Infected with COVID? Check latest WHO guidelines for risks, symptoms, treatment

For COVID treatment, dissecting the word care in four terms – Confirm, Assess, Respond, Evaluate, the UN health agency said, these are the tools to support health care workers visualize the current WHO recommendations for the care of patients with COVID-19.

Here are the four stages of treatment of COVID patients:

Stage 1: The first stage is to confirm the disease through a Rapid or PCR test. 

Stage 2: Then early clinical assessment needs to be provided as per the symptoms, emergency signs or risk factors. The patients need to be guided whether they require treatment, clinical referral or admission to hospital care

What are risk factors? 

Risk factors for patients below 60 years: Hypertension, diabetes, cardiac disease, chronic lung disease, cerebrovascular disease, dementia, mental disorders, chronic kidney disease, immunosuppression (including HIV), obesity, cancer and unvaccinated against COVID-19.

Risk factors in pregnant or recently pregnant women: advanced maternal age (>=35 years), obesity, chronic medical conditions, and pregnancy specific disorders (e.g. gestational diabetes and pre-eclampsia/eclampsia).

What are the emergency signs?

Emergency signs are obstructed or absent breathing, severe respiratory distress, cyanosis, shock, coma and/or convulsions.

Stage 3: The third stage is to respond with appropriate care and treatment based on the severity of disease and risk factors.

What is the course of treatment?

Mild infection: If the infection is mild, all that is needed are symptom management and monitoring

Mild to moderate infection with risk factors: For patients with mild or moderate COVID-19​ (non-severe symptoms) but have risk factors for severe disease​ ​include medications – sotrovimab or casirivimab and imdevimab

Severe infection: For patients with severe or critical COVID-19, the treatment ​care plan includes Oxygen therapy, ​Corticosteroids, ​Venous thromboembolism prophylaxis, ​ Interleukin-6 receptor blocker (tocilizumab OR sarilumab) OR baricitinib.

For seronegative patients, consider including casirivimab and imdevimab* ​(neutralizing monoclonal antibodies)​

Stage 4: The fourth stage of the treatment is evaluation. WHO says all patients receiving COVID-19 treatment require clinical monitoring and follow up by a health care professional throughout their illness and recovery, including those who develop post COVID-19 condition.

When to report?

If patients have emergency signs OR SpO2 <90%, seek ​urgent medical assistance. ​And, in case, the patients have SpO2 between 90-94%, worsening symptoms, ​side-effects or concerns, the patient or caregiver should immediately seek advice from a health care professional.

Also, advise patient or caregivers to monitor for change or worsening of symptoms, such as chest pain, fast or difficulty in breathing (at rest or while speaking), fast heart rate, palpitations, confusion, altered mental status, or any other emergency signs

It is important that all COVID-19 treatments are prescribed, completed or stopped under guidance of a health care professional, WHO says. 

For COVID treatment, dissecting the word care in four terms – Confirm, Assess, Respond, Evaluate, the UN health agency said, these are the tools to support health care workers visualize the current WHO recommendations for the care of patients with COVID-19.

Here are the four stages of treatment of COVID patients:

Stage 1: The first stage is to confirm the disease through a Rapid or PCR test. 

Stage 2: Then early clinical assessment needs to be provided as per the symptoms, emergency signs or risk factors. The patients need to be guided whether they require treatment, clinical referral or admission to hospital care

What are risk factors? 

Risk factors for patients below 60 years: Hypertension, diabetes, cardiac disease, chronic lung disease, cerebrovascular disease, dementia, mental disorders, chronic kidney disease, immunosuppression (including HIV), obesity, cancer and unvaccinated against COVID-19.

Risk factors in pregnant or recently pregnant women: advanced maternal age (>=35 years), obesity, chronic medical conditions, and pregnancy specific disorders (e.g. gestational diabetes and pre-eclampsia/eclampsia).

What are the emergency signs?

Emergency signs are obstructed or absent breathing, severe respiratory distress, cyanosis, shock, coma and/or convulsions.

Stage 3: The third stage is to respond with appropriate care and treatment based on the severity of disease and risk factors.

What is the course of treatment?

Mild infection: If the infection is mild, all that is needed are symptom management and monitoring

Mild to moderate infection with risk factors: For patients with mild or moderate COVID-19​ (non-severe symptoms) but have risk factors for severe disease​ ​include medications – sotrovimab or casirivimab and imdevimab

Severe infection: For patients with severe or critical COVID-19, the treatment ​care plan includes Oxygen therapy, ​Corticosteroids, ​Venous thromboembolism prophylaxis, ​ Interleukin-6 receptor blocker (tocilizumab OR sarilumab) OR baricitinib.

For seronegative patients, consider including casirivimab and imdevimab* ​(neutralizing monoclonal antibodies)​

Stage 4: The fourth stage of the treatment is evaluation. WHO says all patients receiving COVID-19 treatment require clinical monitoring and follow up by a health care professional throughout their illness and recovery, including those who develop post COVID-19 condition.

When to report?

If patients have emergency signs OR SpO2 <90%, seek ​urgent medical assistance. ​And, in case, the patients have SpO2 between 90-94%, worsening symptoms, ​side-effects or concerns, the patient or caregiver should immediately seek advice from a health care professional.

Also, advise patient or caregivers to monitor for change or worsening of symptoms, such as chest pain, fast or difficulty in breathing (at rest or while speaking), fast heart rate, palpitations, confusion, altered mental status, or any other emergency signs

It is important that all COVID-19 treatments are prescribed, completed or stopped under guidance of a health care professional, WHO says.