COVID-19 in India: Remdesivir isn't magic bullet that decreases mortality, says AIIMS director Dr Randeep Guleria

The COVID-19 sitaution in India is getting worse with each passing day. Currently, the country is dealing with various crisis like shortage in beds, oxygen, medicines, drugs and many other things related to the health infrastructure. Over the current scenario, AIIMS Director Dr. Randeep Guleria has said that in last 1 year of COVID-19 management, we have learnt that 2 things are most important – drugs and timing of drugs.

In his opinion, if you give drugs/medics too early or late, it would cause harm. "Giving cocktail of drugs on day 1 can kill your patient and would be more harmful," he added.

Commenting on the usage of the Remdesivir, the AIIMS chief said, "It's imp to understand that the injection isn't magic bullet and isn't a drug that decreases mortality." He further told, "we may use it as we don't have an anti-viral drug but it's of no use if given early to asymptomatic individuals/ones with mild symptoms. "Also of no use, if given late," he added.

According to him, Remdesivir should only be given to patients who are hospitalised, had fall in oxygen saturation and have infiltrates on the chest X-ray or CT-scan.

He also cited certain studies which show plasma therapy has limited role and isn't of much use. "Less than 2% COVID-19 patients require Tocilizumab that's being used lot these days. Majority of patients with mild symptoms/asymptomatic will improve with just symptomatic treatment," he added.

Based on ICMR data, the current variants are also being picked up by the RT-PCR tests. The RT-PCR test has sensitivity of around 80 per cent and therefore 20 per cent of the cases can still be missed out.

"Also, if the sample is not properly taken or if the test is done too early when the viral load is low, it may come out negative. So, if a person is symptomatic, a combination of clinical features, laboratory reports, CT/chest X-ray can be used for presumptive diagnosis of COVID-19 and treatment should be started accordingly. The test should also be repeated after 24 hours," AIIMS Director told.

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