New guidelines prescribe inhaled steroid 'Budesonide', antiparasitic drug 'Ivermectin' for mild Covid cases

Express News Service
NEW DELHI: The latest guidelines by the Centre on home isolation of mild and asymptomatic Covid patients have incorporated drugs Ivermectin and Budesonide (inhaled steroid) and even oral steroids. 

This seems to be a tacit acknowledgment of the fact that many patients with advanced stages of Covid illness are not able to receive hospital care as these drugs were not prescribed for patients recommended for home isolation in the last guidelines, issued in July last year.

“Inhalational Budesonide (given via inhalers with spacer at a dose of 800 mcg twice daily for 5 to 7 days) to be given if symptoms (fever and/or cough) are persistent beyond 5 days of disease onset,” said the guidelines issued by the Union Ministry of Health and Family Welfare.

It adds that while systemic oral steroids are not indicated in mild disease if symptoms persist beyond 7 days which include persistent fever and worsening cough, the treating doctor can be consulted for treatment with low dose oral steroids.

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In case of falling oxygen saturation or shortness of breath — with an oxygen saturation level of less than 94%, the patient should require hospital admission and seek immediate consultation of their treating physician or surveillance team, according to the advisory.

While asymptomatic cases have been defined as laboratory-confirmed cases not experiencing any symptoms and having oxygen saturation at room air of more than 94%, clinically assigned mild cases are patients with upper respiratory tract symptoms along with or without fever but without shortness of breath and having oxygen saturation at room air of more than 94%.

The guidelines also recommend warm-water gargles and steam inhalation twice a day for infected people at home. 

If fever is not controlled with a maximum dose of paracetamol 650 mg four times a day, other drugs like non-steroidal anti-inflammatory drug Naproxen 250 mg twice a day, can be considered on the advice of a treating doctor.

Also, antiparasitic drug Ivermectin, the guidelines suggest, can be taken while the decision to administer Remdesivir or any other investigational therapy must be taken by a medical professional.

“Do not attempt to procure or administer Remdesivir at home,” it has been recommended.

Also, the guidelines say that the masks used by the patient and the caregiver should be discarded only after disinfecting them with 1% Sodium Hypochlorite.