In particular, the section “Pathogenetic treatment” has been completely updated, where the criteria and timing of prescribing genetically engineered biological drugs and drug combinations have been clarified, the Ministry of Health said. The same section describes the features of the appointment of anticoagulants.
The Russian drug uminfenovir, widely known under the brand name Abidol, is still recommended for outpatient use, but has been removed from the list of drugs for hospitalized patients at risk of mild COVID-19. In a previous version of the interim guidelines, it was mentioned that there was no data on the efficacy and safety of the drug for patients with coronavirus.
Updated ambulatory regimens for lung patients include budesonide, an inhaled glucocorticoid used for asthma and chronic obstructive pulmonary disease (COPD). A small study from the UK at the beginning of the year showed a 90% reduction in the need for emergency care and hospitalization in patients who used an inhaler. In addition, the symptoms of infection in the volunteers disappeared significantly faster than in the control group.
For patients with moderate disease, the recommendations include a treatment regimen using baricitinib and tofacitinib, drugs used to treat arthritis. Remdesivir and human immunoglobulin are proposed for etiotropic therapy of critically ill patients – this approach was considered by the Ministry of Health to be the most effective today.
A new section “Antimycotic therapy” has appeared in the recommendations, which describes the features of the treatment of invasive aspergillosis and candidiasis in patients with COVID-19. In addition, schemes for a more rational use of oxygen with respiratory support for critically ill patients in intensive care units have been proposed.
Information on indications for vaccination of pregnant women has been added to the section on specific prevention – for the time being, expectant mothers are recommended to be vaccinated from the 22nd week of pregnancy only if they belong to risk groups for COVID-19. These are women with obesity, diabetes, liver disease and various chronic conditions.
“The experience of clinical use of the drug Gam-COVID-Vac during pregnancy is insufficient. In this regard, the Gam-COVID-Vac vaccine should be used during pregnancy in cases where the expected benefit to the mother outweighs the potential risk to the fetus, ”the document says.