COVID-19 Treatment Guidelines

Symptomatic Management

• Paracetamol is preferred over NSAIDs for fever and symptom relief in COVID-19 patients, according to the British Medical Journal 1, 2
• Patients should be advised to take paracetamol only while fever and symptoms are present, not solely to reduce body temperature, as recommended by the British Medical Journal 1, 2
• Ensuring adequate hydration with regular fluid intake, limited to no more than 2 liters per day, is crucial for COVID-19 patients, as suggested by the British Medical Journal 1, 2
• Fever typically peaks around day 5 after exposure, so close monitoring during this period is essential, according to the British Medical Journal 1, 2
• Honey is recommended as first-line treatment for cough in adults, as stated by the British Medical Journal 1, 2
• Patients should be encouraged to avoid lying flat on their back, as this makes coughing ineffective, according to the British Medical Journal 1, 2
• If cough becomes distressing despite simple measures, consider short-term use of codeine linctus, codeine phosphate tablets, or morphine sulfate oral solution, as recommended by the British Medical Journal 1, 2
• Teaching controlled breathing techniques, including pursed-lip breathing, can help manage breathlessness, as suggested by the British Medical Journal 1, 2
• Positioning is crucial, with sitting upright increasing peak ventilation and leaning forward with arms bracing improving ventilatory capacity, according to the British Medical Journal 1, 2
• Relaxing and dropping shoulders reduces anxiety-related hunched posture that worsens breathlessness, as recommended by the British Medical Journal 1, 2

Monitoring and Follow-Up

• Establishing a treatment escalation plan immediately is vital, as COVID-19 patients can deteriorate rapidly and require urgent hospital admission, as stated by the British Medical Journal 1, 2
• Monitoring vital signs, including heart rate, pulse oximetry, respiratory rate, and blood pressure, is essential, according to Military Medical Research 3 and other sources 4
• Instructing patients to seek immediate medical attention if they develop worsening breathlessness, persistent chest pain, confusion, inability to stay awake, or oxygen saturation <94% on room air is crucial, as recommended by Military Medical Research 3 and other sources 4
• Ensuring adequate nutritional support with protein-rich foods, with ideal energy intake of 25-30 kcal/(kg·day) and protein intake of 1.5 g/(kg·day), is important, as suggested by Praxis Medical Insights 4
• Bed rest is recommended during the acute phase, according to Military Medical Research 3 and other sources 4
• Avoiding blind antibiotic use unless there is clear evidence of secondary bacterial infection is essential, as recommended by Military Medical Research 5, 3 and other sources 4

Antibiotic and Corticosteroid Use in Mild COVID‑19

Antibiotic Use

• In adults with confirmed mild COVID‑19, antibiotics should be avoided unless there is clear evidence of a secondary bacterial infection (e.g., documented bacterial pathogen, markedly elevated white‑blood‑cell count, C‑reactive protein, or procalcitonin > 0.5 ng/mL). 6

• Routine empirical antibiotic therapy is not recommended for mild COVID‑19 patients who lack clinical signs of bacterial co‑infection, thereby preventing unnecessary drug exposure and resistance. 6

• When antibiotics are deemed necessary for a mild COVID‑19 patient, a comprehensive microbiologic work‑up (cultures, rapid antigen tests, or molecular diagnostics) should be performed before initiation to allow targeted therapy and timely de‑escalation. 6

Corticosteroid Use

• Routine administration of systemic corticosteroids is not advised for adults with mild COVID‑19, as evidence indicates that corticosteroid use in viral pneumonia can worsen infection and increase mortality rates. 7