The decision to administer Remdesivir or use any other investigational therapy must be taken by a medical professional and the drug must be administered only in a hospital setting, said the ‘Revised guidelines for home isolation of mild/asymptomatic Covid-19 cases’ issued by the Union Health Ministry on Thursday.
“Do not attempt to procure or administer Remdesivir at home,” the revised guidelines said.
The guidelines said that systemic oral steroids are not indicated in mild disease and if symptoms persist beyond seven days (persistent fever, worsening cough etc.), one should consult the treating doctor for treatment with low dose oral steroids.
“In case of falling oxygen saturation or shortness of breath, the person should require hospital admission and seek immediate consultation of his/her treating physician/surveillance team,” the revised guidelines said.
For the treatment of asymptomatic patients or those with mild symptoms under home isolation, the revised guidelines said, “Patients to follow symptomatic management for fever, running nose and cough, as warranted. Patients may perform warm water gargles or take steam inhalation twice a day.”
“If fever is not controlled with a maximum dose of Paracetamol 650 mg four times a day, consult the treating doctor who may consider advising other drugs like non-steroidal anti-inflammatory drug (NSAID) (ex: Tab. Naproxen 250 mg twice a day). Consider Tab Ivermectin (200 mcg/kg once a day, to be taken empty stomach) for three to five days,” the guidelines said.
AInhalational Budesonide (given via inhalers with spacer at a dose of 800 mcg twice daily for five to seven days) to be given if symptoms (fever and/or cough) are persistent beyond five days of disease onset, they added.
The guidelines said that a patient or a caregiver will keep monitoring the health and seek immediate medical attention if serious signs or symptoms develop.
“These could include difficulty in breathing, dip in oxygen saturation (SpO2 < 94 per cent on room air), persistent pain or pressure in the chest and mental confusion or inability to arouse,” they said.
The guidelines added that a patient in home isolation will stand discharged and end isolation after at least 10 days have passed from the onset of symptoms (or from the date of sampling for asymptomatic cases) and no fever for three days. There is no need for testing after the home isolation period is over.
