| Intervention | Mild | Moderate | Severe | Critical | Certainty of evidence | Date 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 | ||||
| Antiviral | Azithromycin | Not recommended | Not recommended | Not recommended | Not recommended | HIGH | 27/09/2021 |
| Ivermectin | Not recommended | Not recommended | Not recommended | Not recommended | HIGH | 06/10/2022 | |
| 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 | 14/02/2023 | |
| 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 | 04/04/2024 | |
| 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 | |
| Thromboprophylaxis | Therapeutic dose Vs Nontherapeutic dose of thromboprophylaxis | Recommended α | Recommended β | Recommended β | Recommended α | MODERATE | 08/08/2022 |
| Antibody | Convalescent 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 Therapies | NIV Vs HFNO | Recommended | Recommended | Recommended | Recommended | VERY LOW | 27/07/2021 |
| Oxygen Saturation Targets | Recommended Ω | Recommended Ω | Recommended Ω | Recommended Ω | VERY LOW | 12/02/2022 | |
| Other Supportive Management | Prone 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 | |||||||
Covid Guidelines India