This guideline for coronavirus treatment the new (Coronavirus) (COVID-19) was developed based on the latest evidence and scientific evidence.
These guidelines are not standard because it differ from each country and health organization.
It includes scientific evidence, guidelines for health practitioners that have been adopted by Health organizations, and related to dealing with patients (COVID 19), and it is constantly updated.
This is living guidance that is subject to change as more evidence accumulates.
It will be updated regularly whenever needed.
The guidance should be used to assist healthcare practitioners select the best available pharmacotherapy for COVID-19 infection according to the best available and current evidence and is not intended to replace clinical judgment but rather to complement it.
The evidence is inconclusive regarding the efficacy of most medications for COVID-19.
It is important to explain this to the patient and family and obtain informed consent for use of these medications for unapproved indications.
Mild to Moderate cases of coronavirus treatment:
Symptoms with no shortness of breath Treat symptoms
If no indication for admission, you should follow instructions and
Mild to Moderate with high-risk coronavirus treatment:
mild Symptoms with no shortness of breath in high-risk patients as Diabetic and Hypertensive Or Immunocompromized
- Treat symptoms
- If admission or observation in hospital needed assessment of the pt should be done carefully, and if no admission is not required, follow instructions and recommendations
- initiate empirical antiviral therapy, while awaiting the PCR result.
- Do not stop ACEI/A
- RBs in patients with hypertension, post-MI, heart failure
Mild to Moderate cases coronavirus : Symptoms (no O2 equirements)
- Mild to Moderate cases coronavirus treatment: Symptoms (no O2 requirements
- NO evidence of pneumonia but with other symptoms of covid 19
- Treat symptoms
- Follow instructions and recommendations
- Triple combination therapy (for adults): Lopinavir /Ritonavir, Ribavirin
- and interferon beta-1b for 14-days. Start within 7 days from symptoms
Severe cases of coronavirus :
- Symptoms ≥ 1 of the following:
- Respiratory rate ≥30/min (adults); ≥40/min (children < 5 years)
- Blood O2 saturation level ≤93%
- PaO2/FiO2 ratio <300
- Lung infiltrates >50% of the lung field within 24- 48 hours
corona virus treatment for severe cases
- Treat symptoms
- Follow instructions and recommendations published by health organizations.
- ICU admission, the decision by ICU treating team
- Antibiotics and antifungals according to local antibiogram and institutional pneumonia Consider starting any of the following according to clinical evaluation and treating consultant’s discretion
- Triple combination therapy (for adults): Lopinavir /Ritonavir, Ribavirin and interferon beta-1b for 14-days. Start within 7 days from symptoms appearance.
Hydroxychloroquine contraindication in coronavirus treatment
- Known hypersensitivity to hydroxychloroquine, aminoquinoline derivatives, or any component of the formulation.
- Preexisting retinopathy
Hydroxychloroquine interaction in coronavirus treatment
- Avoid concomitant use: Artemether; Lumefantrine; Mefloquine
- Hydroxychloroquine may alter the effects of Antipsychotic Agents (Phenothiazines); Beta-Blockers; Cardiac Glycosides; Dapsone
- (Systemic); Dapsone (Topical); Haloperidol; Hypoglycemia-Associated Agents; Lumefantrine; Mefloquine; QT-prolonging Agents (Highest Risk)
- The effects of Hydroxychloroquine may be altered or increased if patient is using: Androgens; Antidiabetic Agents; Artemether; Dapsone (Systemic); Herbs
- (Hypoglycemic Properties); Maitake; Mefloquine; Monoamine Oxidase Inhibitors; Pegvisomant; Prothionamide; Quinolones; Salicylates; Selective
- Serotonin Reuptake Inhibitors; Tamoxifen
Dose adjustment in coronavirus treatment
- No dose adjustment required with a patient with hepatic nor renal impairment
- Fetal risk cannot be ruled out. Fetal ocular toxicity has been reported.
- Hydroxychloroquine use should be avoided during pregnancy unless absolutely indicated and only after assessing maternal benefit and fetal risk