Health Ministry releases revised guidelines on use of Covid-19 drugs, therapies. Check here

There is no evidence of injectable steroids benefitting Covid19 patients not requiring oxygen supplementation or in continuation after discharge according to the revised Clinical Guidance for Management of Adult COVID19 PatientsThe revised guidelines issued by AIIMS ICMRCOVID19 National Task Force and Joint Monitoring Group DGHS under the Union health ministry also stated that antiinflammatory or immunomodulatory therapy such as steroids can have the risk of secondary infection like invasive mucormycosis when used too early at higher dose or for longer than requiredInjection methylprednisolone 05 to one mgkg in two divided doses or an equivalent dose of dexamethasone can be given usually for a duration of five to 10 days in moderate cases the guidelines stated The same drug in two divided doses of one to two mgkg can be given for same duration in severe casesInhalational budesonide given via metered dose inhalerdry powder inhaler at a dose of 800 mcg BD for five days can be given in mild cases if symptoms fever andor cough are persistent beyond five days of disease onsetrdquo it was stated in the guidelinesIf cough persists for more than twothree weeks one should opt for investigation for tuberculosis and other conditions they statedThe revised guidelines continue to recommend emergency use authorization EUA or offlabel use of remdesivir in patients with ldquomoderate to severerdquo disease and those with no renal or hepatic dysfunction within 10 days of the onset of any symptomIt warned against use of the drug for patients who are not on oxygen support or in home settingsAccording to the guidelines EUA or offlabel use of the tocilizumab drug may be considered for use in the presence of severe disease preferably within 24 to 48 hours of onset of severe disease or intensive care unit ICU admission Tocilizumab may be considered for patients with significantly raised inflammatory markers and not improving despite use of steroids with there being no active bacterial fungal or tubercular infection they stated Coronavirus patients have been classified into those affected by mild moderate and severe disease the guidelines statedAccording to the guidance note upper respiratory tract symptoms without shortness of breath or hypoxia has been categorised as mild disease and have been advised home isolation and carerdquo Those suffering from mild Covid should seek medical attention if they have difficulty in breathing high grade fever or severe cough lasting for more than five daysThose having breathlessness with SpO2 fluctuating between 9093 per cent can get admitted to a ward and they will be considered moderate cases Such patients should be given oxygen support and awake proning should be encouraged in all patients requiring supplemental oxygen therapy in sequential position changes every two hours the guidelines statedRespiratory rate over 30 per minute breathlessness or SpO2 lower than 90 per cent on room air should be considered as severe disease and such patients have to admitted to an ICU as they will need respiratory support they statedSuch patients should be put on respiratory support Noninvasive ventilation NIV helmet or face mask interface depending on availability may be considered in those with increasing oxygen requirements if work of breathing is low High flow nasal cannula should be considered in patients with increasing oxygen requirements Intubation should be prioritised in patients with high work of breathing if NIV is not tolerated and institutional protocol for ventilatory management should be used when required the new guidelines statedThose aged above 60 years or those having cardiovascular disease hypertension and coronary artery disease diabetes mellitus and other immunocompromised states such as HIV active tuberculosis chronic lung kidney or liver disease cerebrovascular disease or obesity are at high risk for severe disease and mortality the guidelines statedThis story has been sourced from a third party syndicated feed agencies Midday accepts no responsibility or liability for its dependability trustworthiness reliability and data of the text Midday managementmiddaycom reserves the sole right to alter delete or remove without notice the content in its absolute discretion for any reason whatsoever