Shalini Bhardwaj was written by Shalini Bhardwaj
New Delhi India January 18 ANI According to the revised guidelines issued by AIIMS, ICMR COVID 19 National Task Force and Joint Monitoring Group DGHS under the Union Health Ministry for management of adult COVID 19 patients, there is no evidence of injectable steroids in those who don't require oxygen supplementation or in continuation after discharge, because that can lead to a risk of secondary infection like mucormycosis.
There is no evidence for the benefit of injectable steroids in those not requiring oxygen supplementation, or for continuation after discharge anti-inflammatory or immunomodulatory therapy such as steroids can have a risk of secondary infection such as invasive mucormycosis when used too early, at higher doses or longer than required, according to the guidelines.
Under Anti-inflammatory or immunomodulatory therapy, Injection Methylprednisolone can be given in two divided doses or equivalent dose of dexamethasone in two divided doses or equivalent dose of dexamethasone in two divided doses, usually for a duration of 5 to 10 days in patients who are improving or moderate.
If breathing is low and patients with an increasing oxygen requirement intubation are prioritized for high work of breathing and injection Methylprednisolone 1 to 2 mg kg IV in 2 divided doses or an equivalent dose of dexamethasone, usually for a duration of 5 to 10 days, the guidelines stated.
The patient who tested positive has been divided into three categories: mild, moderate, and severe disease, but none of the categories has been recommended for medicines like ivermectin, favipiravir and doxycycline. Antivirals like Molnupiravir and monoclonal antibodies are not included in the guidelines.
The HRCT chest is recommended only if there is worsening. If cough persists for more than two-three weeks, tuberculosis and other conditions need to be investigated.
The revised guidelines recommend EUA or off-brand use of Remdesivir in patients with'moderate to severe' symptoms, and may be considered with 10 days of onset of symptoms.
Tocilizumab may be considered only with severe conditions of COVID 19, those who need oxygen supplementation and do not respond adequately to steroids.
These medications are only required within 24 -- 48 hours of the onset of severe disease hospitalised or in ICU admission.