‘Patient’s category is key to coronavirus treatment’

Different Covid protocols ensure speedy cure, says pulmonologist Gopichand.

VIJAYAWADA: Exactly a month ago, Andhra Pradesh got its first coronavirus positive case. As coronavirus cases increased to 405 within a month, TNIE tried to find out the course of treatment given to Covid-19 positive patients.

Dr Gopichand, HoD of Pulmonology,
Vijayawada GGH and Nodal Officer

“Once a person is admitted to hospital, we collect the swabs and send them for testing. Till the report comes, we give symptomatic treatment to the patient as per the symptoms shown by  that person. If the person tested positive, we will check as to which category the patient belongs to start the prescribed treatment,” Nodal Officer and Head of Department of Pulmonology at the GGH in the city, which has been converted into Covid-19 special hospital, Dr Gopichand told TNIE.

At present, 12 out of 24 patients at the GGH are in ICU. “Only patients with comorbidity and very low immune system and hypoxia are being treated in ICU management. We are also keeping a track of those suffering with pneumonia. We are admitting them based on their vitals. If they are hypoxic or with comorbidity, we are admitting them into ICU. Youngsters who are comparatively stable, are being admitted to normal wards,” explained Dr A Shweta, a PG in pulmonology medicine, involved in treating Covid-19 patients at the hospital.

Covid-19 treatment
Each patient is given different course of treatment depending on the category he or she belongs to. Those belonging to the Category 1 are given vitamin B complex 1 BD for five days, thrice a day; for those in Category 2A,  along with the medication of Category 1, paracetamol tablet of 650 mg, cough syrup 5-10 ml for five days or cetirizine tablet for five days are given. For those in Category 2B, 650 mg paracetamol tablet for five days, cough syrup 5 ml thrice a day for five days, B Complex tablet twice a day for 5 days, 400 mg hydroxychloroquine tablet twice a day are given.

For pregnant women, chloroquine tablets are given. In case of H1N1 symptoms added to coronavirus symptoms, oseltamivir tablet is given, which is discontinued after the H1N1 test reports come negative. Further for the Category 3 patients, hydroxychloroquine 400 mg BD is given on the first day, which is reduced to 200 mg for four days. Patients of Category 4 are kept in ICU on ventilator. For them, hydroxychloroquine tablets are crushed and administered through NGT if the patient is unable to take it orally. 

Patients divided into five categories

• Asymptomatic persons with travel history or contact history come under Category 1
• Category 2A are people with mild to moderate symptoms such as fever higher than 100 F, coryza, cough, sore throat and myalgia
• People suffering from dry cough, body pains, cold with diabetes, High BP or & kidney, liver problems, asthama, HIV, cancer, smoking, pregnancy come under  Category 2B 
• Category 3 includes persons with severe disease, RR more than 30, Spo lesser than 93, Pao2/Fio2 lesser than 300, lung infiltrate higher than 50 per cent of lung within 24 to 48 hours 
• Category 4 includes people with critical disease along with either of ARDS, SEPSIS, Altered, Consciousness or multi organ failure