COVID-19 patient
Any one of:
- Respiratory rate > 24 /min
- SpO2 < 93% on room air
Oxygen Support:
➢ Target SpO2: 92-96% (88-92% in patients with COPD)
➢ Preferred devices for oxygenation: non-rebreathing face mask
➢ Awake proning should be encouraged in all patients who are requiring supplemental oxygen therapy (sequential position changes every 1-2 hours)
Anti-inflammatory or immunomodulatory therapy
➢ Inj. Methylprednisolone 0.5 to 1 mg/kg in 2 divided doses (or an equivalent dose of dexamethasone – 0.1 to 0.2 mg/kg per day) usually for a duration of 5 to 10 days
➢ Patients may be initiated or switched to oral route if stable and/or improving
Anticoagulation
➢ Conventional dose prophylactic UFH or LMWH (weight based e.g., enoxaparin 0.5mg/kg per day SC OD)
Monitoring
➢ Clinical Monitoring: Work of breathing, Hemodynamic instability Change in oxygen requirement
➢ Serial CXR; HRCT chest to be done ONLY If there is worsening
➢ Lab monitoring: CRP and D-dimer every 48 to 72 hrly; CBC KFT, LFT every 24 to 48 hrly; IL-6 levels to be done if deteriorating (Subject to availability)