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The Covid Management Guidelines India Group is a collection of senior expert clinicians, academics and methodologists in reputed institutions nationally, led by the Christian Medical College Vellore in partnership with the Clinical Infectious Diseases Society of India (CIDS). We are supported by methodologists at the Prof BV Moses Centre for Evidence Informed Healthcare and the Cochrane Infectious Diseases Group.

We are using a rigorous evidence-based approach to make guidelines to support clinicians managing patients with COVID-19 in secondary and tertiary care settings in India. Prioritised management interventions are each subjected to systematic evidence review, followed by application of GRADE methodology by experts in the field to appraise the evidence and interpret the intervention’s place in an Indian context. As each recommendation or clinical practice guideline is ready, it will appear on this website in a modular fashion, enabling immediate use by clinicians.

. . . . . 

Intervention MildModerateSevereCriticalCertainty of evidenceDate of Recommendation
Symptomatic (any acute COVID-19 related symptoms)
• AND respiratory rate <24/min
• WITHOUT pneumonia or hypoxia
Pneumonia (clinical or radiological) OR hypoxia (SpO2 <94% in adults with no underlying lung disease)
• AND respiratory rate ≤30/min
• AND SpO2 ≥90% on room air
Pneumonia with ANY ONE of the following:

• RR >30/min
• severe respiratory distress
• SpO2 <90% on room air
• NO invasive or non-invasive respiratory support needed
Requirement for high-level respiratory support: NIV or HFNO or IMV
• OR ARDS (PaO2/FiO2 ratio of <300)
• OR sepsis
• OR shock
AntiviralAzithromycin Not recommended
Not recommended Not recommended Not recommended
⨁⨁⨁⨁
HIGH
27/09/2021
Ivermectin Not recommended Not recommended Not recommended Not recommended
⨁⨁⨁⨁
HIGH
15/05//2021
Hydroxychloroquine / Chloroquine Not recommended Not recommended Not recommended Not recommended
⨁⨁⨁◯
MODERATE
04//02/2022
Favipiravir Not recommended Not recommended Not recommended Not recommended
⨁◯◯◯
VERY LOW
19/07/2021
Remdesivir Not recommended Recommended % Recommended % Recommended %
⨁⨁⨁◯
MODERATE
16/06/2022
Interferons Not recommended Not recommended Not recommended Not recommended
⨁⨁⨁◯
MODERATE
27/10/2021
Molnupiravir Recommended *
Recommended *
Not recommended Not recommended
⨁◯◯◯
VERY LOW

16/02/2022
Anti- inflammatories Tocilizumab /
Sarilumab
Not recommended Not recommended Recommended *
Recommended *
⨁⨁⨁◯
MODERATE
24/05/2021
Baricitinib Not recommended Recommended π Recommended π Recommended π
⨁⨁⨁◯
MODERATE
17/09/2021
Inhaled corticosteroids Recommended $ Not recommended Not recommended Not recommended
⨁⨁◯◯
LOW
21/06/2021
Systemic corticosteroids Not recommended Not recommended Recommended @ Recommended @
⨁◯◯◯
VERY LOW
15/07/2021
Colchicine Not recommended Not recommended Not recommended Not recommended
⨁⨁◯◯
LOW
03/09/2021
Itolizumab Not recommended Not recommended Not recommended Not recommended
⨁◯◯◯
VERY LOW
22/11/2021
ThromboprophylaxisTherapeutic dose Vs Nontherapeutic dose of thromboprophylaxis Recommended α Recommended β Recommended β Recommended α
⨁⨁⨁◯
MODERATE
08/08//2022
AntibodyConvalescent Plasma Not recommended Not recommended Not recommended Not recommended
⨁⨁⨁⨁
HIGH

27/10/2021
Casirivimab-Imdevimab Recommended £ Recommended £ Not recommended Not recommended
⨁⨁⨁⨁
HIGH
11/08/2021
Respiratory TherapiesNIV Vs HFNO Recommended Recommended Recommended Recommended
⨁◯◯◯
VERY LOW

27/07/2021
Oxygen Saturation Targets Recommended Recommended Recommended Recommended
⨁◯◯◯
VERY LOW
12/02/2022
Other Supportive ManagementProne Positioning Not recommended
Recommended Recommended Recommended
⨁◯◯◯
VERY LOW

05/11/2021
* :- Only in patients with mild to moderate covid-19 with risk factors for developing severe disease.
# :- Tocilizumab 8mg/kg, maximum 800mg as a single dose
$ :- for symptomatic relief.
@ :- 6 mg of Dexamethasone or equivalent per day IV or Oral till normalization of Oxygen saturation or max 10 days.
% :- Remdesivir 200 mg IV OD on the first day followed by 100 mg IV OD from Day 2-5, to be given with in 5 days of symptom onset
α :-Enoxaparin 40 mg SC OD
β :- Enoxaparin 40 mg OD to 1 mg/Kg BD SC
π :- 4 mg once daily for 14 days or until discharge
£ :- Only for patients with non-omicron variant with a risk factor for severe illness, and no detectable covid-19 antibodies present in their body. Casirivimab 600 mg + Imdevimab 600 mg as a single infusion within 10 days of symptom onset.
Ω :- Target SPO2 at 94-98%.

Strong against recommendation
Conditional against recommendation
Conditional for recommendation
Strong for recommendation