Moderate covid-19

There is no single curative (“magic-bullet”) therapy for COVID-19. The disease is a multi-phase viral-inflammatory syndrome, therefore treatment requires:

• Stage-specific therapy

• Organ support

• Thrombosis prevention

• Careful monitoring for deterioration

Management differs according to severity:

1. Mild disease (Home care)

2. Moderate disease (Pneumonia)

3. Severe disease (Severe pneumonia)

4. Critical disease

MODERATE COVID-19 DISEASE (PNEUMONIA)

Clinical definition

Pneumonia with SpO₂ ≥ 90% on room air

Goals of Care

• Prevent deterioration to severe disease

• Reduce inflammation

• Treat bacterial superinfection

Treatment/management protocol

Supportive care

Same supplements as mild disease.

Anti-Inflammatory therapy

Dexamethasone 6 mg PO OD for 5 days or Prednisolone 20 mg PO OD for 5 days

Antibiotics (If suspected superinfection)

Option 1

• Azithromycin 500 mg OD × 5 daysPLUS

• Amoxicillin/Clavulanate 625 mg BD × 7 days

Option 2

• Azithromycin 500 mg OD × 5 daysPLUS

• Amoxicillin 500 mg TDS × 7 days

Option 3

• Azithromycin 500 mg OD × 5 daysPLUS

• Ceftriaxone 1 g OD × 5 days

Monitoring

• Daily symptom review

• Oxygen saturation monitoring

• Educate on danger signs

CORE PRINCIPLE OF COVID-19 MANAGEMENT

• Mild → symptomatic care

• Moderate → anti-inflammatory therapy

• Severe → oxygen + steroids + anticoagulation

• Critical → organ support + ICU care