Health Ministry adds steroid dexamethasone in COVID-19 treatment protocol
New Delhi: An inexpensive, widely used steroid dexamethasone was included in the treatment protocols for COVID-19 patients in moderate to severe stages of illness among other therapeutic measures by the Union health ministry on Saturday.
The updated protocol includes the advice to use dexamethasone as an alternative choice to methylprednisolone for managing moderate to severe cases of COVID-19. The change has been made after considering the latest available evidence and expert consultation, the ministry said.
According to the revised 'Clinical Management Protocols for COVID-19', dexamethasone which is already used in treating lung infections besides in a wide range of conditions for its anti-inflammatory and immunosuppressant effects can be used as an alternative to methylprednisolone which already existed in the treatment guidelines.
The health ministry on June 13 had also allowed the use of antiviral drug remdesivir for restricted emergency use and off-label application of tocilizumab, a drug that modifies the immune system or its functioning, and convalescent plasma for treating COVID-19 patients in moderate stage of the illness as an investigational therapy .
It also recommended hydroxychloroquine in patients during the early course of the disease and not on critically ill patients.
The use of these drugs continues to be included in the revised treatment protocols under the 'investigational therapy'.
The revised treatment protocols for moderate cases advised considering methylprednisolone 0.5 to 1 mg/kg or dexamethasone 0.1 to 0.2 mg/kg for three days, preferably within 48 hours of admission or if oxygen requirement is increasing and if inflammatory markers are increased. The duration of administration should be reviewed as per clinical response.
For patients having respiratory distress requiring mechanical ventilation, both non- invasive and invasive, the ministry said methylprednisolone 1 2mg/kg/day or dexamethasone 0.2 to 0.4 mg/kg per day should be considered for 5-7 days in two divided doses, if not given already.
"Note that a larger dose of glucocorticoid will delay the removal of coronavirus due to immunosuppressive effects," the treatment protocols stated.
The revised treatment protocols were issued as India's COVID-19 tally raced past the five-lakh mark on Saturday with the biggest single-day surge of 18,552 cases while the death toll climbed to 15,685 with 384 fatalities, the updated figure at 8 am showed.
According to WHO, the corticosteroid dexamethasone was tested in hospitalised patients with COVID-19 in the United Kingdom's national clinical trial 'RECOVERY' and was found to have benefits for critically ill patients.
According to preliminary findings shared with WHO, for patients on ventilators, the treatment was shown to reduce mortality by about one-third, and for patients requiring only oxygen, mortality was cut by about one-fifth.
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Putin meets Iran's FM Araghchi, says Russia ready to do its best to help bring peace to West Asia
Moscow (PTI): Iran's Foreign Minister Abbas Araghchi on Monday met Russian President Vladimir Putin, who hailed the Iranian people for fighting bravely and heroically for their sovereignty and said Moscow is ready to do its best to help bring peace to West Asia as soon as possible.
Araghchi, who held talks with Omani and Pakistani leadership before arriving in Russia, met Putin in St. Petersburg and thanked him for supporting Iran, state-owned TASS news agency reported.
"Russia is ready to do everything in its power to ensure that peace in the Middle East is achieved as soon as possible," Putin said during his meeting with Araghchi, which was also attended by Russian Foreign Minister Sergey Lavrov.
Revealing that he received a message from Iranian Supreme Leader Mojtaba Khamenei last week, Putin asked Araghchi to convey his "gratitude for this message and best wishes for his health and well-being."
He praised the Iranian people for fighting "bravely and heroically" for their sovereignty, Iran's state-run PRESS TV reported.
"We really hope that, based on the courage and desire for independence, the Iranian people, under the guidance of the new leader, will weather this difficult period of trials and peace will come,” Putin said.
He also stressed that Russia “intends to maintain” its strategic relations with Iran.
Araghchi said that the world witnessed Iran’s strength in countering the US during the recent war, and that the Islamic Republic is a "stable and powerful establishment."
"With their courage, the Iranian people succeeded in resisting the US aggression and will be able to endure it,” he said.
He said that it became clear that Iran has “great friends and allies” like Russia, and conveyed “warmest greetings” from Supreme Leader Mojtaba Khamenei and President Masoud Pezeshkian to the Russian leader.
Araghchi said relations between Moscow and Tehran represent a “strategic partnership at the highest level” and will continue to develop "regardless of circumstances."
"We are grateful to you for the solid and strong positions in support of the Islamic Republic of Iran," he said.
Foreign Minister Lavrov said that the talks between President Putin and the Iranian Foreign Minister were "useful and constructive."
Kremlin Spokesman Dmitry Peskov later said that Russia is "ready to provide any good offices, any mediation services that are acceptable to the parties."
"We will be ready to do everything so that ultimately peace ensues, guaranteed peace, and that there is no return to hostilities," Peskov was quoted as saying by TASS.
He was asked how Moscow can assist in future negotiations on the Iranian settlement.
Araghchi arrived in Russia after his whirlwind trip to Islamabad, which, according to him, was “very productive” and involved “good consultations" with Pakistan's Army Chief Field Marshal Asim Munir, amid uncertainty over the second round of peace talks to resolve the war in West Asia.
"We held good consultations with our friends in Pakistan. The trip was successful. We assessed the outcome of our recent (meetings) and discussed in what direction and under what conditions talks can move on,” Araghchi said in a video posted on his Telegram channel upon his arrival in St Petersburg.
Referring to the second round of talks between the US and Iran to resolve the conflict in West Asia, Araghchi said: "Developments have taken place in the negotiations."
"Despite some progress in earlier rounds, the talks failed to reach their objectives due to the Americans' approach, the excessive demands they made, and the wrong approaches they adopted. Therefore, it was necessary to consult with our friends in Pakistan to review the latest situation,” Iran's official news agency IRNA quoted him as saying.
He said that the trip to Pakistan was a good opportunity to review developments related to the US-Israeli war against Iran, expressing confidence that “these consultations and coordination between the two countries will be highly significant.”
Araghchi arrived at St. Petersburg's Pulkovo Airport early Monday, where he was welcomed by Russian officials and Iran’s ambassador to Russia, Kazem Jalali, the report said.
The first round of peace talks between Iran and the US, held on April 11 and 12, failed to bring the desired result for the parties to the conflict.
The Iranian minister arrived in Islamabad for the second time on Sunday after a short visit to Oman, where he held talks with Sultan Haitham bin Tariq al-Said on security in the Strait of Hormuz and diplomatic efforts to end the Iran-US conflict.
After Araghchi left Pakistan for Oman on Saturday, President Donald Trump announced that US negotiators Steve Witkoff and Jared Kushner would no longer be going to Islamabad for talks with Iran, contending that Washington held all the cards on the matter.
Trump on Sunday reiterated that the US and Iranian officials can talk by phone for a peace solution to the conflict.
On Tuesday, Trump extended the two-week ceasefire with Iran indefinitely to give Tehran more time to prepare a unified proposal to end the war, just hours before the truce was set to expire.
The war began when the US and Israel jointly attacked Iran on February 28, killing Iranian Supreme Leader Ayatollah Ali Khamenei and several top commanders. The retaliation by the Islamic Republic extended the war to the entire Gulf region.
