Are there any new treatments for covid-19 ?

COVID 19 TREATMENT UPDATES :

COVID19 Frontlines

Are there any new treatments for covid-19 ?

COVID 19 TREATMENT UPDATES :

These are salient points/ experiences over the past few months which I did not have the time to jot down. I will try to compile them here based on latest developments with time. They have no fixed sequence but would be a useful aggregation.

  1. SARS COV 2 positive patients with any oxygen requirement should be started on dexamethasone. Ideally 6 mg OD for a 10 day course.
  2. If Oxygen requirement surpasses 40 % then Remdesevir should be added to this regimen. Ideally a patient should be on both Remdesevir and Dexamethasone if there is any oxygen requirement but due to availability constraints this is an acceptable pathway.
  3. Antibiotic cover should be given for superimposed bacterial pneumonia.
  4.  Single dose InflixImab , CPAP and Tocilizumab would require a selection criteria e.g  patients with severe COPD , lymphopenia / immune suppression would not fit the criteria to be given Infliximab.
  5. COVID bloods should include routine (Full blood count, U and E and Clotting profile) + LDH, Troponin, D Dimers, Clotting profile and blood cultures.
  6.  Discharge of the patient should be predicted 24 to 48 hours in advance to get a repeat swab done and ideally discharge them with a negative result.
  7. Day of onset of symptoms should be clear on admission to interpret a positive test later in the illness in the appropriate clinical context.
  8.  Face mask , visor and gloves are appropriate gear for medical professional taking care of patients with COVID 19.
  9. FFP3/ N 95 should ideally be used in AGP (Aerosol Generating Procedures) only.
  10.  Keep low threshold for considering Pulmonary embolism/ stroke and VTE prophylaxis should be sorted for every admission.
  11.  ITU involvement and escalation plans should be in place and updated during the course of admission.
  12. Updating family about daily progress or any significant development based on patient’s wishes.
  13. Vaccines available for Covid 19 as per the latest updates in this article. Pfizer and Moderna vaccines have been generally well tolerated and reports show good coverage of all strains.
  14. Astra Zeneca vaccine has been associated with a few cases of venous sinus thrombosis and is under investigation. However, the broad recommendation still remains the same – to get vaccinated ASAP.
  15. Wearing masks is the most effective public health measure that can lead to lower transmission and better control. Reinforcement through public and private platforms is necessary to induce a collective habit for mask wearing.

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