June 1, 2023

Dexamethasone has been shown to improve survival rates among severe Covid-19 patients who require oxygen or are on mechanical ventilation. It is a drug classified as a steroid.
Steroids, either glucocorticoids or mineralocorticoids, are anti inflammatory and immune-modulating drugs that are useful in the field of medicine and when used the right way can offer several benefits. They are used in treating inflammatory, allergic, immunologic disorders and also some forms of cancer. They are available as tablets, liquids (syrup), or as inhalers, injections and creams or ointments. Their use is associated with several side effects which occur depending on the dose and duration of use and patient’s response.
Side effects associated with prolonged steroid use include acne formation, muscle weakness, weight gain due to water retention, moon face can also develop, changes in the skin like thinning and easy bruising, inability to sleep, anxiety, panic disorder, mood disorder, and cataract formation.
Topical or so-called non-systemic steroids like creams and ointments to a certain degree are absorbed by the body.
Steroids reduce or prevent the absorption of calcium in the intestine and bring about bone resorption, so that if a person takes oral steroids for more than two months serious fractures can occur. Osteoporosis and osteonecrosis are common adverse effects.
Drug-induced diabetes mellitus is another side effect of prolonged use of oral steroids. These drugs promote insulin resistance leading to elevation of blood sugar levels.
Steroid use can lead to sodium and water retention in the body, leading to edema. This can cause problems in patients with heart or kidney failure. Premature atherosclerotic disease and cardiac arrythmias can also occur. Blood pressure elevation can develop with the use of steroids by mechanisms that are not yet well understood. Steroid use has been associated with increased rate of heart failure, heart attack, and stroke.
Cataracts can slowly develop in both eyes after prolonged use of steroids. It is more common with prednisone doses higher than 10 mg/day or if used for more than one year. Prolonged or acute systemic and steroid eye drops can cause glaucoma or increased pressure inside the eye.
The use of steroids increases the risk for gastritis, ulcer formation, and gastrointestinal bleeding.
The use of steroids should strictly be supervised by a doctor. If the drug was taken for less than seven days, it may be stopped without slowly reducing the dose. If these drugs were used for a long time they should not be stopped suddenly. The dose is gradually reduced to allow the body to adjust. The adverse effects gradually subside.
While dexamethasone can improve survival among severe cases of Covid-19, steroids must not be taken by self-medication to avoid getting infected with the coronavirus. Neither should it be used routinely for pain relief.

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