Are there any new treatments for covid-19 ?doctkhalil
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.
- SARS COV 2 positive patients with any oxygen requirement should be started on dexamethasone. Ideally 6 mg OD for a 10 day course.
- 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.
- Antibiotic cover should be given for superimposed bacterial pneumonia.
- 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.
- COVID bloods should include routine (Full blood count, U and E and Clotting profile) + LDH, Troponin, D Dimers, Clotting profile and blood cultures.
- 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.
- Day of onset of symptoms should be clear on admission to interpret a positive test later in the illness in the appropriate clinical context.
- Face mask , visor and gloves are appropriate gear for medical professional taking care of patients with COVID 19.
- FFP3/ N 95 should ideally be used in AGP (Aerosol Generating Procedures) only.
- Keep low threshold for considering Pulmonary embolism/ stroke and VTE prophylaxis should be sorted for every admission.
- ITU involvement and escalation plans should be in place and updated during the course of admission.
- Updating family about daily progress or any significant development based on patient’s wishes.
- 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.
- 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.
- 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.