New Covid Treatment Guidelines Including Remdesivir and Tocilizumab

The new guidelines that prescribe Remdesivir (EUA) should only be considered in patients within 10 days of symptom onset for those with moderate to severe illness (requiring supplemental oxygen), but these who are not on IMV or ECMO.

New guidelines say to consider Remdesivir for 5 days to treat hospitalized patients with Covid-19. The guidelines clearly state that the drug should not be used in patients who are not receiving oxygen support or home treatment. The recommended dose for this medication is 200 mg IV on the first day followed by 100 mg IV OD for the next 4 days.

Tocilizumab may be considered in cases of rapidly progressive Covid-19 requiring supplemental oxygen or IMV and inadequate response to steroids (preferably within 24-48 hours of onset of severe illness/ICU admission) , follow the instruction.

It should preferably be given with steroids. Drugs may be considered in the absence of active systemic tuberculosis, fungal or bacterial infections. The recommended single dose for the drug is 4 to 6 mg/kg (400 mg in a 60 kg adult) in 100 ml NS over 1 hour.

According to the new guidelines, Covid-19 patients with mild symptoms, no shortness of breath and hypoxia are required to be isolated at home.

People with mild Covid-19 should only seek medical attention if they feel short of breath, have a high fever, or have a severe cough that lasts more than 5 days.

People with moderate Covid symptoms, who have difficulty breathing or have SP02 levels ranging from 90 to 93% in room air, may be admitted to the clinical department to receive Covid treatment.

According to the new guidelines, such patients should receive oxygen support.

Covid patients with SP02 levels lower than 90% should be admitted to the ICU. Such patients should receive respiratory support.

Guidelines are emphasized to consider the use of NIV (helmet or mask interface depending on availability) in patients with increasing oxygen requirements if the work of breathing is less.

HFNC should be used in patients with increasing oxygen requirements. Intubation should be preferred in patients who work heavily with breathing/if NIV is not tolerated.

Other treatments include anti-inflammatory therapy (Inj Methylprednisolone 1 to 2mg/kg IV in 2 divided doses or an equivalent dose of dexamethasone) usually for 5 to 10 days.

After clinical improvement, patients should be discharged according to the revised discharge standards, the guidelines said.

Source: IANS


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