The Ministry of Health will revise the guidelines for the management of adult Covid-19 patients.Learn more here

The revised guidelines issued in the context of the increase in Covid cases in the country have no evidence of the benefits of injectable steroids for those who do not require oxygen supplementation or for continuation after discharge in the moderate risk category. It also suggests that.

Anti-inflammatory or immunomodulatory therapies (such as steroids) state that there may be a risk of secondary infections such as invasiveness Mucormycosis If used too early, at high doses, or longer than necessary — this is DeltaPlusThe second Covid wave to be driven.

AIIMS / ICMR-COVID-19 National Task Force / Joint Monitoring Group (Dte.GHS), @MoHFW_INDIA We publish clinical guidance for the management of adult COVID-19 patients. Revised on January 14, 2022.It is accessible at https://t.co/yvgOGSwOFK@PIB_India @mygovindia #CoronaUpdatesInIndia pic.twitter.com/Wj97STgH7H

— ICMR (@ICMRDELHI) January 17, 2022

Indian Medical Research Council-Guidelines drafted by experts from the Covid19 Task Force, AIIMS, and the Directorate General of Health Services continue to recommend drugs such as the antibiotics doxycycline and azithromycin, and anthelmintic ivermectin for mild cases of Covid-19. I have not. Must be isolated and managed at home.

Dr. Shuchin Bajaj, Founder Director of the Ujala Cygnus Group of Hospitals, said: indianexpress.com The latest guidelines have completely removed all previous medications such as ivermectin, oral steroids, oral antivirals, and plasma therapy.

Dr. Trupti Gilada, an infectious disease specialist at Mumbai’s Masina Hospital, said that all previously contained or prescribed medications, including antibiotics such as doxycycline and azithromycin, actually act on bacteria rather than viruses. Stated.

“Ivermectin, an anti-worm drug that does not act again on the virus, excludes these three drugs and plays no role in the management of mild COVID. Others whose location is not found in the guidelines. The drug is favipiravir. Recently approved molnupiravir, which ICMR has expressed concern about adverse effects, should not be prescribed in a very commonly prescribed manner as it is not included in the guidelines. The third important drug that has been but is still prescribed Single-time antibody cocktail – Only effective for individuals who are at high risk of progression to moderate to severe disease and who have not previously had immunity, and most importantly, Delta variant, Temporary antibody cocktails do not play a role in the management of Omicron And we all know that most of the cases we see today are Omicrons, “Dr. Girada said.

In mild cases, the guidelines describe physical distance, use of indoor masks, and strict house isolation. Hand hygiene.. The guidelines state that it is most important to see a doctor immediately if you have dyspnea, oxygen saturation below 93, or if you have a high fever / severe cough for more than 5 days.

If SpO2 oxygen levels: 92-96 percent (88-92 percent in COPD patients) are not met, moderate patients should be admitted to the ward.

Covid-19 is divided into three main types. Mild Cases — Shortness of breath, no oxygen required. Patients with moderate — shortness of breath or Sp02 level 90-93% oxygen requirement, and severe — dyspnea or Spo2 level <90%. "Patients with moderate to severe illness require hospital care. Patients with mild illness can be managed with symptomatic treatment and home isolation by regular monitoring of temperature and oxygen saturation." Said Dr. Rakesh Rajpurohit MD of Jain Multispeciality Hospital Mira Road, a pulmonologist and critical care consultant.

-Recommended device for oxygenation: non-rebreathing face mask

– stay up Proning Recommended for all patients requiring oxygen supplementation therapy (reposition in turn every 2 hours).

Guidelines continue to recommend emergency use Remdesivir Moderate to severe disease levels in patients with 10 days of onset of symptoms. However, patients should not use IMV or ECMO that require support for oxygen supplementation. “Even remdesivir has a very limited role to be given to some selected patients. It should not be given freely. In severe cases, only inhaled corticosteroids and injectable corticosteroids should be given.” Said Dr. Bajaji.

Not all cases require hospitalization (Source: Express Photograph by Amit Mehra)

Guidelines mention

Consider remdesivir for 5 days to treat inpatients COVID-19 (There is no evidence of the effect of treatment for more than 5 days)
* Do not use in patients without oxygen support or at home.
* Monitor RFT and LFT (remdesivir is not recommended for eGFR5times UNL) (not an absolute contraindication).
Recommended dose: 200 mg IV on day 1 followed by 100 mg IV OD for 4 days.

The most commonly reported symptoms of Covid-19 are:

* Dry cough, cold, sore throat
* Fever or chills
*Malaise, Fatigue, muscle and body aches
*headache
* Congestion or runny nose
* Shortness of breath or difficulty breathing
* Loss of appetite / taste / smell

Experts say that the severity and duration of symptoms in people with Covid-19 can vary. For most people, it usually takes 7 to 14 days for symptoms to subside.Some people may have No symptoms Others may need hospitalization. Recovery from symptoms varies from person to person.

So what’s the point from the latest guidelines?

The most important point from the current guidelines is that almost all cases of mild Covid-19 can be managed without using too many drugs and simply without giving them. Symptomatic treatment.. “This means paracetamol for fever, decongestant for congestion, and cough syrup for cough. It can also be managed without much research. Therefore, you are infected with Covid-19. There is no role in performing a comprehensive CT scan, a comprehensive blood test, or a comprehensive X-ray test for all individuals. These patients have the same viral fever as other symptomatic treatments. You can manage it without doing too much research, or at all, “Dr. Girada argued.

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