Go for test for TB, other conditions if cough persists for more than two weeks: Revised clinical guidance for Covid patients
NEW DELHI: In a significant move that seeks to identify whether the Covid-19 infection may be triggering tuberculosis, the Centre in its latest clinical management protocol said if cough persists for 2-3 weeks, investigation for TB should be carried out.
The latest guidelines that have been prepared by the joint monitoring group under AIIMS, Delhi, and ICMR’s Covid National Task Force, says that the high risk factor for the progression of the disease include age of 60 years and beyond, hypertension, and coronary artery disease.
Other diseases and conditions identified as risk factors for worsening of infection include diabetes mellitus and other immune-compromised states such as HIV, active TB and lung, kidney or liver disease, cerebrovascular disease and obesity. Also, the guidelines say there is no evidence for benefit for injectable steroids in those not requiring oxygen supplementation. It also says continuation of anti-inflammatory or immune-modulatory therapy such as steroids after discharge can have risk of secondary infection such as invasive mucormycosis when used too early, at higher dose or for longer than required.
During the second wave of Covid-19 in India last summer, a large number of mucormycosis or black fungus cases had been registered in people post infection, mainly during their treatment period in hospitals. It had been established that the rampant use of steroids may have caused the parallel public health emergency. Last week, Niti Aayog member (health) and chairman of the national Covid task force, V K Paul had warned against the “overuse and misuse” of several Covid drugs, including steroids.
Meanwhile, the new treatment protocol for Covid also laid down that while mild cases will be home isolated, severe patients will be admitted in intensive care units. Patients with moderate symptoms, on the other hand, will have to be admitted to Covid wards.
Test decline concern
Flagging a decline in the number of tests in many states and UTs, the Centre has asked them to enhance testing so that an effective track of the spread of the pandemic can be kept and immediate citizen-centric action can be initiated.