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MINISTRY OF
HEALTH OF VIETNAM
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SOCIALIST
REPUBLIC OF VIETNAM
Independence – Freedom – Happiness
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No. 437/QD-BYT
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Hanoi, February
27, 2022
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DECISION
AMENDING THE
GUIDELINES FOR DIAGNOSING AND TREATING COVID-19
MINISTER OF HEALTH
Pursuant to Decree No. 75/2017/ND-CP dated June
20, 2017 of the Government on functions, tasks, powers, and organizational
structure of the Ministry of Health;
At request of Director of Vietnam Administration
of Medical Services, Ministry of Health.
HEREBY DECIDES:
Article 1. Amendments to Schedule 4:
Combined rules in treating COVID-19 patients under Section 6.1 and Schedule 5:
Antiviral drugs in COVID-19 treatment under sub-section 6.2.1. Antiviral drugs
of the “Guidelines for diagnosing and treating COVID-19” attached to Decision
No. 250/QD-BYT dated January 28, 2022 of the Minister of Health are attached
hereto.
Article 2. This Decision comes into effect
from the day of signing.
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PP. MINISTER
DEPUTY MINISTER
Nguyen Truong Son
AMENDING THE
GUIDELINES FOR DIAGNOSING AND TREATING COVID-19
(Attached to
Decision No. 437/QD-BYT dated February 27, 2022 of Minister of Health)
VI TREATMENT
6.1. Combined rules in treatment
Schedule 1. Combined rules in treating COVID-19
patients
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Asymptomatic
patients
Mild
Moderate
Severe
Life-threatening
- SpO2 > 96%
- Respiratory rate < 20 breaths/minutes
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- Respiratory rate 20-25 breaths/minutes
- Injury shown by X-ray
imaging < 50%
- Or mild COVID-19
patients have underlying medical conditions, in which case they are
considered moderate cases.
- SpO2 < 94%
- Respiratory rate > 25 breaths/minutes
- Injury shown by X-ray
imaging > 50%
- Patients having
respiratory distress and requiring invasive ventilation or
- Patients suffering from
shock or
- Patients suffering from
multi organ failure
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No
Yes[1]
Yes1
No
No
Note: Asymptomatic COVID-19 patients or
those with mild infection can receive treatment at home or COVID-19 treatment
facilities depending on epidemic situation of their locality.
6.2. Treating the cause
6.2.1. Antiviral drugs
Schedule 2. Antiviral drugs in COVID-19
treatment
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Indication
Contraindication
Dose
Note
Remdesivir
- Patients receiving
inpatient treatment, having mild infection, and having at least one risk
factor; having moderate and severe infection, having developed the conditions
in less than 10 days which include respiratory distress and requiring
supplemental oxygenation, high-flow nasal cannula (HFNC), non-invasive
ventilation
- Recommended for use in
combination with corticoid (prioritizing dexamethason)
- Patients who have taken
remdesivir prior to being subject to invasive ventilation or ECMO may
continue using remdesivir to the full regimen.
- Patients having previous
anaphylaxis to any component of the drugs
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+ Persons ≥ 12 years of age and weighing > 40
kg: 200 mg for the first day , 100 mg/day for subsequent days, one session of
intravenous infusion for 30 - 120 minutes
+ Treatment duration: 5 days, if patients are not
clinically improved, another 5-day treatment can be needed.
- For children < 12 years
of age, comply with guidelines for diagnosing and treating COVID-19 in
children
- Pregnant and breastfeeding
women: Insufficient data. Not recommended unless the gains drastically
outweigh the risks.
- Monitor patients during
infusion period and for 1 hour after infusion to promptly respond to allergic
reaction and infusion reaction (if any).
- Monitor liver enzyme
during drug use period. Stop taking drugs if ALT liver enzyme is 5 times
above the upper limit of normal value
- Data is insufficient to
recommend the drug for patients whose eGFR < 30 mL/minute.
- For more details, refer to
drug instruction manual
Molnupiravir
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- Drug is to be taken within
5 days of developing symptoms or getting positive test results. Patients
requiring hospitalization who have previously taken molnupiravir can continue
taking molnupiravir to complete 5-day regimen depending on decision on
admitting physician.
Patients having anaphylaxis to molnupiravir or
any component thereof.
800 mg/time, 2 times/day.
- Treatment period: 5 days
- Not recommended for
pregnant women, breastfeeding women, children under 18 years of age due to
the drug’s risk of toxin for the fetus, bone, cartilage.
- Women capable of pregnancy
and women in reproductive age should take appropriate contraceptive methods
during treatment and for 4 days after taking the last dose of molnupiravir
- Breastfeeding women:
breastfeeding is not recommended during treatment period and for 4 days after
taking the last dose of molnupiravir
- For male in reproductive
age, use appropriate and effective contraceptive methods during treatment
period and for at least 3 months after taking the last dose of molnupiravir
- For more details, refer to
drug instruction manual approved by Ministry of Health
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[1] Under supervision of health
workers