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Biology
- Most likely source of virus infection originated from transition from Pangolins to Humans and subsequent spread from human to human
- Infection can be spread by asymptomatic carriers
- Viral particles enter in lungs via droplet infection. Other modes of infection unclear​
Epidemiology:
- Typical incubation time 4-14 days (up to 24 days)​
- China notified WHO 31-12-2019
- WHO declared pandemic 11-03-2020
At risk:
- Congregations of people
- Areas of infections
Symptoms
- Cough (65-80%)
- Fever (45%)
- Shortness of breath (20-40%)​
- Upper respiratory tract symptoms (15%)​
- Gastrointestinal symptoms (10%)​
Monitor relevant Vitals
- Temperature
- Heart rate and BP
- Respiratory rate
Laboratory investigations​
- Decreased WCC and lymphopaenia
- Increase BUN/Cr
- LFTs: increase in AST/ALT/Tbil​
- Increase D-dimer​
- Increase CRP
- Increase LDH
- Decrease Procalcitonin (if secondary bacterial infection it will be elevated)​
- PCR COVID-19 test
Chest X-ray
- Hazy bilateral peripheral opacities on chest X-ray
- CT scan: ground glass opacities, consolidation
Treatment
Prevention
- Prevent infection with necessary precautions​
- Hand cleaning: 20+ seconds with soap and water or preferably alcohol based solution​
- Isolate/Quarantine​
Anti flu viral medication and anti retroviral medication being used. Treatment experimental presently. Guidelines to follow.​
- Remdesivir: anti RNA polymerase​
- Chloroquine: blocks virus entry into endosome​​
- Tocilizumab: block IL-6​​
Supportive treatment
- Avoid anti-inflammatory medication (NSAID)​​
- Respiratory failure management
- Adequate nutrition
- Prolonged bed rest: Deep Vein Thrombosis (DVT) exercise routine to prevent DVT and pulmonary embolism complications
Mortality associated with:
- Elderly​​​
- Immunocompromised individulas: examples include HIV/Oncology patients​
- Medical conditions: Diabetes, Chronic Obstructive Airways Disease
Laboratory predictors of poor outcome:
- Increase D dimer​​​
- Increase ferritin​
- Increase troponin​
- Increase cardiac myoglobin​
- Monitor secondary infection​
Use ASSIC Performance Fingerprint to upload and monitor your health parameters
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Precaution
- Glove protection
- N95 masks
- Hand hygiene:20 + seconds with soap and water or alcohol containing solution​
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