The Center will revise the Covid-19 Treatment Guidelines for Mild, Moderate and Severe Symptoms.Click here for details

Guidelines for the management of adult Covid-19 patients with MILD symptoms:

Symptoms of the upper respiratory tract or fever without shortness of breath are classified as “mild” Covid-19 symptoms.

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Isolation of the house, physical distance, use of indoor masks, and monitoring of temperature and oxygen saturation.

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If you are faced with dyspnea, or if SpO2 is below 93%.

High fever / severe cough, especially lasting 5 days or more

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If symptoms (fever or cough) persist for more than 5 days after onset, administer inhaled budesonide (5 days via a quantitative dos inhaler / dry powder inhaler) at a dose of 800 mcg BD.

Guidelines for the management of adult Covid-19 patients with moderate symptoms:

Respiratory rate is less than 24 / min and shortness of breath. SpO2 is between 90% and 93% — these are moderate Covid-19 symptoms.

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Arousal proning is recommended for all patients requiring oxygen supplementation therapy.

Methylprednisolone 0.5-1 mg / kg given in 2 divided doses (or equivalent dose of dexamethasone), usually for 5-10 days

There is no evidence of the benefits of injectable steroids in those that do not require oxygen supplementation or in continuation after discharge.

Anti-inflammatory or immunomodulatory therapies (such as steroids), if used too early, at high doses, or for longer than necessary, may carry the risk of secondary infections such as invasive zygomycosis.

Conventional doses of prophylactic unfractionated heparin or low molecular weight heparin (weight-based, eg enoxaparin 0.5 mg / kg / day SC). It should not be contraindicated or at high risk of bleeding.

Guidelines for the management of adult Covid-19 patients with severe symptoms:

Patients with a respiratory rate of less than 30 / min, shortness of breath, and room air oxygen levels of less than 90% are considered to have severe Covid symptoms.

Anti-inflammatory or immunomodulatory therapy:

Methylprednisolone 1-2 mg / kg IV is given in two divided doses (or equivalent doses of dexamethasone), usually for 5-10 days.

Steroids are at risk of secondary infections such as black fungi if used too early, at high doses, or for longer than required.

Clinical monitoring: respiratory work, hemodynamic instability, changes in oxygen requirements

Serial CXR; HRCT chest performed only when worsening

Lab monitoring: CRP, D-dimer, blood glucose every 48-72 hours. CBC, KFT, LFT every 24-48 hours.

Remdesivir is considered only for the following patients:

-10 days after onset of symptoms in people with moderate to severe illness (needs oxygen supplementation) but not participating in IMV or ECMO

-Consider remdesivir for 5 days to treat inpatients with Covid-19 (no evidence of benefit of treatment beyond 5 days)

-Do not use in patients without oxygen support or at home

-Recommended dose: 200 mg IV on day 1, then 100 mg IV OD for 4 days.

Tocilizumab is only considered if:

-Rapidly progressing Covid-19 requires oxygen supplementation or IMV and does not respond appropriately to steroids (preferably within 24-48 hours of the onset of severe illness / ICU admission)

-Preferably given with steroids

-No active tuberculosis, fungi, systemic bacterial infections

-Long-term follow-up of secondary infections (tuberculosis reactivation, herpes flare, etc.)

-Recommended single dose: 4-6 mg / kg (400 mg for a 60 kg adult) in 100 ml NS over 1 hour

The latest guidelines do not recommend drugs such as ivermectin, favipiravir, or doxycycline. Antiviral drugs such as molnupiravir and monoclonal antibodies are also not included in the guidelines.