New Delhi, April 27: Some painkillers like Ibuprofen are found to worsen COVID-19, known to be harmful to heart failure patients and may increase risk of kidney damage, the ICMR said as it advised against taking non-steroidal anti-inflammatory drugs (NSAIDs) and recommended taking paracetamol, if needed, during the disease.

Listing a series of frequently asked questions (FAQs) for patients with hypertension, diabetes and heart diseases, the ICMR said currently there is no evidence that BP medications -- two group of drugs ACE inhibitors and angiotensin receptor blockers (ARBs) -- increase the susceptibility or severity of COVID-19. ICMR Rolls Out a Validated List of Rapid Antigen Test Kits for COVID-19.

Over reports of BP medications increasing the severity of the disease, the apex health research body said, "After the review of available information, the consensus of various scientific societies and expert group of cardiologists is that currently there is no evidence the two group of drugs -- ACE inhibitors (eg. Ramipril, Enalapril and so on) and angiotensin receptor blockers (ARBs) (eg. Losartan, Telmisartan and so on) increase the susceptibility or severity of COVID-19."

"These drugs are very effective for heart failure by supporting heart function and controlling high blood pressure. It maybe be harmful to stop these medications by yourself. This can worsen your heart condition," the ICMR said.

It said that majority (80 per cent) of people diagnosed with COVID-19 will have mild symptoms of a respiratory infection (fever, sore throat, cough) and make full recovery.

On whether patients with heart disease, diabetes or hypertension are at an increased risk to get the infection, the apex health research body said, "No, people with hypertension, diabetes or heart diseases are at no greater risk of getting the infection than anyone else."

Some people with diabetes, hypertension and heart diseases, including heart failure (weak heart), may develop more severe symptoms and complications, it said, adding that extra care is advised for these patients.

On whether people with diabetes are more prone to COVID-19, the ICMR said that in general, people with uncontrolled diabetes are at an increased risk of all infections.

It said that people with diabetes are not at a higher risk of acquiring the infection, but some individuals are prone to more severe disease and poorer outcomes once infected.

Hence, the ICMR advised following a diet and exercise routine (to the extent possible), taking medications regularly and testing sugar levels frequently so as to keep diabetes under control.

When diabetic patients become sick, they may require frequent monitoring of blood glucose and adjustment of drugs, including insulin, small frequent meals and adequate fluids, it said. The ICMR said one should make sure to take all medications prescribed regularly as before, even if mildly symptomatic.

"Don't stop any medication unless advised by your doctor. Continue with your blood pressure, diabetes and heart disease medications in case you are unable to visit your doctor. Medications to control cholesterol (statins) should be continued," it stated.

It is also important to control risk factor levels, the ICMR said, adding avoid smoking and alcohol, have BP and blood sugar levels under control and have some form of regular physical activity keeping in mind social distancing norms.

Follow the diet and salt restriction as advised. If a person is non-vegetarian, she can continue to be so, it said. Increasing fibre and protein content of the diet and including more vegetables and fruits is advisable, the ICMR said.

It advised people to wear a medical mask in crowded areas and in poorly ventilated rooms, making it a routine part of being around other people. The mask should cover nose, mouth and chin, the ICMR said, and advised against touching the mask frequently and maintaining a physical distance of at least one metre even while wearing it.

"Wear a mask if a visitor comes to your home who is not a member of your household. Clean your hands before and after using a mask, and before touching it while still in use.  Change the mask if it is soiled or wet, and dispose it properly in a trash bin," the document said.

It also advised people to follow social distancing, avoiding contact with anyone who shows symptoms of COVID-19 -- anyone having a cold or cough or fever-- avoiding non-essential travel and use of public transport, avoiding public places, crowds and large family get togethers.

"Keep in touch with friends and relatives using phone, Internet, and social media. Avoid routine visits to hospitals/labs," the ICMR said. It also said avoid handshakes and touching face with hands. It said hands should be washed with soap and water frequently for at least 20-30 seconds and all parts of the hand must be systematically cleaned.

Avoid touching possibly contaminated areas and objects like public toilet doors, door handles etc , the ICMR said.  On getting symptoms suggestive of COVID-19, it said one should call a doctor and seek advice on the phone, contact nearby laboratories and arrange for testing. While awaiting test results, one should stay at home and avoid close contact with family members, maintain hand hygiene, and correctly wear a medical mask.

If one tests positive for COVID-19, they should isolate themselves at home as per the guidelines issued by Ministry of Health. If there is a worsening of symptoms, a doctor should be contacted for further advice, the ICMR added.

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