Revised Covid-19 patient discharge policies; All you need to know
The Union health ministry on Friday revised its discharge guidelines for coronavirus disease (Covid-19) patients. The revised guidelines are different from the government’s previous rules which said a laboratory-confirmed case had to be tested on day 14 once and then again in a span of 24 hours.
If both the results are negative then the patient is fit to be discharged from the health care facility. The revised discharge policy is aligned with the guidelines on the 3 tier COVID facilities and the categorization of the patients based on clinical severity,” the document said.
Here is the revised guideline:
1. Mild/very mild/pre-symptomatic cases
Mild/very mild/pre-symptomatic cases admitted to a Covid-19 care facility will undergo regular temperature and pulse oximetry monitoring.
The patient can be discharged after 10 days of symptom onset and no fever for 3 days. There will be no need for testing prior to discharge. At the time of discharge, the patient will be advised to follow the home isolation for further 7 days as per guidelines available at (https://www.mohfw.gov.in/pdf/GuidelinesforHomeIsolationofverymildpresymptomaticCOVID19case s.pdf).
At any point of time, prior to discharge from Covid-19 Care Centre (CCC), if the oxygen saturation dips below 95%, the patient is moved to dedicated Covid-19 Health Centre (DCHC).
2. Moderate cases admitted to dedicated Covid-19 Health Centre (Oxygen beds)
* Patients whose symptoms resolve within 3 days and they maintain saturation above 95% for the next 4 days
Cases clinically classified as “moderate cases” will undergo monitoring of body temperature and oxygen saturation.
If the fever resolve within 3 days and the patient maintain saturation above 95% for the next 4 days (without oxygen support), such patient will be discharged after 10 days of symptom onset in case of:
- Absence of fever without antipyretics
- Resolution of breathlessness
- No oxygen requirement
There will be no need for testing prior to discharge.
At the time of discharge, the patient will be advised to follow the home isolation for 7 days as per guidelines available at (https://www.mohfw.gov.in/pdf/GuidelinesforHomeIsolationofverymildpresymptomaticCOVID19cases.pdf).
* Patient on oxygenation whose fever does not resolve within 3 days and demand of oxygen therapy continues.
Such patients will be discharged only after the resolution of clinical symptoms and after they are able to maintain oxygen saturation for 3 consecutive days
3. Severe cases including immunocompromised (HIV patients, transplant recipients, malignancy)
Discharge criteria for severe cases will be based on clinical recovery and patient tested negative once by RT-PCR (after the resolution of symptoms)
