Categories based on symptomatology

Category A

Mild sore throat / cough / rhinitis /diarrhea

Category B

Fever and/or severe sore throat / cough /diarrhea

OR

Category-A with any one of
• Lung/ heart / liver/ kidney / neurological disease/ Hypertension / haematological disorders/ uncontrolled diabetes/ cancer /HIVAIDS/ Cardiovascular disease
• On long term steroids /immunosuppressive drugs. • Pregnant lady
• Age –more than 60 years.

Category C

• Breathlessness, chest pain, drowsiness, fall in blood pressure, haemoptysis, cyanosis [red flag signs]
• Children with ILI (influenza like illness) with red flag signs (Somnolence, high/persistent fever, inability to feed well, convulsions, dyspnoea /respiratory distress, etc).
• Worsening of underlying chronic conditions.
*Categorization should be reassessed every 24-48 hours for Category A & B

Clinical Severity Stages

Clinical Severity : Mild

Corresponding Category according to state guidelines : A,B

No breathlessness or Hypoxia

Clinical Severity : Moderate

Corresponding Category according to state guidelines : C

Adult: dyspnea and/ or hypoxia, fever, cough, SpO2≤94% (range 90-94%) on room air, Respiratory Rate ≥24 per minute. Child : dyspnea and or hypoxia, fever, cough, including SpO2 ≤94% (range 90-94%) on room air, Respiratory Rate ≥ 24 per minute. Fast breathing (in breaths/min): < 2 months: ≥ 60; 2–11 months: ≥ 50; 1–5 years: ≥ 40

Clinical Severity : Severe

Corresponding Category according to state guidelines : C

Adult: Pneumonia plus one of
‣ respiratory rate ≥30 breaths/min
‣ severe respiratory distress
‣ SpO2 ≤90% on room air.
Child : cough/dyspnoea, plus one of
‣ central cyanosis or SpO2 ≤90%;
‣ severe respiratory distress (e.g. grunting, chest indrawing);
‣ signs of pneumonia with danger signs: (inability to breastfeed or drink, lethargy. unconsciousness, or convulsions).
‣ Other signs of pneumonia like chest in drawing, fast breathing (in breaths/min): <2 months ≥60; 2–11 months ≥50; 1–5 years ≥40.

Severity categories for treatment purpose

Clinical Severity : Mild

Respiratory Rate < 24/min, SpO2 > 94 on room air

Clinical Severity : Moderate

Respiratory rate between 24-29, SpO2 between 91-94 on room air

Clinical Severity : Severe

Respiratory Rate ≥ 30, SpO2 < 90