CLINICAL GUIDANCE FOR MANAGEMENT OF COVID-19
Dated: 22nd May'2021
Daily Lifestyle should include
- Plenty of fluids to maintain adequate hydration
- Steam inhalation (3x a day x 10min)
- Gargle (3x a day x 10min)
- SPO2 Monitoring (>=94%)
- Avoid chilled water (warm/hot sips are good for body)
- Download & register yourself in Arogya Setu app
- Take care & Do-VMASH
– V: Vaccine
– M: Masks
– A: ACTIVE (Exercise/Yoga) when inside & AWARE when outside
– S: Social Distancing
– H: Handwashing
Food intake you should increase in your diet in order to boost immunity and reduce inflammation include(s)
- Fresh fruits, green vegetables (particularly Broccoli, Cauliflower and Cabbage)
- Green tea
- Carom seeds
- Black pepper
- Nigella Sativa
- Food which reduces IL6 inflammation (Beetroot juice, Berries, Vitamin D, Omega-3)
- Vitamin C (Citrus fruits)
- Zinc (Boiled eggs)
The management/treatment protocol for COVID patients with mild, moderate & severe disease
EUA/Off label use (based on limited available evidence and only in specific circumstances):
Remdesivir (EUA) may be considered ONLY in patients with
- Moderate to severe disease (requiring SUPPLEMENTAL OXYGEN), AND
- Who are within 10 days of symptom onset, with
- No renal or hepatic dysfunction (eGFR <30 ml/min/m2; AST/ALT >5 times ULN (Not an absolute contradiction), AND Recommended dose: 200 mg IV on day 1 f/b 100 mg IV OD for next 4 days.
- Not to be used in patients who are NOT on Oxygen support or in home settings
Tocilizumab (Off-label) may be considered when ALL OF THE BELOW CRITERIA ARE MET
- Presence of severe disease (preferably within 24 to 48 hours of onset of severe disease/ICU admission).
- Significantly raised inflammatory markers (CRP &/or IL-6).
- Not improving despite use of steroids.
- No active bacterial/fungal/tubercular infection. Recommended dose is: 4 to 6 mg/kg (400 mg in 60kg adult) in 100 ml NS over 1 hour.
You Should Know!
- This disease is STEROID Responsive, we have to be cautious over the optimum timing of use of steroid. Indiscriminate use may do more harm than the good. One such adversity is seen with patients experiencing fungal infection named Mucormycosis
- In many researches- Ivermectin has shown consistent benefit, especially if used EARLY in the disease stages.
- Medicines for Corona have side effects on Liver and pancreas. So, keep checking your sugar levels and Liver status (SGPT score). Talk to your doctor and inform them in case you are Diabetic.
- In pace of Limcee (Vitamin C), B-Complex & Zinconia one can take Multivitamin dosage.
- Types of Oxygenation Support:
- Oxygen Cylinder: is a storage tank which can be refilled with Oxygen as required
- Oxygen Can: is a one-time use for minimal Oxygen support
- Oxygen Concentrator: is a device that concentrates the oxygen from a gas supply (air) by selectively removing nitrogen to supply an oxygen-enriched product gas stream.
How to do above oxygenation at home in case of emergency/non-availability of medical attention at hospitals?
Oxygen Concentrator: Follow this link from Medanta Hospital https://www.youtube.com/watch?v=GtX9CV7-EIU
Post COVID Recovery- Seeking full recovery post COVID Rehabilitation is as important as seeking prevention before the same
Daily Lifestyle should include
- Consistency in breathing exercise, no intense workout
- SPO2 Monitoring (2x a day)
- Steam inhalation (2x a day)
- Stay hydrated
- Keep having multivitamins as recommended by doctor (Tab B-Complex, Vitamin C & Zinconia)
- Don’t put too much stress on yourself
- Keep social distancing
5-step sample meal plan by Govt. of India
- Soaked almonds & raisin
- Breakfast: Ragi Dosa, or a bowl of porridge (Oatmeal)
- Jaggery/Ghee post or during lunch
- Dinner: Skip heavy meals, preferable are Polenta (Khichdi)
- Apart from water, intake of homemade lemon juice & buttermilk
- AIIMS guideline dated 17th May/2021 https://covid.aiims.edu/clinical-guidance-for-management-of-adult-covid-19-patients/
- *Given link has Revised guidelines for Home Isolation of mild /asymptomatic COVID-19 cases (dated 28th April,2021) https://www.mohfw.gov.in/pdf/RevisedguidelinesforHomeIsolationofmildasymptomaticCOVID19cases.pdf
- **Awake Proning reference:
4. ***Monitoring reference: