Home management of Covid-19:

  • The most important factor is oxygen saturation. Target is 92-94.

  • If your oxygen saturation is 92-94, You do not need to read this message any further 

  • Continue monitoring oxygen levels, STAY HOME 

  • You do not need to go to the hospital 

  • You do not need steroids but if you do take steroids at this time you have the risk of dying. If you are already taking steroids before you got Covid for some long term disease, then you should continue steroids and do not stop 

  • You do not need Remdesivir 

  • You do not need Tocilizumab 

  • You do not need oxygen 

  • You do not need a CT scan to check your score 

  • You do not need an x-ray 

  • You do not need any blood test 

  • You do not need to repeat any type of Covid test like rapid antigen test or PCR test

Home isolation/quarantine for at least 10days or preferably 14days to decrease the risk of spreading to your family.


If your oxygen saturation is 91% or less:

  1. Start steroid treatment.

    • It can be any type of steroids, tablet or injection whatever is available.

    • Injection and tablets have the same effectiveness, one is not better than the other.

    • Dexamethasone 6mg tablet or injection- once a day for 10days

Or

  • Prednisone/Prednisolone 30mg tablet once a day for 10days

Or

  • Methylprednisolone 30mg injection once a day for 10days

  1. If your risk of bleeding is less, you are not on blood thinners like clopidogrel or anything similar, you do not have any history of bleeding problems in the past, then you can start taking blood thinners.

    • You can take any one of the following, all have the same effectiveness: All are tablets.

    • Dabigatran 75mg Twice a day

Or

  • Apixaban 2.5mg Twice a day

Or

  • Rivaroxaban 10mg once a day

  • Stop blood thinners if you have any type of bleeding like blood in stools or black stools or blood from nose or any other place

  1. Remdesivir is not of great help 

    • Useful only if given within 5days of getting sick 

    • It helps by decreasing length of sick period 

    • It does not improve oxygen levels 

    • It does not prevent you from dying 

    • Small chance of kidney failure from it

  2. Tocilizumab only if you are in the hospital 

    • Requiring more than 50% oxygen with a BiPAP or if you are on the ventilator 

    • High risk of getting fungal pneumonia or other bad pneumonia or other infections as it decreases body’s immunity severely

    • As you can see above, all decisions are made based on how much oxygen you are needing. 

    • There is no need for any CT scan or X-ray

    • CT or X-ray does not help decide any treatment

    • It's a waste of time and money

  3. If you are needing more than 3L oxygen at home, try to find a hospital bed.


Home oxygen management of Covid-19:

  • Most important is monitoring oxygen saturation. It should be 92-94

  • If oxygen saturation is 91 or below, then start using oxygen

  • Can start oxygen at 1L or 2L or higher flow to get oxygen saturation 92-94

  • If oxygen saturation goes low again, you can increase flow to 3L or 4L or 5L or higher if there is an option on the machine to get saturation readings of 92-94

  • 92-94 is enough. No need to increase oxygen flow to make it 99 or 100. More is sometimes harmful

  • It does not take very long for oxygen levels to start improving once oxygen is started. It takes about 2-3 minutes or less. If oxygen levels are not improving in 2-3 minutes, then it means you need to increase oxygen flow

  • Any oxygen device/machine is ok. There is no difference in the quality of oxygen between a concentrator or tank

  • Oxygen tank needs refill when finished. Oxygen concentrator can go on and on indefinitely

  • Oxygen concentrator needs electricity to run. Oxygen tanks have the benefit of working even when there is no electricity as it does not need electricity

  • Controlling the flow of oxygen on a tank is generally through a knob which on rotation shows number 0-5 or 6 or higher depending on the kind of regulator

  • Oxygen concentrators sometimes have digital control. One can increase/decrease the flow by pressing a plus or minus button

  • Oxygen can be used via a nasal cannula or a mask. Either option whichever available is ok

  • The length of tubing with the nasal cannula or mask is generally about 5/6 feet

  • When patients take off oxygen to get out of bed, their oxygen level drops. Or sometimes oxygen level is ok when sitting/lying in bed but the level drops when they get out of bed. One can get 25 or 50 feet long tubing. This helps to keep oxygen on if the patient wants to get up and use the toilet or walk around in the room without the need to take off oxygen

  • Use the long tubing only when getting out of bed otherwise you would waste oxygen if using long tubing all the time. This is because longer tubing needs more oxygen flow to get to target levels of 92-94