Covid-19/corona Virus

Admission criteria

All suspected/ confirmed cases of COVID-19 presenting as

•  Moderate case- clinical or radiological evidence of pneumonia
•  Severe Pneumonia- clinical or radiological evidence of pneumonia with signs of severe pneumonia (RR > 30 /min or oxygen saturation <90%)
• Critical COVID-19: ARDS, Sepsis, Septic shock
• Hypoxia (SPO2 ≤93%) even in the absence of any clinical signs
•  Patient with multiple uncontrolled comorbidities or prothrombotic state such as high-risk pregnancy, active malignancy, DVT irrespective of severity etc.

Asymptomatic Case(mild): NO Symptoms but test positive

• Treatment is symptomatic
• Stem inhalation may improve

Rx:

if fever:

Tab.Napa([post id="449" title="Paracetamol"])(500mg)

• 1+1+1……...3-5 days

Cap.seclo ([post id="391" title="Omeprazole"])(20mg)

• 1+0+1(30 min before meal)….7 days

If Cough  & runny nose

Syp.Ambrox(ambroxol)

• 2/3 Tsf .......tds ......7 days

Tab.Fexo ([post id="541" title="Fexofenadine"])(120mg)

• 0+0+1...................7 days 

Antazole Nasal Drop(xylometazoline)

• 2-3 drops each nostril ..........3/4 times daily........10 days

If anorexia

Tab.Motigut([post id="465" title="Domperidone"])(10mg)

• 1+1+1……..(20 min before meal )….10 days

If abdominal pain:

Tab.Algin ([post id="451" title="Tiemonium"])(50mg)

• 1+1+1…………….3-5 days

If Insomnia :

Tab.Lexotanil ([post id="475" title="Bromazepam"])(3mg)

• 0+0+1…………3-5 days

immunity boostup:

Tab.xinc(20mg)

• 1+0+0……….1 month

Cap.D-rise(2000IU)

• 0+1+0….........1 month

 Note: Look for any danger signs of COVID as for example-

• Breathing difficulties
• chest pain
• light headedness
• disorientation
• extreme weakness which results in even difficulties in walking
• drop in oxygen saturation to or ≤93% etc. 

Modarete case:

• Oxygen through nasal cannula (Maximum 5 L/min) if required. Target SPO2 is 94% during initial resuscitation and 90% for stable patients. For pregnant patients and patients with other organ failure target SPO2 is 94%
•  Proning- Maintain prone position for a total of 4-6 hours/day (divided in shorter period over the day)

Investigation:

• CBC
• CRP
• D-dimer
• S. LDH
• S. ferritin
• S. creatinine
• ALT
• CXR PA view
• HRCT

Rx:

1. Inj.Enoxaperin(cardinex)(40mg)

• Subcutaneous …………OD (if wt>40kg) then BD

If In.Enoxaperine contraindicated then unfractionated heparin

In.Heparon(heparin) (25000IU)

• Subcutaneous ………… BD                                                                                          

2.Tab.Rivaroxaban (Rivarox)(10mg)

• 0+1+0…………….1 month

OR

Tab.Apixaban(apixa)(2.5mg)

• 1+0+1……………..1 months

Anti-viral :

Tab.Paxlovid(Nevirax)

3 tab orally .........Bd.....5 days

Or 

Inj.Remdesivir(pandovir) (200mg) 

daily ...........3 days

200 mg on day 1 and 100 mg on days 2 and 3.

Or

Tab.Monlopiravir 9monlumax)(200mg)

2+0+2...........5 days

If respiratory distress: Spo2 < 93 %

Tab.Dexamethasosne (0.5mg)

• 3+3+3+3………3-5 days

 If Suspect bacterial infection with covid:

Tab. Moxaclav(amoxicillin) (625mg)

• 1+1+1…………..7 days

OR

Cap. Doxicap (Doxycycline)(100mg)

• 1+0+1……5…7 days