NEW DELHI: Loss of smell and taste, diarrhea and muscle pain are among the Covid-19 symptoms people should watch out for even as the Centre on Saturday recommended against the use of anti-malaria drug hydroxychloroquine for severely sick patients.
Releasing the revised clinical management protocol for Covid 19 patients in India, the Ministry of Health and Family Welfare said loss of smell (anosmia) or loss of taste (ageusia) preceding the onset of respiratory symptoms could be one of the signs of the disease.
An Indian Council of Medical Research official said the clinical criteria for identifying the disease had been expanded after many Covid-19 patients reported atypical symptoms.
“These symptoms could soon reflect in our testing protocol, which will be further amended,” he said of the revised clinical management protocol.
Other than the most common signs such as fever, cough and breathing trouble, muscle pain, mucous formation in throat, clogged nasal cavity, sore throat, diarrhoea and loss of taste and smell have been included among the symptoms. People over 60 and those with non-communicable diseases such as diabetes, hypertension, cardiac disease, chronic lung disease, cerebro-vascular disease, chronic kidney disease, immune-suppression and cancer are among the high risk category, the Ministry said.
The fresh advisory has also dropped antibiotioc azithromycine to be prescribed along with HCQ for serious Covid-19 patients. The new guidelines admitted that HCQ may not be helping in reducing mortality in very sick patients.
Earlier, this drug was specifically recommended for Covid-19 patients in ICU.“This drug has demonstrated in vitro activity against SARS-CoV-2 and was shown to be clinically beneficial in several small single center studies though with significant limitations,” the new advisory said.
An ICMR official who helped frame the guidelines said the recommendation for azithromycine along with HCQ was dropped as there was increasing evidence that the combination raised cardiac toxicity.
Importantly, the guidelines also allow the off-label usage of the Ebola drug remdesivir, immune-suppressive drug tocilizumab and convalescent plasma for moderately sick patients on compassionate grounds.
Remdesivir is likely to be available in India in a couple of weeks. The advisory said the drug can be used for patients with moderate disease but said the intravenous medicine cannot be given to those with severe kidney disease, pregnant or breastfeeding women and children under 12.
Another drug mentioned in the advisory is tocilizumab, which is already being given to patients. It has been formalised under the new protocol.