COVID-19 Treatment Guidelines by National Institute of Health(NIH) USA for Omicron (B.1.1.529) varient infection managmet

The National Institute of Health of the United States has published a guideline for providing Treatment for COVID 19, due to the increased number of Omicron (B.1.1.529) Variants of concern.

The guideline is an eye opener, when NIH mentioned in it that the recently developed monoclonal antibodies treatment for treatment of SARS-COV-2 may not be effective against the Omicron (B.1.1.529).Therefore it has advised in its guideline that doctors should also give remdesavir intravenous dosage to out patients.as well, the use of remedisavir was limited to hospitalized patients, while NIH recommend to make use of the remedisavir in outpatient as well along with NIH in its guideline has also recommended use of only one monoclonal antibody Sotrovimab 500 mg Intravenous as a single infusion (AIIa) immediately within 10 days of symptoms onset.
1.Sotrovimab 500 mg Intravenous as a single infusion (AIIa) immediately and within 10 days of symptom onset .
2. Remdesivir 200 mg intravenous on day 1, then 100 mg once daily on Days 2 and 3 (BIIa) initiated as soon as possible and within 7 days of symptom onset.
Remedesivir intravenous injection requires for three consecutive days therefore it’s one of the concerns for outpatients. 
Due to the greater variation in spike protein due to variation in gene sequence the antibodies which were developed with earlier sequence viz bamlanivimab plus etesevimab and casirivimab plus imdevimab, may not be effective against the Omicron (B.1.1.529). Therefore if at all someone makes use of them, it should be kept in mind that they may not work.
Remdesivir is a nucleotide prodrug of an adenosine analog which inhibits the intake of adenosine base by viral RNA during the replication process of SARS COV-2 virus.
Sotrovimab  is a Monoclonal antibody.
Reference : National Institute of Health guidance for Omicron varient treatment approach.
 

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