From the Guidelines
If you have COVID-19, you should isolate yourself at home and follow the management guidelines to reduce symptoms and prevent complications. The most recent and highest quality study 1 recommends putting treatment escalation plans in place for patients with COVID-19 because they may deteriorate rapidly and need urgent hospital admission.
Managing Symptoms
To manage symptoms, patients with cough should avoid lying on their back and consider short-term use of codeine linctus, codeine phosphate tablets, or morphine sulfate oral solution 1. Controlled breathing techniques, such as positioning, pursed-lip breathing, breathing exercises, and coordinated breathing training, can also help manage breathlessness 1.
Monitoring and Seeking Medical Attention
It is essential to monitor symptoms closely, especially oxygen levels if possible using a pulse oximeter, and seek immediate medical attention if severe symptoms occur, such as difficulty breathing, persistent chest pain, confusion, inability to stay awake, or bluish lips or face. Patients at high risk for severe disease, such as the elderly, immunocompromised, or those with underlying conditions, should contact their healthcare provider promptly to discuss potential treatments like Paxlovid or monoclonal antibodies 1.
Preventing Dehydration and Managing Fever
Patients should drink fluids regularly to avoid dehydration, with a maximum of 2 liters per day, and take paracetamol if they have fever and other symptoms that antipyretics would help treat 1.
Preventing Transmission
To prevent spreading the virus to others, patients should isolate themselves at home for at least 5 days from symptom onset (or positive test if asymptomatic), wear a high-quality mask if they must be around others, and practice good hand hygiene. By following these guidelines, patients with COVID-19 can reduce their symptoms, prevent complications, and protect those around them.
From the FDA Drug Label
VEKLURY is indicated for the treatment of coronavirus disease 2019 (COVID-19) in adults and pediatric patients (birth to less than 18 years of age weighing at least 1. 5 kg) who are: Hospitalized, or Not hospitalized and have mild-to-moderate COVID-19, and are at high risk for progression to severe COVID-19, including hospitalization or death. The recommended treatment course of VEKLURY should be initiated as soon as possible after diagnosis of symptomatic COVID-19 has been made.
- For hospitalized patients, the recommended total treatment duration is:
- 10 days for patients requiring invasive mechanical ventilation and/or ECMO
- 5 days for patients not requiring invasive mechanical ventilation and/or ECMO, with the option to extend treatment for up to 5 additional days if clinical improvement is not demonstrated
- For non-hospitalized patients diagnosed with mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19, the recommended total treatment duration is 3 days 2 2
From the Research
COVID-19 Diagnosis and Treatment
- If you have COVID-19, it is essential to seek medical attention immediately 3, 4, 5.
- Symptoms such as fever, cough, or loss of sense of smell (anosmia) or taste (ageusia) can help flag early on if the disease is present 4.
- The presence of anosmia or ageusia may be useful as a red flag for the presence of COVID-19, and the presence of cough also supports further testing 4.
- Reverse transcription polymerase chain reaction (RT-PCR) is commonly used to detect viral RNA in patient samples, but RNA extraction constitutes a major bottleneck in current testing 6, 7.
Treatment Options
- Remdesivir has shown in vitro activity against SARS-CoV-2 and has been used on a compassionate-use basis to treat patients with severe Covid-19 3, 5.
- A study found that early initiation of Remdesivir can lead to better clinical outcomes and help in reduction of associated mortality and morbidity of COVID-19 3.
- Remdesivir is administered intravenously, with a 10-day course consisting of 200 mg on day 1, followed by 100 mg daily for the remaining 9 days of treatment 5.
Testing and Diagnosis
- RT-PCR is a viable option for COVID-19 testing, and direct RT-PCR without RNA extraction is a feasible method that can increase diagnostic availability and efficiency 6.
- A comprehensive approach is vital for diagnosing COVID-19, and clinicians should be aware of the sensitivity and specificities of tests, which can have grave implications on the patient and community if the diagnosis is missed 7.