I am getting calls from friends/ family in India about COVID. From neurosurgeons to urologists, doctors are being roped in to handle the crisis.
1/ Having managed pts with COVID for the last year & having the luxury of time, here are my thoughts for those new to this battle.
2/ Diagnosed COVID? What next ?
Check oxygen sats.
If sats > 90%, reassure
-Paracetamol as needed for fever
-Inhaled steroids (budesonide)
-Continue to follow sats
-No need for hospitalization
-No need for chest CT
3/ if O2 Sats < 90%
-Supplemental oxygen
-Dexamethasone 6 mg/day or equivalent steroid (prednisone 40 mg, methylprednisolone 30 mg; hydrocortisone 150 mg
Steroid preparation/route does not make a difference
-Prone positioning ( sleeping on stomach)
4/ If O2 sats <90%, admit to hospital if bed available. If not treat with oxygen and oral steroids at home.
5/ Following are not useful. Do not use routinely
⁃Azithromycin
⁃Doxycycline
⁃Ivermectin
⁃Hydroxychloroquine
⁃Favipravir
6/ Remdesivir may be helpful in shortening duration of illness when used early. No real benefit in reducing mortality.
7/ Continue to promote vaccination, masking, physical distancing.
Don't give up prevention !!!!
Happy to answer questions
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