PMR and Covid

[dolphin39]

I have been following your advice on slow reduction of prednisolone and am now down to 2mg a day. I have not had a flare for a year, Today I tested positive for covid. Is it advisable to increase the pred and if so, how much and how long for?

[SnazzyD]

Oh dear, poor you. Hopefully you’ll be one of many who aren’t too bad. Ideally you need the advice of your doctor. How have you been up to now? Any signs of adrenal insufficiency or PMR before you were ill? Personally I didn’t bump up the dose for illness unless I felt like I couldn’t cope and knew the signs. However, there are the sick day rules as noted by Mrs Nails below. healthunlocked.com/pmrgcauk....

[dolphin39 in reply to SnazzyD]

Thank you

[SheffieldJane]

On your low dose I would be inclined to follow the sick day rules ( with doctor’s approval). An extra 5 mgs for about 10 days then back to 2 mgs if you were coping well at that dose. Your own Adrenaline production maybe a bit unreliable at the moment, hence the boost.

[dolphin39 in reply to SheffieldJane]

Thanks for advice

[Exflex]

You raise a very good question. I’ve have thought through similar scenarios as I had a cytokine storm in 2020 when my exertion exceeded supply of artificial cortisol that hospitalised me. My thoughts: I would not take a preemptive increase in Prednisolone, but would be watchful for early signs of cytokine excess, and then follow the sick day plan. With Covid it’s a balancing act between enabling our immune response and controlling the inflammation. Doctors are best placed to advise.

[dolphin39 in reply to Exflex]

Thank you

[PMRpro Ambassador]

I would see how I feel - but I would also look at the sick day rules Snazzy has linked to and call your GP and discuss the rules with them.

The idea is that the body would normally produce extra cortisol to help the body deal with the stress of illness - and you need it sooner rather than later. At 2mg your adrenal response is still probably still unreliable at best.

[dolphin39 in reply to PMRpro]

Had a look at all the helpful advice and took an extra 5mg. Already feeling much better.

[Maidmarrion66]

Hi I have been off steroids for may be two months now I got positive test on good Friday so far I am doing OK very tired have to rest offen. Everyone is different see how you feel. Good luck.

[dolphin39 in reply to Maidmarrion66]

Thanks

[Notspeedy in reply to dolphin39]

Having just got down to Zero pred. ( less than 1 week ago) And had Covid just over a month ago- my suggestion would be to come back down to 2mg after a few days and then take it even slower down to Zero. Half mg steps seems to work

[dolphin39 in reply to Notspeedy]

Thanks for reply. I am following dead slow method, but an increase of 5mg is helping me cope with covid for a few days.