appointment of this drug in the treatment regimen for COVID-19 must be decided by the doctor after a very careful assessment of the patient's condition.