COVID-19 Treatment
COVID SUPPORT INITIATIVE
If unfortunately, we get infected with COVID 19, the following factors govern whether we end being asymptomatic/mildly symptomatic or severely symptomatic.
- Viral Load: The amount of Viral Load during our unfortunate exposure to COVID 19 is an important factor. The more virus entering our body the more chances we end up having severe disease because it overwhelms our defenses. Social Distancing, Facial Masking, PPE and Personal Hygiene contributes to a decreased Viral Load during exposure, thus protecting us from severe Viral Load.
- Body’s Inherent Condition or Basic Immunity: We need to optimize our Immunity to Optimum Levels, so when we face COVID 19 virus, our body can mount a good immune response and withstand the inflammation
How to Stay Prepared?
People without any apparent co morbidities i.e. no preexisting medical condition, less than 60yrs should get the following
- Basic Blood parameters: CBC. LFT, KFT, Coagulation profile to help in basic optimization such as correcting Anaemia, Cholesterol, Urea, Creatinine, etc
- Check Vit D levels, majority of us our deficient and Vitamin D plays very important role in immunity
- Measure Se G6 PD for identifying if IV Vitamin C can be safely given; In Wuhan high dose injection of Vitamin C is being given when the fever starts, and it has been shown to decrease ICU admissions substantially. It can be safely given to people with normal Se G6PD (an enzyme in our body) levels
- Blood Grouping: People with Blood Group A get severe form of disease, if we know the blood groups we can be extra careful
People with comorbidities such as Diabetes, Hypertension should consult their primary physician and do the needful modifications in their treatment, if required
What to do when Infected or Symptoms of COVID-19?
When someone report with COVID symptoms such as Fever, Cough, Fatigue (We should encourage people to report early, as time to treatment is key to recovery):
Start with
- Paracetamol to control the fever
- Saline gargles with steam
- Antiallergics (antihistamines): Cetirizine, Avil, Allegra, Montlair LC etc
- Antacids
- Zinc, Selenium, Vit D, Vit B complex, Vit C, etc. (Injectable IV VITAMIN C can also be used)
Facilitate COVID Testing:
The sample should be drawn by 5th day (before 5 days the chances of false negative report is high) so that we can be sure of the diagnosis early, If COVID positive, and symptoms are improving then continue same treatment
COVID positive and Symptoms does not improve:
Add
- Tb Dexamethasone
- Tb HCQ
- Tb Ivermectin stat
- Tb Doxycycline / Azithromycin
- Tb Favipiravir
Monitor: Pulse, Temperature, SPO2 by oximeter and Pulse
COVID positive and Symptoms Deteriorates:
Add
- Oxygen Supplementation
- Advise shifting to institutional care if possible, continue with Oxygen support
- Facilitate procurement of drugs like Remdesvir and tests like measuring IL 6 levels and other inflammatory markers to understand the need of Tociluzymab (At present it is very difficult to get these medicines)
Support Needed for Better COVID Management
- Doctors available for Tele Consults
- Trained Manpower for sampling, providing and administering medicines, providing infrastructure such as oxygen delivery, training patient and family to document the required observed parameters like temperature, SPO2, analysis of the data to understand which patient is improving and which patient requires more care
- Resources, Logistics ad Network to make this happen
Dr Mandeep S Malhotra
Sr Consultant & Dept Head for Head Neck & Breast Cancer Oncology
Fortis Hospital, Vasant Kunj
