Management Protocol for

CManagement
VID-19Protocol
Patients

in Hospitals

Ministry of Health and Population, Egypt

Management protocol for COVID-19
Patients
Version 1.4 / November 2020
Version 1.4 / November 2020 1
2 Version 1.4 / November 2020
 Table of contents

Page
Item
Number

Triage Protocol
4

Management Protocol
6

Gastrointestinal Manifestations
of COVID-19 15

Anticoagulation of COVID-19
Patients 16

High-Velocity Nasal Insufflation

17

Post-acute COVID Syndrome

18

Prevention and Control of COVID-19 Inside

Health Care Facilities 20

Antibiotics in Covid-19 25

List of Editors 26

Version 1.4 / November 2020 3

 Triage Protocol

1st Step: Triage

Case definition + severity assessment
Suspect Case Definition
A) Clinical AND epidemiological criteria: OR: B

-Acute onset of fever and cough OR

-≥ 3 of the followings: fever, cough, sore
throat, coryza, general weakness/fatigue,
headache, myalgia, dyspnea, anorexia/nausea/ Patient with severe acute
vomiting, diarrhea, altered mental status respiratory illness (SARI: acute
respiratory infection with history
And 1 of the followings within 14 days of of fever or measured fever ≥ 38°C
symptom onset: and a cough; onset within last 10
Residing or days; requires hospitalization)
Working in Residing or
working in an
a healthcare travel to an area
area with high
with community
risk of setting transmission
transmission*

*Closed residential settings, humanitarian settings such as camp and camp-like settings for displaced persons.

NB: Minimal role for the epidemiological criteria during the period of community spread

Probable Case
A patient who meets clinical criteria AND is a contact of a probable or confirmed case,
or epidemiologically linked to a cluster with at least one confirmed case.
OR
Suspect case with chest imaging showing findings suggestive of COVID-19 disease*
OR
Recent onset of loss of smell or taste in the absence of any other identified cause
OR
Unexplained death in an adult with respiratory distress who was a contact of a probable
or confirmed case or epidemiologically linked to a cluster with at least 1 confirmed case

*Hazy opacities with peripheral and lower lung distribution on chest radiography; multiple bilateral ground
glass opacities with peripheral and lower lung distribution on chest CT; or thickened pleural lines, B lines, or
consolidative patterns on lung ultrasound.

Confirmed Case
A person with laboratory confirmation* of COVID-19 infection, irrespective of clinical signs
and symptoms
*Molecular testing(PCR) with deep nasal swab is the current test of choice for the diagnosis of acute COVID-19
infection
During seasonal flu period, clinical differentiation between influenza and COVID 19 is difficult.
Swab for influenza A &B may help in early differentiation.

4 Version 1.4 / November 2020

Triage Protocol

Severity assessment

Suspected case

-PCR to confirm the diagnosis *

-Assess disease severity
(clinical, lab & imaging)

SpO2 < 92%, PaO2/FiO2 < Respiratory failure,

-Mild symptoms Imaging: +ve
300, septic shock, and/or
-Normal imaging SpO2 ≥ 92%
respiratory rate > 30 multiorgan
breaths/min, or dysfunction
lung infiltrates > 50%
Moderate

Mild Risk Factor Severe Critical illness

No Yes

Home isolation &

close follow up Hospitals admission Admit to Admit to
If possible, < 65 years COVID area Intermediate Care Intensive care
old & no uncontrolled
comorbidity

In severe and critically ill patients, if-ve 1st PCR, repeat within 48 hours, negative case is considered after 2 –ve
consecutive RT-PCR results from respiratory samples tested at least 1 day apart.
NB: Unstable patient who don’t meet the suspected criteria should receive 1st aid therapy in non-COVID area
before referral to general hospital.+ Risk factors include, old age > 60 years, uncontrolled comorbidity as hyperten-
sion, DM, ……. or Social un applicable to home isolation.

All persons with suspected, probable or confirmed COVID-19 should be immediately

isolated to contain the virus transmission.

Version 1.4 / November 2020 5

 Management Protocol

2nd Step: Management

All patients with symptomatic COVID-19 and Check Every Patient For Risk
risk factors for severe disease should be closely Factors
monitored. The clinical course may rapidly . Age 65 years
progress in some patients. . SpO2 < 92%
Antibiotics are not recommended to prevent . Heart Rate ≥110
bacterial infection in mild patients. Administer . Respiratory Rate ≥ 25 /min.
empiric antibiotics if bacterial . Neutrophil / lymphocyte ratio on
pneumonia/sepsis strongly suspected; re-evaluate CBC ≥ 3.1
daily. . Uncontrolled Comorbidities
In non-hospitalized patients, do not initiate . On Immunosuppressive or
therapeutic anticoagulants or antiplatelet chemotherapy drug
unless other indications exist. . Pregnancy
No harmful effect for administration of vitamin . Active Malignancy
C or D or Zinc or Lactoferrin within the required . Obesity (BM>40)
daily dose.

Time is an important issue in management of COVID-19. Before day 12( stage of viral
load), Antiviral drug is essential. After day 12, the role of antiviral declines with
augmentation for the role of anti-inflammatory, immune-modulators and Supportive drugs
(stage of hyper-immune state).

Potential antiviral drugs under evaluation for the treatment of COVID-19 include:
- Hydroxy Chloroquine 400mg/ 12 hours 1st day followed by 200 mg/12 hours for 6 days,
- Ivermectin 6 mg (36 mg on day 0 -3-6),
- Favipiravir 1600 twice daily first day then 600 mg twice daily,
- Remdesivir 200 mg IV on day 1, followed by 100 mg IV daily for high risk population for 5
days that could be extended to 10 days if the response is unsatisfactory or
- Lopinavir/Ritonavir 200/ 50 mg 2 tablets PO BID
- Monoclonal antibodies:
antibodies early testing in blocking SARS-CoV-2.
- Convalescent plasma:
plasma for impending severely ill after counseling the scientific committee

Mild illness

Home isolation and symptomatic treatment (eg, antipyretics for fever, adequate nutrition,
appropriate rehydration).
Educate the patients on signs/symptoms of complications that, if developed, should prompt
pursuit of urgent care.
There are insufficient data to recommend either with or against any antiviral or im-
mune-based therapy in patients with COVID-19 who have mild illness.

6 Version 1.4 / November 2020

Flu or COVID-19

IS IT A FLU OR COVID-19?
SYMPTOM FLU COVID-19
FEVER

FATIGUE

COUGH

SORE THROAT

HEADACHES

RUNNY NOSE

SHORTNESS OF BREATH

BODY ACHES

DIARRHEA AND/OR
VOMITING
ONSET 1-4 days after infection About 5 days after infection but can range
from 2-14 days

LOSS OF TASTE AND/OR

SMELL
RED, SWOLLEN EYES

SKIN RASHES

All patients with symptomatic COVID-19 and risk factors for severe disease should
be closely monitored. In some patients, the clinical course may rapidly progress.

Version 1.4 / November 2020 7

 Mild Case
Symptomatic case
with lymphopenia or leucopenia
with no radiological signs for pneumonia

Check for

1. Age 65
2. Temperature > 38
3. SaO2 ≤ 92%
4. Heart Rate ≥ 110
5. Respiratory Rate ≥ 25 /min.
6. Neutrophil / lymphocyte ratio
All No on CBC ≥ 3.1 Any YES
7. Uncontrolled Comorbidities
8. Immunosuppressive Drug
AND 9. Pregnancy OR
10. Active Malignancy
11. On Chemotherapy
12. Obesity (BMI>40)
Age < 65 Age ≥ 65

• Strict Home Isolation (Symptomatic If more than 3

Treatment) symptoms admit
• Follow and use personal protective guide
equipment
• If any deterioration occurs, back to
hospital
NB: Paracetamol is the preferred antipyretic

Treatment

- Hydroxychloroquine (400 mg twice in - Zinc 50mg daily

first day then 200 mg twice for 6 days) - Acelylcysteine 200 mg t.d.s.
- lactoferrin one sachet twice daily
OR Ivermectin 6 mg (36 mg on day 0 + - Vitamin C 1 gm daily
-3-6)
OR Favipiravir 1600 TWICE daily first
day then 600 mg twice daily

8 Version 1.4 / November 2020

 Moderate Case

Patient has pneumonia manifestations on radiology associated with symptoms &/Or

leucopenia or lymphopenia.

Immune-modulators
Anti-virals Anti-coagulation
Anti-inflammatory

Hydroxychloroquine + Steroids Prophylactic

Ivermectin or (if patient has severe anticoagulation if
dyspnea) RR>24 or CT D-Dimer between
scan showing rapid 500 -1000
Lopinavir/Ritonavir
deterioration Therapeutic
or
Dexamethasone 6 mg anti-coagulation if
Remdesivir for high or its oral equivalent D-dimer > 1000
risk population with
SaO2 < 92

Severe cases
RR > 30, SaO2 < 92 at room air, PaO2/FiO2 ratio < 300, Chest radiology showing more than
50% lesion or progressive lesion within 24 to 48 hrs.

Admit to Intermediate Care

Anti-coagulant Convalescent
Anti-virals Anti-inflammatory
Prophylactic plasma
anticoagulation if Steroids Before day 12
Remdesivir (Dexamethasone 6
D-Dimer between
or mg or methyl (under clinical trial)
500 -1000
Lopinavir/ prednisolone (1 mg / (after scientific
Therapeutic
Ritonavir kg /24 hours) committee
anti-coagulation if
D-dimer > 1000   approval)
Or if severe Tocilizumab
hypoxia 4-8 mg/kg/day for 2
doses 12 to 24 hours
apart after failure of
steroid therapy to
improve the case for
24 hours

Version 1.4 / November 2020 9

 Critically ill patients
RR > 30, Sa02 < 92 at room air, PaO2/FiO2 ratio < 300, Chest radiology showing more than
50% lesion or progressive lesion within 24 to 48 hrs. Critically ill if SaO2 <92, or RR>30, or
PaO2/FiO2 ratio < 200 despite Oxygen Therapy.

Admit to Intensive care

Anti-virals Anti-coagulant Anti-inflammatory

Steroids
Remdesivir (Methyl prednisolone 2mg /kg or its
or Therapeutic equivalent)
anti-coagulation  
Tocilizumab
Lopinavir/ 4-8 mg/kg/day for 2 doses 12 to 24 hours
Ritonavir apart after failure of steroid therapy to
improve the case for 24 hours

Early Block
the storm Tocilizumab
if steroids 4-8mg/kg/dose
failed 2 doses

Antiviral Steroids Anti- Prone Avoid

Drugs As is In Methylpred- Coagulation Awake or Hypoxia
Severe case nisolone Enoxaparine ventilated O2/ NIV/
1-2 mg/kg/d 1 mg/kg BID HFNC/IMV

Don’t wait
Add 1 mg for non Consider Improves too much for
Antibiotics ventilated D-dimer level V/Q matching any type of
As per and 2 mg for as a guide and survival support Keep
protocol ventilated plateau<30

High flow nasal oxygen is an important modality in the early management of critically ill patients.

10 Version 1.4 / November 2020

Non Invasive Ventilation or High Flow Nasal Cannula

(HFNC):
Conscious patients with minimal secretions.
Hypoxia SpO2 < 90% on oxygen. Or PaCO2 >40 mmHg provided pH 7.3 and above.
NIV trial shall be short with ABG 30 minutes apart.
Any deterioration in blood gases from baseline or oxygen saturation or consciousness
level shift to IMV.
CPAP gradually increased from 5-10 cmH2O.
Pressure support from 10-15 cm H2O.
HFNC can be alternative to NIV.

Invasive Mechanical Ventilation:

Use PPE specially goggles during intubation and avoid bagging.

Indications:
Failed NIV or not available or not practical.
PaO2 < 60 mmhg despite oxygen supplementation.
Progressive   Hypercapnia.
Respiratory acidosis (PH < 7.30).
Progressive or refractory septic shock.
Disturbed consciousness level (GCS ≤ 8) or deterioration in consciousness level from
baseline

Version 1.4 / November 2020 11

 COVID-19 PNEUMONIA (type L & type H)

Type L Type H

Lung Damage Progression

(Virus + P-SILI)

STOP STOP STOP

Inspiratory effort - edema

Type L

Low elastance Non invasive

Low VA/Q mismatch Early intubation Late intubation
support Type H
Low lung weight
Low recruitability HFNC PEEP (5-10 cmH2O) Higher PEEP(10-15 High elastance
CPAP Sedation cmH2O) High RL shunt
NIV NMBA Prone High lung weight
(ECMO) High recruitability

Type L and Type H patients are best identified by CT scan and are affected by different
Pathophysiological mechanisms. If CT not available, definition could be used as surrogates:
Respiratory system elastance and recruitability.

Understanding the correct pathophysiology is crucial to establishing the basis for appropriate
treatment.

12 Version 1.4 / November 2020

Step 1: Initiation of Invasive Mechanical Ventilation

VCV
TV 8 ml/kg
PEEP 5 cmH2O

Plateau
Pressure Inspiratory Pause for 1 second

Less than 30 Less than 30 More than 30

cmH2O Sat<93 ARDSnet
Sat >93 Increase PEEP protocol
Keep and Watch to 10

IF PLATEAU ABOVE 30 CMH2O

Step 2: Shift to ARDSNet protocol if needed

- ARDSNet protocol:

Plateau
P<30 cmH2O
LOW TV Incremental
6-4 ml/kg PEEP Driving
P<15 cmH2O

Version 1.4 / November 2020 13

 Start with tidal volume of 6 ml/Kg to keep plateau pressure on volume controlled
ventilation (VCV) below 30 cmH2O, decrease to 4 ml/kg if the plateau remain higher
than 30 allow permissive hypercapnia so long the pH is above 7.3
compensate by increasing respiratory rate up to 30 breath/ minute. Consider heavy
sedation and paralysis. If pressures are high or any evidence of barotrauma shift to
pressure controlled ventilation and be cautious about low tidal volume alarms for
fear of unnoticed endotracheal tube obstruction. Consider ECMO
early if eligible. Increase PEEP gradually if the patient remains hypoxic
according to FIO2 level to keep driving pressure < 15cmH2O. NEVER FORGET
PRONE POSITION.

Step 3: Assessment of respiratory support outcome

Assess
ABGs, Clinical
Radiological

Improved Stationary Deteriorating

Weaning of Continue Criteria for
respiratory respiratory ECMO*
support support as
needed

*Criteria for VV ECMO: Age below 55, mechanical ventilation duration

less than 7 days, no comorbidities, preserved conscious level,
PaO2/FiO2 <100 despite prone RESPscore >0.
Expert opinion is needed and depends on availability.

14 Version 1.4 / November 2020

Gastrointestinal Manifestations
of COVID-19

Gastrointestinal Manifestations of COVID-19

- Gastrointestinal (GI) symptoms are seen in patients with COVID-19. The preva-
lence could be as high as 50%, but most studies show ranges from 16% to 33%

- Some patients with COVID-19 have presented with isolated GI symptoms that may
precede the development of respiratory symptoms

- It is important to note that medications used for COVID-19 may be associated with
GI symptoms as well.

- Approximately 50% of patients with coronavirus disease 2019 (COVID-19) have

detectable viral RNA in the stool

- Loss of appetite or anorexia is the most commonly reported symptom.

- Diarrhea was the second most common symptom.

- Other digestive manifestations include nausea or vomiting and abdominal pain.

- Dysgeusia has also been reported, often in conjunction with anosmia.

- Currently, management of GI symptoms in patients with COVID-19 is mainly sup-

portive.

- Treatment should be individualized according to the patient’s symptoms, underly-

ing comorbidities and COVID-19–associated complications.

- Oral or intravenous hydration

- The antidiarrheal agent loperamide can be used in an initial dose of 4 mg and with
a maximum daily dose of 16 mg in patients without fever, bloody stools, or risk fac-
tors for C. difficile infection

- Antiemetic drugs can often help relieve symptoms.

Version 1.4 / November 2020 15

 Anticoagulation in COVID-19
Patients

Anticoagulation in COVID-19 Patients

the patient clinically indicated
for hospitalization

Yes No

Is he/she critically ill

No Yes

Prophylactic dose

Therapeutic dose
Higher than standard
dose
0.5 mg/kg/m

The preferred agents

Consider also therapeutic are LMWH and
anticoagulation for Fondaparinux unless
patients with high contraindicated
clinical susceptibility In renal patients, heparin
of VTE and those with is the preferred agent.
Severe hypoxia not If the dose of LMWH
explained by the chest CT exceeds 150 twice daily
findings use heparin instead.

16 Version 1.4 / November 2020

High-Velocity Nasal Insufflation

High Velocity Nasal Insufflation

(Hi-VNI)

• Hi-VNI is a first-line therapy for COVID-19 patients who are struggling to

breathe.
• Hi-VNI Technology and WOB reduction: The fact that small-bore
cannulas reduce the time required to fully purge the upper airway dead space3 is
significant because as the respiratory rate of a patient in respiratory distress
increases, the time between breaths decreases. By quickly clearing the upper
airway dead space of end-expiratory gas rich in CO2, Hi-VNI Technology helps
patients breathe directly from a fresh gas reservoir and thereby reduces their
WOB.

70
Velocity (m.sec-1)

60
HVNI
50
40
30
HFNC
20
10
0
10 20 30 40 50 60

Volumetric Flow (L.min-1)

Version 1.4 / November 2020 17

 Post-acute COVID syndrome

Post- acute COVID syndrome

(long COVID)

Definition & incidence:

In the absence of agreed definition, it may be defined as “patients not

recovering for several weeks or months following the start of symptoms that
were suggestive of COVID, whether patients were tested or not.” It may
extend beyond 3 weeks from the onset of first symptoms up to 3 months,
sometimes occurring after a relatively mild acute illness. If symptoms are
extending beyond 3 months, it is termed Chronic COVID.

In short, “Despite their illness being ‘over,’ they are having a lot of
trouble returning to normal life.” It occurs in around 10% of patients.

Patients can be divided into those who may have serious sequelae (such as
thromboembolic complications) and those with a non-specific clinical pic-
ture, often dominated by fatigue and breathlessness. One last group of
covid-19 patients whose acute illness required intensive care management.

Management:

Specialist referral may be indicated based on clinical finding, for example:

Respiratory: if suspected pulmonary embolism, severe pneumonia.

Cardiology: if suspected myocardi-
al infarction, pericarditis, myocarditis or new heart failure.
Neurology: if suspected neurovascular or acute neurological event.
Pulmonary rehabilitation may be indicated if patient has persistent
breathlessness.

18 Version 1.4 / November 2020

Post-acute COVID syndrome

Medical management:

Symptomatic: treating fever by paracetamol & NSAIDs

Management of co-morbidities including diabetes, hypertension, kidney

diseases & ischemic heart diseases

Listening and empathy

Consider antibiotics for secondary infection

Treat specific complication as indicated

Self-management:

Daily pulse oximetry.

Attention to general health like:
Good diet
Good sleep hygiene
Quitting smoking
Limiting alcohol
limiting caffeine
Rest and relaxation.
Self-pacing and gradual increase exercise.
Set achievable targets.

Version 1.4 / November 2020 19

 Prevention and Control of Transmission
of COVID-19 inside
Health Care Facilities

20 Version 1.4 / November 2020

General Recommendations

General Recommendations for

Prevention and Control of Transmission of COVID-19
inside Health Care Facilities

1-Daily screening of health care workers and patients before entering the
health care facility (HCF) based on clinical signs (fever, respiratory symp-
toms…….).

2- Any health care worker appears/reports to be diseased should be segregated

until proper examination/management.

3- All health care workers are required to wear surgical masks during work
hours (during existence in HCFs).

4- Minimal number of health care workers should be present at the same time
in patient’s units to keep social distancing

5- Restrict unneeded movements between departments.

6- Suspected or confirmed cases should take a separate route from other pa-
tients beginning from the facility entrance (Triage area), and all facility sec-
tions should follow the same separation.

7- Suspected or confirmed cases should be isolated in a well- ventilated isola-

tion room.

8- Standard precaution should be applied :

• Hand hygiene
• Cough etiquette.
• Personal protective equipment.
• Clean and disinfected Environmental surfaces.
• Sterile instrument and devices
• Sharp safety.
• Isolation transmitted precaution.
• Safe injection practices.

Version 1.4 / November 2020 21

 Medical Recommendations

Recommendations
According To The Type Of Procedure

1) Non Aerosol Generating Procedures (AGPs)

• Standard precautions.

• Isolation precautions taken to prevent the spread of infection by spray and

contact.

• The need to adhere to washing hands before donning personal protective

equipment and immediately upon doffing.

• The necessity to adhere to donning personal protective equipment as

follows:

1- Surgical mask.

2- Protect your eyes by wearing goggles or face shield.

3- Long-sleeve medical gowns (gown) clean, non-sterile or sterile, according to

type of technique.

4- Clean or sterile gloves depending on type of technique.

5- Health care worker are not required to wear protective boots and protective
suits during routine care of cases.

6- Extended use of surgical masks, gowns, eye protectors, and face shields can
be applied while caring for COVID-19 patients in the event of a shortage of
personal 2 protective equipment for the length of the work shift (preferably
not more than six hours).

7- Always remember not to touch the eyes, mouth or nose with contaminated
hands or used gloves (wash your hands or rub using alcohol when touch any
environmental surface).

8- Always clean and disinfect surfaces .

22 Version 1.4 / November 2020

Medical Recommendations

2) Procedures that include (AGPs):

• Tracheal intubation .

• Non-invasive ventilation e.g. BiPAP, CPAP.

• Tracheotomy.

• Cardiopulmonary resuscitation.

• Manual ventilation before intubation or bronchoscopy.

• Sputum induction by using nebulizer hypertonic saline.

The health care workers must adhere to the following:

• Standard precautions.

• Perform procedures inside a well-ventilated room.

• Follow the isolation precautions taken to prevent the spread of infection

through air and contact.

• The need to adhere to washing hands before donning personal protective

equipment and immediately upon doffing them.

Version 1.4 / November 2020 23

 Personal Recommendations

Donning personal protective equipment as follows:

- A high-performance respiratory masks such as N95 or FFP2 or equivalent,

with the need to conduct a tightness test to ensure that there is no leakage.

- Protect your eyes by wearing goggles or face shield.

- Long-sleeve medical gowns (gown) clean, non-sterile or sterile according to

the procedure.

- Clean or sterile gloves depending on type of technique.

- The extended use of a mask, medical gown, eye goggles, or face shield
(Extended use) can be applied while caring for patients with COVID-19 in the
event of a lack of personal protective equipment and for the length of the work
shift (preferably no more than six hours).

- Care must be taken not to touch the eyes, mouth or nose with contaminated
bare hands or using gloves (wash your hands or rub using alcohol when touch
any environmental surface).

- Always clean and disinfect surfaces regularly.

24 Version 1.4 / November 2020

ANTIBIOTICS IN COVID-19

ANTIBIOTICS IN COVID-19

Indications:

- Rapid development of consolidation pattern.

- Development of lobar consolidation.
- Leukocytosis with absolute neutrophilia.
- Reappearance of fever after afebrile days.
- Increased CRP with improved other markers as ferritin.
- Procalcitonin is highly specific.

Low-risk inpatients:

- Combination therapy:
β-lactam (eg, ceftriaxone, or cefotaxime) plus either a macrolide
(eg, azithromycin or clarithromycin) or doxycycline.

- Monotherapy:
Respiratory fluoroquinolone (eg, levofloxacin or moxifloxacin)

High-risk inpatients:

- β-lactam plus a macrolide or fluoroquinolone is recommended.

Version 1.4 / November 2020 25

 Treatment Protocol
Revised By:

NAME AFFILIATION

Professor of Chest Diseases. Head of

Hossam Hosny Masoud Pulmonary Hypertension Unit, Faculty of
Medicine, Cairo University

Professor of Chest Diseases, faculty of

Gehan Elassal
Medicine , Ain Shams University

Fellow of Infectious Diseases and Endemic

Dr. Mohamed Hassany Hepatogastroentrology , National Hepatology
and Tropical Medicine Research Institute

Professor of Chest Diseases, faculty of

Dr. Ahmed Shawky
Medicine , Tanta University

Professor of Chest Diseases, faculty of

Dr. Mohamed Abdel Hakim
Medicine , Cairo University

Professor of Hepatogastroentrology and

Dr. Samy Zaky Infectious Diseases, faculty of Medicine ,
Al Azhar University

Consultant and Head of Hepatology ,

Gastroentrology and Infectious Diseases
Dr. Amin Abdel Baki
Department. National Hepatology and Tropical
Medicine Research Institute

Professor of Critical care Medicine , Cairo

Dr. Akram Abdelbary University
Chairman elect of ELSO SWAAC chapter

Lecturer of Critical care Medicine , faculty of

Dr. Ahmed Said
Medicine, Cairo University

Assistant Professor of Critical care Medicine ,

Dr. Khaled Taema
faculty of Medicine, Cairo University

Minister”s Counselor for Research and Health

Development
Chairman of Research Ethics Committee
Dr. Noha Asem
MOHP, Lecturer of Public Health , Cairo
University

26 Version 1.4 / November 2020

Treatment Protocol
Revised By:

NAME AFFILIATION

Minister of Health Assistant for Continuous

Dr. Ehab Kamal Medical Education
General Director of Fever hospitals Directorate

Dr. Wagdy Amin Director General for Chest Diseases , MOHP

Dr. Ehab Attia General Director of IPC Department , MOHP

Infectious Diseases Consultant , National

Dr. Hamdy Ibrahim Hepatology and Tropical Medicine Research
Institute

Dr. Alaa Eid Head of Preventive Medical Sector MOHP

Version 1.4 / November 2020 27

 Ministry of Health and Population
Egypt / November 2020
28 Version 1.4 / November 2020