Filenews 9 July 2021
The Doctors of the Therapeutic Clinic of the Medical School of the National and Kapodistrian University of Athens, Theodora Psaltopoulou, Panos Malandrakis, Giannis Danasis and Thanos Dimopoulos (Rector of EKPA) summarize the ten recommendations for COVID-19 infection as published in the reputable international journal Nature.
For the public:
1. Use a properly placed mask, always in public places. N95 masks and double surgical masks seemed more effective than a simple mask in an analysis of a total of 39 studies, including more than 12,000 people.
2. Avoid crowded areas, especially indoors. Data from 38 observational studies showed that the risk of transmission is significantly reduced when the distance of at least one metre is observed. Adequate ventilation of the interiors also seems to contribute decisively to reducing dispersion.
3. Test if you have symptoms of COVID-19 and isolate yourself if you have mild symptoms such as febrile [fever], pharyngalgia [sore throat], coughing, loss of taste or smell. Most patients can recover at home only with regular monitoring of temperature and saturation, with the sole intervention of adequate hydration and the use of paracetamol for febrile [fever] and headache. No other medicine is indicated.
4. Talk to a doctor if you experience shortness of breath or if oxygen saturation drops below 92%.
5. Vaccinate as soon as possible, even if you are infected with COVID-19.
For health officials:
6. Do not use unproven or ineffective treatments for COVID-19 infection. There is insufficient data to support the efficacy of the following medicines: favipiravir, ivermectin, azithromycin, doxycycline, oseltamivir, lopinavir-ritonavir, hydroxychloroquine, tocilizumab, bevacizumab, IFN-a2b, fluvoxamine, convalescent plasma, and not recommended by the World Health Organization.
7. Do not use medicines such as remdesivir and tocilizumab, except in circumstances where they are indeed appropriate. Tocilizumab is indicated in patients with severe disease already treated with corticosteroids, who have a systemic inflammatory reaction and rapidly increasing oxygen needs. Remdesivir demonstrably shortens the time to adult healing when administered early to the disease in some patients in clinical studies in need of oxygen support.
8. Use corticosteroids wisely in patients with hypoxygenemia, closely monitoring blood sugar values to keep them within normal limits. Studies have shown benefit in the administration for a short period of 5-10 days of dexamethasone 6 mg (or methylprennisolone equivalents 16mg twice a day or prednisolone 20 mg twice a day) to patients in need of oxygen therapy, while not benefiting and may harm those who do not need oxygen. The longer dose or duration of cortisone has not been shown to have any benefit. Proper glycaemic regulation is very important to avoid secondary fungal infections.
9. There is no need to regularly schedule imaging such as CT scans or indicators of inflammation, such as ferritin, IL-6, LDH and prolactonin. We only carry out as many tests as we need to decide or modify the treatment.
10. Due attention should be paid to other serious conditions not related to COVID-19. Studies show that at the time of the pandemic the care of diseases such as malignancies, heart and kidney disease, mental health, childcare is neglected, having serious effects on their development.
