Management of COVID-19 Moderate Illness

Clinical Signs and Symptoms

Management Approaches

  • Moderate illness is described as a patient having mild pneumonia using appropriate criteria in adults (CURB-65) or children.
  • Adults with pneumonia but no signs of severe pneumonia and no need for supplemental oxygen.
  • A child with non-severe pneumonia who has cough or difficulty breathing + fast breathing but no other signs of severe pneumonia.

Fast breathing (in-breaths/min):

  • < 2 months: ≥ 60;
  • 2–11 months: ≥ 50;
  • 1– 5 years: ≥ 40,
  • Admit patients to the hospital and monitor vital signs at least six hourly.
  • Follow closely for clinical deterioration especially in the vulnerable patients with high risk of developing severe disease.
  • Maintain O2 Sat > 92% with O2 via non-rebreather mask if available (up to 10-15L O2; equivalent to 60-80% FiO2), or can give additional 6-10L O2 via Nasal Cannula under a non-rebreather mask (equivalent to 80% FiO2). Refer Section on Oxygen therapy
  • Avoid IV fluid unless there is a clinical indication
  • Add empiric oral antibiotics if you have strong suspicion of bacterial pneumonia
  • In adult: Amoxicillin 500mg PO TID or Amoxicillin-clavulanate 1gm PO BID or 625 mg PO TID for 7days