Take home points for Covid-19 management

These points are from Dr. Ramasubramaniam’s lecure held on 27/06/2020. He is an Infectious Diseases Consultant at Apollo Hospital, Chennai. This summary of his lectures corroborates with his lecturer and it appears to be verified by Dr. L. Murugan on 28/06/2020

1. Prolonged fever is not an indication for admission. Patients with fever for more than 14 days have been managed at home.

2. Repeat testing on discharge is not needed as even dead virus will give PCR positive.

3. Two proved drugs are paracetamol and oxygen therapy

4. No role for Azithromycin

5. No role for HCQ except for prophylaxis in HCW and positive contact at home

6. CRP above 100 and high Neutrophil lymphocytes ratio NLR are bad prognostic indicator

7. Oxygen saturation monitoring and respiratory rate monitoring are two good indicators for home care

8. No proven role for Vitamin D, Vitamin C and Zinc

9. No antivirals except Remdesivir has a role. Fabipiravir no proven role yet. Awaiting studies in these area. Remdesivir for moderate cases. Monitor liver enzymes and creatinine

10. LMWH no prophylactic role hence use only when D-Dimer level are high.

11. Check Ferritin, LDH and D-Dimer for all cases in moderate severity

12. IL-6 levels needs to be tested if u are suspecting cytokines storm and then start Tocilizumab

13. Never take NSAIDS