March 20, 2020
The recommended management of Bell’s Palsy is for the administration of oral steroids for 10-14 days . In light of the current COVID-19 virus pandemic, we have been asked about the safety of oral steroids in those diagnosed with acute onset facial paralysis. The effect of giving steroids to those patients with COVID-19 is not known. The virus has a long incubation period where a person may not display symptoms, therefore steroids may be prescribed without anyone being aware that there was an infection. It is possible that this will put those infected at risk of worse outcomes if their immune system is compromised .
There is evidence that higher risk patient groups, such as the elderly and those with significant medical issues such as lung disease are at greater risk.
As with all medical treatments, the balance of risk and benefit has to be weighed up in a discussion between the doctor and patient. A pragmatic approach for those who decide to take steroids is to self-isolate so that they may be at a lower risk if encountering the virus whilst their immune system is compromised.
- Nice Guidance on the management of Bell’s Palsy (Last revised May 2019). https://cks.nice.org.uk/bells-palsy#!management
- Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected. 2020 World Health Organization. WHO. https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected
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