The steroid should only be used after the oxygen level decreased below 92 and only after the consultation with specialist/Physicians


As Nepal bears the brunt of soaring Covid-19 cases on an everyday basis, hospitals and health care providers, by default, are getting overwhelmed with heavy influx of patients and corresponding shortages.

Many groups and individuals have come together to share relevant information on social media to facilitate people, especially those that are infected and in home isolation, with access to knowledge on at-home-management of Covid-19 related woes. Some groups have been working as pool between health care providers and service seekers during these trying times.

In the same regard, Internist and Infectious Diseases Physician Dr Anup Subedee, who from time to time cautions the government and the public alike regarding 'Covid-19 etiquette' and dangers of violation of the same, took to Twitter to disseminate some useful tips that can be followed by the infected with falling levels of oxygen, while they continue their search for hospital beds for treatment.

Dr Subedee had been alarming people to not take it as the threat has passed even as the cases had started to 'seemingly deflate' prior to emergence of the second wave of the pandemic.

Highlighting the importance of prior consultation, Dr Subedee suggested that Covid-19 patients in home isolation with low oxygen levels must immediately start steroid medications to save the life till they are admitted to the hospital.

According to him, in cases where a patient's oxygen levels drop to 92 per cent or lower (when a finger is kept inside an oximeter for at least 30 to 60 seconds), they should immediately start steroids which cuts down the threat of further deterioration of their health.

However, Dr Subedee has cautioned that the medication should only be administered after body's oxygen level decreases below 92, and only upon consultation with specialists to avoid a severe negative effect.

He further shared patients with low oxygen levels can ingest either Tab Methylprednisolone 32 mg (two tablets of 16 mg or four tablets of 8 mg) together once a day or Tab Dexamethasone 6 mg (12 tablets of 0.5mg) once a day or Tab Prednisolone 40 mg one tablet per day.

All tablets should be taken after a meal, he added.

"The use of steroids will increase the level of blood sugar in cases of diabetic patients. Therefore, such individuals need to regularly measure their sugar levels and seek advice from their doctors to increase the dose of their diabetese medication(s) or take insulin for some days."

In addition to the tips, Dr Subedee shared with THT a poster on proning (image below) containing instructions for patients that have cough or have trouble breathing.

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He also urged all to keep on looking for oxygen for the patients or try to get them admitted to the hospital even as they resort to the aforementioned prescriptions.

As the steroids will slow down the intensity of infection, it will buy some precious time to forage oxygen and hospital beds, Dr Subedee added while claiming that some patients might not even need oxygen support after the use of steroids.

As these medications can easily be found in pharmacies, he asked people to not hoard them which could lead to an artificial shortage, and only buy them as and when needed.

There are many helplines available across the country for covid patients to remotely avail service regarding Covid-19 management at home.