5. DEXAMETHASONE
It can inhibit the production of pro-inflammatory
cytokines such as interleukin IL-1, IL-2, IL-6, IL-8,
TNF, IFN-gamma
Many of these inflammatory markers play role in
severe covid presentation.
6. DOSAGE
6 mg OD for 7-10 days ( duration can be extended
in certain cases )
Always prescribe with a PPI
Keep an eye on BMs
7. ENOXAPARIN
IT IS A FACTOR X-A INHIBITOR
DOSAGE:
IN COVID PNEUMONITIS PATIENTS : 1.5 mg / kg
FOR 14 DAYS
NOT SUITABLE FOR CPAP/HFNO
8. EVIDENCE
In noncritically ill patients with Covid-19, an initial strategy
of therapeutic-dose anticoagulation with heparin increased
the probability of survival to hospital discharge with reduced
use of cardiovascular or respiratory organ support as
compared with usual-care thromboprophylaxis.
(ATTACC, ACTIV-4a, and REMAP-CAP ClinicalTrials.gov
numbers, NCT04372589. opens in new tab, NCT04505774. opens in new
tab, NCT04359277. opens in new tab, and NCT02735707. opens in new tab.)
9. RONAPREVE
Ronapreve is a combination of neutralising
monoclonal antibodies nMAB.
Neutralising monoclonal antibodies (nMABs)
bind to specific sites on the spike protein of the
SARS-CoV-2 virus particle, blocking its entry into
cells and therefore inhibiting its replication.
Ronapreve contains equal amounts of casirivimab
and imdevimab.
10. EVIDENCE
The RECOVERY trial has demonstrated that the
casirivimab and imdevimab combination reduces
the relative risk of mortality by 20%, and the
absolute risk of mortality by 6%, in hospitalised
patients with COVID-19 who have not mounted
an antibody response of their own to the virus
(i.e. are seronegative1 ) at the time of treatment
11. DOSAGE
Patients hospitalised with acute COVID-19 (total
dose of 2.4g)
Patients with hospital-onset COVID-19 (total dose
of 1.2g)
12. MOLNUPIRAVIR
It is an antiviral drug.
Molnupiravir increases the frequency of viral RNA
mutations and impairs SARS-CoV-2 replication.
It is not recommended during pregnancy.
13. EVIDENCE
Final results from the Phase 3 MOVe-OUT trial
show that the oral antiviral molnupiravir resulted in
a relative risk reduction of 30% in the composite
primary outcome of hospitalisation or death at day
29.
14. DOSAGE
Eligible patients aged 18 and above, and who are
within 5 days of symptom onset, may be treated
with the oral anti-viral molnupiravir at a dose of 800
mg (four 200 mg capsules) taken orally every 12
hours for 5 days (if an nMAB is contraindicated or
treatment with an nMAB is not possible)
15. SARILUMAB AND TOCILIZUMAB
Both are human monoclonal antibodies that
specifically bind to interleukin-6 receptors and
block the activity of pro-inflammatory cytokines.
IL-6 inhibitors are immunosuppressants which
can suppress C-Reactive Protein (CRP) response
for up to 3 months after administration.
16. DOSAGE
Tocilizumab should be administered as an
intravenous infusion at a dose of 8mg per kg, up
to a maximum dose of 800mg.
Sarilumab should be administered as a single
dose of 400mg (using 2 x 200mg prefilled
syringes) as an intravenous infusion
