Agree and disagree with @VincentRK statements

Agree - harmful if given early or given too long

Disagree - only useful after they become hypoxic (SpO2 <92)

If we wait for patient to become hypoxic, there's no easy availability of oxygen beds.

See my viewpoint below.
Timely start is key
Empowering patients to recognize warning signs is key
Access to an informed doctor is key

Considerable anecdotal reports of benefit with above strategy from peripheral centresc
Critics say no evidence it helps (rather evidence of possible harm). But closer reading of RECOVERY trial shows that at least 50% of patients in group not requiring O2 or resp support were started on steroids between 3 to 6 days of symptom onset.
At least in the face of massive resource crunch, Evidence Based Medicine must take the backseat. Absence of evidence is not the same as evidence of absence (can't believe I said it).
@KrutikaKuppalli @paimadhu @cspramesh et al must have a re-look into their resourceful cheatsheet for COVID home care.

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More from @ajumathew_

16 May
Steroids in #COVID19 (thread)
Steroid therapy is one of the cheapest and most effective therapy for COVID pneumonia. But, confusions abound. Stay with me. It's a little complicated.
RECOVERY trial looked at short course steroid use for hospitalized patients with COVID. Patients lived longer when steroids were given for patients who needed supplemental oxygen or resp device support. Image
Read 18 tweets
20 Feb 18
An RCT published in @bmj_latest with two authors from rural India and NO FUNDING. :) Quite impressive. bmj.com/content/342/bm…
My new heroes in medicine - That's the two-people trial team. One day I hope to visit their hospital in rural Maharashtra. For more: ncbi.nlm.nih.gov/pmc/articles/P…
"he prepared a paper on data of 51 cases of scorpion stings and sent it to an Indian journal. It was rejected for editorial reasons like “English writing not good enough.”
Read 13 tweets

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