The Health Ministry has issued a revised Clinical Guidance for Management of Adult COVID-19 Patients. The guidelines issued by AIIMS, ICMR-COVID-19 National Task Force and the Joint Monitoring Group DGHS under the Ministry said, under emergency use authorization, Remdesivir may be considered for only those patients with moderate to severe diseases requiring supplemental oxygen within 10 days of onset of symptoms.
It said, Remdesivir is not recommended for those with severe renal impairment or hepatic dysfunction. It said, Remdesivir not to be used in patients who are not on oxygen support or in home settings. The guidelines recommended Emergency Use Authorization or off-label use of Tocilizumab drug in case of severe diseases, preferably within 24 to 48 hours of the onset of the disease or ICU admission.
It said, Tocilizumab may be considered in patients with significantly raised inflammatory markers and not improving despite use of steroids with there being no active bacterial or fungal or tubercular infection. The guidelines recommended off-label use of convalescent plasma only in the early moderate disease, preferably within seven days of symptom onset and only on availability of high titre donor plasma.
It said, upper respiratory tract symptoms or fever without shortness of breath or hypoxia has been categorised as mild disease and people have been advised home isolation and care.