The word covid-19 now refers to a “pandemic” that caused a “Universal Pandemonium” and opened a Pandora’s Box to the necessity of improving health care facilities worldwide.
It began in Wuhan, a city in Hubei province of china at the end of 2019. The virus is known as SARS-COV 2 (Severe Acute Respiratory Syndrome Corona Virus 2). The initial spread is suspected from bats to human beings. It can be Asymptomatic or Symptomatic it can be
(a) Mild (b) Moderate (c) Severe (d) Critical disease.
High Risk factors: Age 75, Diabetes, Hypertension, Chronic Kidney Disease, Chronic Liver Disease, Cancer, Obesity, Cardiovascular Disease, and Smoking.
Clinical Features:
Incubation Period: within 14 days following exposure.
The symptoms are Cold, Cough, Fever, Myalgia, Headache, Dyspnea, Sore Throat, Diarrhea, Nausea, Vomiting, Loss of Smell, Abdominal Pain, Rhinorrhea, Shortness of breath.
There is drop in oxygen saturation Happy Hypoxic. Patient’s oxygen level in blood is low but patient does not appear sick. However, patient will deteriorate if treatment is not sought.
Laboratory parameters associated with worst outcome
(1) D-dimer > 1000mg/ml.
(2) CRP > 100 mg/Lt
(3) LDH > 245u/Lt
(4) Troponin > 2 x upper limit of normal
(5) Ferritin > 500 mcg/Lt
(6) CPK > 2 x upper limit of normal
(7) Absolute Lymphocyte Count < 800/microLt
Complications:
- Acute respratory disters syndrome
- Cardiac Arrhythemias
- Shock
- Thrombo-embolic complications
- Cytokine storm
- Secondary infection
- Recovery time can vary from 3weeks to 6weeks with patients suffering from mild disease recovering early.
- Why to worry?
High mortality rate in patients with moderate to severe disease and in those on invasive mechanical ventilation and cytokine storm.
Treatment
(1) Antivirals: Ramdesivir / Fabipiravir
Other drugs: Oseltamivir, Azithromycin, Hydrochloroquine, Ivermectin, Doxycyclin, Lopinivir, Ritonavir
(2) Steroid
(3) Anticogulation: low molecular weight heparin
(4) Immuno modulates: Toulizumab, Itolizumab, Tocilizumab
(5) Convalescent Plasma
(6) vitamin C, Thaimin, Zinc, N-acetyl cystine
Quarantine is restriction of movement.
As it has high infectivity and rapid spread on critical home or hospital quarantine is necessary.
Mild cases without co-morbidities can be quarantined at home with tele counseling with medical team. Rest cases can be admitted to Covid care centers, Covid hospital.
Diagnosis:
- RT- PCR nasal and throat swab
- Rapid Covid Antigen
- HRCT scan chest: CORADS, CT SEVERITY SCORE.
- Detection of Covid Antibodies post infection.
Prevention:
(1) Social distancing
(2) N 95 mask
(3) Alcohol level hand sanitaiger
(4) Coughing and sneezing etiquettes
(5) Social awareness
(6) Various states have established state wise norms for travel which are listed on website
(6) Can also download Aarogya setu App.
(7) Details can be also be obtained from WHO site, Health & family welfare site.