The Ministry of Health and Family Welfare on Thursday released revised clinical guidelines for coronavirus patients amid a surge in cases in India. It recommended the use of remdesivir for patients with moderate to severe symptoms and Tocilizumab for those with severe ones, preferably within 24 to 48 hours of intensive care unit admission.
In a separate document, the health ministry elaborated on a technique to help patients at home experiencing breathing discomfort. Called proning, the process involves turning a patient with precise, safe motions, from their back onto their abdomen, so they are lying face down. It improves comfort and oxygenation.
Pregnant women and those suffering from deep venous thrombosis, major cardiac conditions and an unstable spine, femur or pelvic fractures have been advised not to practice proning.
The revised rules, titled Clinical Guidance for Management of Adult Covid-19 Patients, provide the treatment plan according to the severity of symptoms.
In severe cases, where the patient’s respiratory rate is more than 30 breaths per minute or their oxygen saturation is less than 90% on room air, they must be admitted to an intensive care unit, the guidelines said. It is recommended that patients with moderate symptoms be admitted to wards.
The guidelines recommend off-label use of convalescent plasma only in the early moderate disease, preferably within seven days of the onset of symptoms.
The health ministry said patients with severe renal impairment or hepatic dysfunction must not take remdesivir. “It is not to be used in patients who are not on oxygen support or in home settings,” the government added.
For patients in home isolation with mild symptoms, the document recommended observing physical distancing, using masks and maintaining strict hand hygiene. Symptomatic patients were advised to stay in contact with their treating physician and monitor their temperature and oxygen saturation.
“Seek immediate medical attention if difficulty in breathing, high grade fever/severe cough, particularly if lasting for more than five days,” the guidelines added.
India is struggling to contain a ferocious second wave of the coronavirus. Several states are experiencing crippling shortages of oxygen and other critical equipment.
On Friday, India reported a record-breaking 3,32,730 new coronavirus cases, taking the total number of infections to 1,62,63,695 since the pandemic broke out in January 2020. This is also the highest ever single-day rise in cases reported by any country so far. For the first time, the country reported 2,263 deaths. The toll rose to 1,86,920.
This is the ninth consecutive day the country has recorded over 2 lakh coronavirus cases. As many as 1,36,48,159 patients have recovered from the disease so far, while there are 24,28,616 active cases.