Health

When do you use remdesivir and tocilizumab? When will the HRCT chest be held?Government issues clinical guidance for Covid-19 treatment

Patients who do not receive oxygen support or are at home should not be recommended for remdesivir, the latest clinical guidance on the management of adult Covid-19 patients states.

After classifying active Covid-19 patients into three broad groups: mild, moderate, and severe, Union Health has issued new clinical guidance on the management of adult Covid-19 patients. Specific situation.

Ivermectin or HCQ

Clarifying that this is based on low certainty of evidence, the guidelines are for patients who have mild symptoms of tabivermectin (200 mcg / kg once daily for 3 days) and are being treated at home. It states that it may be administered.

An alternative to ivermectin is Tab HCQ (400 mg BD 1 day f / b 400 mg OD 4 days), unless contraindicated.

For these mild patients, inhaled budesonide (administered via a metered dose inhaler / dry powder inhaler) at a dose of 800 mcg BD if symptoms (fever and / or cough) persist for more than 5 days after onset. Can be administered.

Methylprednisolone

Coovid-19 patients admitted with moderate symptoms of room air oxygen levels between 90% and 93% receive methylprednisolone 0.5 to 1 mg / kg in two divided doses (or equivalent dexamethasone). can do. 5-10 days period

Serial CXR, HRCT chest can only be given to these patients if they are deteriorating.

Remdesivir (USA)

Remdesivir (EUA) is only considered for patients with moderate to severe illness who require oxygen supplementation and are within 10 days of the onset of symptoms. Patients who do not receive oxygen support or are at home should not be recommended for remdesivir.

Recommended dose: 200 mg IV f / b on day 1 100 mg IV OD for the next 4 days.

Tocilizumab (off label)

Severe Covid-19 patients admitted to the ICU had no improvement despite steroid use and were within 24-48 hours of admission if inflammatory markers were significantly elevated only in the absence of active bacteria / fungi / You can administer this drug to the patient. Tuberculosis infection.

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

Convalescent plasma (off label)

This may only be considered within 7 days of the onset of symptoms.

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