SARS COV-2 Assessment and Treatment Guidelines
The global fight against COVID-19 continues to evolve, with new research and clinical evidence shaping updated treatment guidelines. Here, we provide an overview of the latest recommendations for managing COVID-19, focusing on key advancements in therapies, preventive strategies, and patient management.
Assessment of Clinical severity of COVID 19 to target treatments
| Mild to moderate COVID 19 | spO2 > 94% on room air and not needing supplemental oxygen but with risk factors for progression to severe disease, hospitalization or death
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| Severe COVID -19 | Sp02 < 94 % on room air or needing low flow supplemental oxygen
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| Critical COVID -19
| Needing high flow oxygen or NIV |
| Critical COVID-19
| Needing mechanical ventilation or ECMO
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Risk factors: Age > 60 years, BMI > 25 years, hypertension, cardiovascular disease, Chronic lung disease, chronic kidney disease, immunocompromised states
Treatment
| Mild to moderate COVID-19 with risk factors for progression to severe disease, hospitalization or death | ||||||
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| Severe to critical COVID 19 requiring oxygen administration in any form |
| 1. Dexamethasone IV 2. Remdesivir 3. IL-6 receptor blocking agent like Tocilizumab 4. JAK stat signalling pathway block like Baricitnib or Tofacitnib 5. Enoxaparin in elevated D dimer levels with documented thromboembolism. Prevention of DVT with enoxaparin for all hospitalized patients |
Post-Exposure Prophylaxis (PEP)
Evusheld (tixagevimab/cilgavimab) remains an option where effective against circulating variants, pending local guidelines.
Step up Oxygen Therapy
- Non-invasive ventilation as the initial strategy for hypoxic patients
- High-flow nasal oxygen
- Early intubation for patients with refractory hypoxia or progressive respiratory failure
Anticoagulation:
-Prophylactic-dose anticoagulation for all hospitalized COVID-19 patients unless contraindicated.
-Therapeutic-dose anticoagulation for selected cases with documented thrombosis or high D-dimer levels.