Indian Council of Medical Research (ICMR)-COVID-19 National Task Force Joint Monitoring Group dropped the usage of Ivermectin and Hydroxychloroquine (HCQ) drugs from revised clinical guidelines for the management of adult COVID-19 patients.
However, the new guidelines mention the use of Remdesivir and Tocilizumab in specific circumstances.
Among the key guidelines which are routinely stressed include–wearing masks, physical distancing and hand hygiene.
Suggesting a moderate use of other drugs like Remedesivir, the guideline advises the former to be used only in select moderate or severe Covid-19 patients on supplemental oxygen within 10 days of onset of symptom.
For the use of Tocilizumab, the guideline said that to use the medicine only for severe Covid-19 patients, preferably within 24 to 48 hours of the onset of severe disease or ICU admission.
It suggested that those with mild infection must maintain physical distancing, indoor mask use, strict hand hygiene.
It further said that symptomatic patients may take antipyretic, antitussive and multivitamins and asked to seek immediate medical attention if they experience difficulty in breathing or high-grade fever or severe cough, particularly if lasting for more than five.
People with moderate disease with SpO2 level 92-96 per cent (88-92 per cent in patients with Chronic obstructive pulmonary disease) may take Methylprednisolone injection and Anticoagulation medicine.
They should work on breathing, Hemodynamic instability and change in oxygen requirement.
As per the guidelines, for the severe infection, the guideline suggests using NIV (Helmet or face mask interface depending on availability) in patients with increasing oxygen requirement, if work of breathing is low.
“Consider the use of HFNC in patients with increasing oxygen requirement, Intubation should be prioritized in patients with high work of breathing /if NIV is not tolerated and Use conventional ARDSnet protocol for ventilatory management,” it said.
The guidelines also said to take Methylprednisolone injection of 1 to 2 mg divide into two doses usually for a duration of 5 to 10 days.
It informed that the severe disease or mortality risk is higher in people above age 60, people with Cardiovascular disease, hypertension, Coronary artery disease (CAD), Diabetes mellitus, Chronic lung/kidney/liver disease, Cerebrovascular disease, Obesity and other immunocompromised states.
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