While the Central government has indicated drugs like Remdesivir and Tocilizumab as an “investigational therapies” for the treatment of hospitalized coronavirus patient, the Union health ministry has alarmed all states, union territories and medical college hospitals that their (drugs) indiscriminate use or use in conditions for which they are not desirable, may cause more harm than good.
In a video conference with states on COVID case management, officials at the health ministry emphasised that in the absence of a cure, the clinical management protocol for COVID-19 of health ministry would be most effective for the standard of care treatment for mild, moderate and severe coronavirus cases.
“The States have been told that the available evidence for Remdesivir suggests that it may decrease the time for clinical improvement when used in moderate to severe cases. However, there have been no benefits in terms of reduced mortality. It has to be used with extreme caution due to its potential for serious adverse effects including liver and kidney injury,” said the health ministry official.
Similarly, Tocilizumab studies have not shown any benefits in mortality reduction. However, if used for patients with severe conditions, proper informed consent is required. Rampant use is to be discouraged since the effect of the drug is directed at the “cykotine storm”, added the official.
“For mild cases, which are nearly 80 percent of the total cases, Hydroxychloroquine (HCQ) has been recommended. The standard of care treatment strategies have shown to yield positive results,” said the official.
According to the health ministry, all the “investigational therapies” are required to be carried out only in proper health care facilities where close monitoring of patients is possible so that potential complications can be managed.
“ICMR strongly recommended that the focus of clinical management should continue to remain on oxygen therapy (including high flow nasal oxygen), steroids (which are widely available and inexpensive), appropriate and timely administration of anti-coagulants and high-quality supportive care, including mental health counselling for patients and clinical management of pre-existing illness and palliation of symptoms,” said ICMR official.
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