COVID-19 Home Treatment Guidelines

Symptomatic Management

• The American College of Physicians recommends using paracetamol as the preferred antipyretic for fever and symptom relief in patients with mild COVID-19 1
• Patients with mild COVID-19 should take paracetamol only while fever and symptoms are present, not routinely to reduce body temperature 1
• Fever typically peaks around day 5 after exposure, requiring close monitoring during this period 1
• Honey is recommended as first-line treatment for cough in adults with mild COVID-19 1
• Patients with mild COVID-19 should avoid lying flat on their back, as this makes coughing ineffective 1
• If cough becomes distressing despite simple measures, consider short-term use of codeine linctus, codeine phosphate tablets, or morphine sulfate oral solution 1
• Teach controlled breathing techniques, including pursed-lip breathing, to patients with mild COVID-19 1
• Patients with mild COVID-19 should sit upright to increase peak ventilation and lean forward with arms bracing to improve ventilatory capacity 1
• Relax and drop shoulders to reduce anxiety-related hunched posture that worsens breathlessness in patients with mild COVID-19 1

Supportive Care Measures

• Ensure adequate hydration with regular fluid intake, limited to no more than 2 liters per day, in patients with mild COVID-19 1
• Maintain 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) in patients with mild COVID-19 1
• Bed rest is recommended during the acute phase of mild COVID-19 1
• Monitor vital signs including heart rate, pulse oximetry, respiratory rate, and blood pressure in patients with mild COVID-19 1
• Healthcare personnel should perform regular (daily) follow-up through face-to-face visits or phone interviews to follow symptom progression in patients with mild COVID-19 2

Isolation and Infection Control

• Isolate patients with mild COVID-19 in a well-ventilated single room 3, 4
• Maintain a bed distance of at least 1 meter from others in patients with mild COVID-19 3, 4
• Restrict the patient's activity and limit visits by relatives and friends in patients with mild COVID-19 3, 4
• Wear a medical mask when coughing or sneezing, or cover with a paper towel and bent elbow, cleaning hands immediately afterward in patients with mild COVID-19 3, 4
• Clean and disinfect household articles using 500 mg/L chlorine-containing disinfectant frequently every day in patients with mild COVID-19 3, 4
• Open windows for ventilation in shared areas such as toilets and kitchens in patients with mild COVID-19 3, 4
• Avoid sharing toothbrush, towel, tableware, bed sheets and other items with patients with mild COVID-19 3, 4
• Patient's daily necessities should be for single use only and placed separately from family members' items in patients with mild COVID-19 3, 4
• Caregivers should wear N95 masks when in the same room with patients with mild COVID-19 3, 4
• Clean and disinfect hands after contact with the patient, before leaving patient's room, before and after eating, after using the toilet, and after entering house from outside in patients with mild COVID-19 3, 4
• Avoid direct contact with patient's secretions or discharges, especially oral or respiratory discharges and feces in patients with mild COVID-19 3, 4
• Wear disposable gloves (double layers) when providing oral and respiratory care, handling feces and urine, and cleaning the patient's room in patients with mild COVID-19 3, 4

Red Flags Requiring Immediate Medical Attention

• Seek immediate hospital evaluation if worsening breathlessness or respiratory rate ≥30 breaths/min develops in patients with mild COVID-19 1, 5, 6
• Seek immediate hospital evaluation if persistent chest pain develops in patients with mild COVID-19 1
• Seek immediate hospital evaluation if confusion or inability to stay awake develops in patients with mild COVID-19 1
• Seek immediate hospital evaluation if oxygen saturation <94% on room air (or ≤93% at rest) develops in patients with mild COVID-19 1, 5, 6
• Seek immediate hospital evaluation if progressive worsening of symptoms despite home care develops in patients with mild COVID-19 2

What NOT to Do

• Avoid blind or inappropriate use of antibacterial drugs unless there is clear evidence of secondary bacterial infection in patients with mild COVID-19 1
• Do not use corticosteroids for mild COVID-19, as they may prolong viral clearance time and increase mortality in non-severe cases 5, 6
• Hydroxychloroquine is not recommended, as it does not improve outcomes and may increase adverse events in patients with mild COVID-19 5, 6
• Lopinavir/ritonavir alone is not recommended for mild cases due to lack of benefit and increased risk of gastrointestinal side effects in patients with mild COVID-19 5, 6

Important Caveats

• Home care requires careful clinical evaluation and safety assessment by healthcare professionals to determine appropriateness in patients with mild COVID-19 2
• This approach is only suitable for suspected or confirmed mild cases without risk factors for severe disease in patients with mild COVID-19 2, 3
• Establish a treatment escalation plan immediately, as COVID-19 patients can deteriorate rapidly and require urgent hospital admission in patients with mild COVID-19 1
• The 14-day observation period should be strictly followed from the last day of exposure in patients with mild COVID-19 2, 7