Steroid therapy could worsen swine flu, even leading to death, Chinese experts say.
Overuse of the steroid glucocorticoid weakens the patient's immunity badly, noted recalls Li Ning, president of Beijing Youan Hospital, one of the two government-designated hospitals to treat severe H1N1 cases.
So far, 15 of the 49 serious H1N1 patients have died at the hospital, including two pregnant women, said Li.
All the dead had received steroids before being admitted to Youan, said Li, who does not use that line of treatment.
Most of the victims had been given steroid therapy in high doses ranging from 300 mg to 1,200 mg.
The mortality among those who had earlier received high doses of steroid reached 70 percent at the Beijing hospital, twice that among those who did not use steroids, Li noted.
As of Jan. 2, China had recorded more than 120,000 H1N1 flu cases including 659 deaths.
"Random use of steroids in all severe SARS or H1N1 patients is definitely wrong," said Zhong Nanshan, a Guangzhou-based doctor famous for exposing a cover-up of the SARS epidemic and who initiated steroid therapy in China.
"But the right use of steroids in terms of timing, duration and dosage is definitely effective for the treatment of severe SARS and H1N1 patients," he said.
Zeng Guang, chief epidemiologist at the Chinese Center for Disease Control and Prevention, said critically-ill SARS and H1N1 patients suffering respiratory failure could die without steroid treatment, Xinhua reported.
"Given known side effects from steroid treatment like bone degeneration, hypertension and even cancer, the right use of the steroid remains a tough choice facing not only China but the world, " he said.
Internationally, there is no published evidence demonstrating an improvement in morbidity or mortality with steroid treatment in SARS or H1N1.
However, clinicians turn to it as a last resort for treating H1N1 patients, according to media reports.
During the SARS outbreak, high dose steroid therapy was widely used. Roughly 30 percent of SARS survivors in China who received the therapy have developed severe bone degeneration, according to Chen Weiheng, a leading bone specialist in Beijing.
In 2003, SARS infected more than 8,000 people worldwide. China was the worst hit with more than 300 SARS-related deaths and 5,000 infections.