scholarly journals Do Not Huff, Puff, or Vape That Stuff: Interstitial Airspace Disease in a Teenager

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Amee A. Amin ◽  
Erica Haught ◽  
Youmna Mousattat
Keyword(s):  
Respiratory Distress ◽  
Social History ◽  
Clinical Symptoms ◽  
Supplemental Oxygen ◽  
Nasopharyngeal Swab ◽  
Reactive Protein ◽  
The Social ◽  
Chest X Ray ◽  
Hypoxic Respiratory Failure ◽  
D Dimer

A 17-year-old previously healthy male was admitted to the hospital for intractable and persistent vomiting, fever, cough, abdominal pain, and intermittent diarrhea and dehydration. He presented with severe chest pain and O2 desaturations up to 80% on room air. An infectious (including a nasopharyngeal swab), GI, and cardiac workup was completed and was negative except for elevated inflammatory markers with a C-reactive protein (CRP) level of 261 mg/L, erythrocyte sedimentation rate (ESR) of 53 mm/hr, and a D-dimer level of 0.93 mcg/ml. Chest X-ray showed diffuse multifocal infiltrates. The patient was treated with ceftriaxone and azithromycin initially for a suspected pneumonia. He was also started on 4L of nasal cannula O2 supplementation. Due to persistent hypoxic respiratory failure, worsening respiratory distress clinically, with tachypnea and retractions, and lab findings of elevated D-dimer, a chest CT was performed to rule out a pulmonary embolism (PE). Computed tomography (CT) findings were negative for PE but notable for diffuse airspace opacities, primarily within the lower lobes, with a ground-glass appearance concerning for ARDS. Upon further investigation of the social history, the patient admitted to vaping nicotine products for the past 4 years and tetrahydrocannabinol (THC) products within the last several months. He was immediately started on prednisone 30 mg BID for a diagnosis of e-cigarette or vaping product use-associated lung injury (EVALI) and started showing clinical improvement. The patient was able to be weaned off of supplemental oxygen to room air, and clinical symptoms of respiratory distress began to improve over the next 24 hours.

scholarly journals Laryngo-Tracheal Displacement and Respiratory Distress in an Infant with Congenital Thymic Hyperplasia

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Michael Wolff ◽  
Süha Demirakca ◽  
Anna Kristina Kilian ◽  
Horst Schroten ◽  
Tobias Tenenbaum
Keyword(s):  
Young Children ◽  
Respiratory Distress ◽  
Corticosteroid Therapy ◽  
Clinical Symptoms ◽  
Thymic Hyperplasia ◽  
Feeding Disorder ◽  
X Ray ◽  
Chest X Ray

Thymic hyperplasia is usually an asymptomatic condition observed in infancy. A five-week-old boy presented with respiratory distress and feeding disorder, in which chest X-ray and bronchoscopy revealed a strong laryngotracheal displacement. Sonography and MRI confirmed the diagnosis of a thymic hyperplasia. Corticosteroid therapy led to improvement of clinical symptoms. Thymic hyperplasia may lead to laryngo-tracheal displacement and respiratory distress in neonates and young children.

scholarly journals Clinical characteristics of Egyptian male patients with COVID‐19 acute respiratory distress syndrome

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249346
Author(s):  
Ahmed S. Doghish ◽  
Walid F. Elkhatib ◽  
Essam A. Hassan ◽  
Ahmed F. Elkhateeb ◽  
Eman E. Mahmoud ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Clinical Characteristics ◽  
Distress Syndrome ◽  
Monocyte Count ◽  
Reactive Protein ◽  
Link Type ◽  
Male Patients ◽  
D Dimer

Background Coronavirus disease 2019 (COVID-19) is a serious illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and in severe cases associated with acute respiratory distress syndrome (ARDS). Objective To describe the clinical characteristics of patients with ARDS-COVID-19. Materials and methods This study involved 197 male Egyptian participants, among them111 COVID-19 patients presented with ARDS, 60 COVID-19 patients presented with non-ARDS, and 26 Non-COVID-19 patients. We reported the analysis results of clinical and laboratory information, including blood routine tests, blood biochemistry parameters [aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine and C‐reactive protein (CRP)], thrombotic activity (D‐dimer) and serum ferritin and lactate dehydrogenase (LDH). Results The levels of hemoglobin, AST, creatinine, monocyte count, monocyte %, RBC count, TLC, and platelet count were not significantly different among the groups. The lymphopenia and increased CRP, ALT, D-dimer, ferritin, and LDH were observed in patients with ARDS-COVID-19. Conclusion COVID-19 patients with ARDS presented with lymphopenia, increased thrombotic activity, increased CRP, LDH, and ferritin levels. The results revealed that CRP, D-dimer, LDH levels, and lymphopenia have a significant association with the COVID-19 severity and can be used as biomarkers to predict the disease severity.

scholarly journals Evidence-based of conjunctival COVID-19 positivity: An Italian experience: Gemelli Against COVID Group

2020 ◽  
pp. 112067212097654
Author(s):  
Maria Cristina Savastano ◽  
Gloria Gambini ◽  
Alfonso Savastano ◽  
Benedetto Falsini ◽  
Umberto De Vico ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Chemistry ◽  
Nasopharyngeal Swab ◽  
Reactive Protein ◽  
Italian Experience ◽  
Impairment Score ◽  
Pulmonary Impairment ◽  
Respiratory Coronavirus ◽  
D Dimer

Background: The possible transmission of severe acute respiratory coronavirus 2 (SARS-CoV-2) by tears and conjunctiva is still debated. Methods: Main outcome was to investigate the agreement between nasopharyngeal swab (NPs) and conjunctival swabs (Cs) in patients with SARS-CoV-2 infection. We divided patients into four groups: (1) NPs and Cs both negative (C−NF−), (2) NPs positive and Cs negative (NFs+Cs−), (3) NPs negative and Cs positive (NFs−Cs+), and (4) NPs and Cs both positive (NFs−Cs+). The secondary outcomes were to correlate Cs results with systemic clinical parameters such as: oxygen saturation (SpO2), dyspnea degree (DP), radiologic pulmonary impairment based on chest radiography (XR) or computed tomography (CT), blood chemistry as D-Dimer (D-Dimer), fibrinogen, ferritin, lactate dehydrogenase (LDH), and C-reactive protein (C-RP). Results: A total of 100 conjunctival swabs in 50 patients with SARS-CoV-2 have been enrolled in this interventional clinical trials. Ocular signs (conjunctivitis) were present in five patients (10%). NPs and Cs highlighted a poor level of agreement (0.025; p = 0.404). Median SpO2 levels are the highest in the NF−C− group (98%) and the lowest (90%) in the group NF+C+ ( p = 0.001). Pulmonary impairment was statistically significantly different between NFs and Cs groups ( p = 0.019). Pulmonary impairment score increased from NFs−Cs− group (3.8 ± 3.9), to NFs+Cs+ group (6.7 ± 4.1). Intensive care unit patients showed higher COVID-19 Cs positivity in conjunctiva (12.5%) against hospitalized ones (5.8%). Conclusions: In patients hospitalized for SARS-CoV-2 the virus can be detected in conjunctival swab. Intensive care unit patients may reveal a higher COVID-19 presence in the conjunctiva. The most severe pulmonary impairment can be observed in NFs and Cs positivity. Trial registration: Clinicaltrials.gov registration. Ethical committee authorization: ID number: 0013008/20

scholarly journals What is the clinical course of patients hospitalised for COVID-19 treatment Ireland: a retrospective cohort study in Dublin’s North Inner City (the ‘Mater 100’)

2020 ◽  
Vol 3 ◽  
pp. 80
Author(s):  
Brendan O’Kelly ◽  
Colm Cronin ◽  
Stephen Peter Connolly ◽  
Walter Cullen ◽  
Gordana Avramovic ◽  
...  
Keyword(s):  
Intensive Care ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Supplemental Oxygen ◽  
University Hospital ◽  
Initial Assessment ◽  
Hospital Treatment ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
D Dimer

Background: Ireland has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While several cohorts from China have been described, there is little data describing the epidemiological and clinical characteristics of Irish patients with COVID-19. To improve our understanding of this infection we performed a retrospective review of patient data to examine the clinical characteristics of patients admitted for COVID-19 hospital treatment. Methods: Demographic, clinical and laboratory data on the first 100 patients admitted to Mater Misericordiae University Hospital for in-patient COVID-19 treatment after onset of the outbreak in March 2020 was extracted from patient records. Results: The median age was 45 years (interquartile range [IQR] =34-64 years), 58% were male, and 63% were Irish nationals. Patients had symptoms for a median of five days before diagnosis (IQR=2.5-7 days), most commonly cough (72%), fever (65%), dyspnoea (37%), fatigue (28%), myalgia (27%) and headache (24%). Of all cases, 54 had at least one pre-existing chronic illness (most commonly hypertension, diabetes mellitus or asthma). At initial assessment, the most common abnormal findings were: C-reactive protein >7.0mg/L (74%), ferritin >247μg/L (women) or >275μg/L (men) (62%), D-dimer >0.5μg/dL (62%), chest imaging (59%), NEWS Score (modified) of ≥3 (55%) and heart rate >90/min (51%). Supplemental oxygen was required by 27 patients, of which 17 were admitted to the intensive care unit - 14 requiring ventilation. Antiviral therapy was administered to 40 patients (most commonly hydroxychloroquine or lopinavir/ritonavir). Four died, 17 were admitted to intensive care, and 74 were discharged home, with nine days the median hospital stay (IQR=6-11). Conclusion: Our findings reinforce the consensus of COVID-19 as an acute life-threatening disease and highlights the importance of laboratory (ferritin, C-reactive protein, D-dimer) and radiological parameters, in addition to clinical parameters. Further cohort studies followed longitudinally are a priority.

scholarly journals Evaluation of demographic, clinical and paraclinical features of children with Guillain-Barré syndrome

2020 ◽  
Vol 5 (2) ◽  
pp. e23-e23
Author(s):  
Ahad Ghazavi ◽  
Ezatolah Abbasi ◽  
Sahar Mohammadi
Keyword(s):  
Respiratory Distress ◽  
Clinical Symptoms ◽  
Cross Sectional Study ◽  
Guillain Barre Syndrome ◽  
Severe Respiratory Distress ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Guillain Barré Syndrome ◽  
Urban Rural ◽  
Guillain Barré

Introduction: Guillain-Barré syndrome (GBS) is an acute polyneuropathy accompanied by muscle weakness, myalgia, and bulbar involvement. Objectives: We evaluated demographic, clinical and paraclinical features of children with this disease. Patients and Methods: In this cross-sectional study, the data of 83 patients with GBS were studied. All data about age, gender, place of residence (urban, rural), season of infection, history of infection or vaccination in the last month, clinical demonstrations and spinal magnetic resonance imaging findings with contrast, electromyography (EMG), nerve conduction velocity (NCV), cerebrospinal fluid (CSF), C-reactive protein (CRP) analysis was analyzed. Results: In this study, the highest incidence of GBS was in the summer (30.12%). Regarding clinical symptoms, 54.21% of patients were unable to walk, and around14.45 % of cases had positive Gowers’ sign. Additionally, 27.71% of patients reported pain, since 7.22% of them had severe respiratory distress with the need for mechanical ventilation. In patients who underwent EMG-NCV, findings were in favor of GBS in most cases (89.83%). In lumbar puncture, 53% of patients had normal CSF. Most patients (75.9%) had an erythrocyte sedimentation rate (ESR) below 30 mm/h. CRP of most patients (83.33%) was less than 10 mg/L. Conclusion: The predominant clinical symptoms of patients with GBS are the inability to walk, imbalance, positive Gowers’ sign, pain and respiratory distress, since ESR and CRP less than 30 and 10 mg/L are helpful, respectively.

scholarly journals STROKE IN COVID-19 PATIENTS: A SCOPING REVIEW

2021 ◽  
Vol 30 ◽  
Author(s):  
João Cruz Neto ◽  
Emanuel Messias Silva Feitosa ◽  
Brenda Silva Cunha ◽  
Maria Naiane Rolim Nascimento ◽  
Nuno Damácio de Carvalho Félix
Keyword(s):  
Scoping Review ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Diagnostic Procedures ◽  
C Reactive Protein ◽  
Neurological Damage ◽  
Medical Subject Headings ◽  
Reactive Protein ◽  
The Brain ◽  
D Dimer

ABSTRACT Objective: to map the scientific production on patients infected by COVID-19 and the occurrence of stroke. Method: a scoping review, according to the framework proposed by the Joanna Briggs Institute, using the LILACS, MEDLINE, WoS, EMBASE, CINAHL and SCOPUS databases, from April to September 2020. The following keywords were used: coronavirus infections, stroke, nervous system diseases and inpatients, based on the Medical Subject Headings. Results: 24 studies that evidenced specific clinical symptoms of stroke such as dysarthria, facial paralysis, sensory deficit, headache, hemiparesis and ataxia in patients with COVID-19 were included. The association between stroke and COVID-19 was found by the following exams: C-reactive protein, D-dimer, computed tomography and, magnetic resonance, among others, as well as by care procedures focused on the findings in the exams, associated with three clinical outcomes, based on the brain ischemia zone affected and the time of viral manifestation of each patient. Conclusion: the specific clinical manifestations of patients who suffered a stroke after COVID-19 were mapped, as well as diagnostic procedures and therapies used, in addition to identifying neurological damage based on the clinical outcome of these patients.

scholarly journals Evaluation of Pregnant Patients with Suspected Pulmonary Embolism: A Descriptive Cross-Sectional Study

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Javad Fallahi ◽  
Behnam Dalfardi ◽  
Reza Jalili ◽  
Seyed Masoom Masoompour ◽  
Behrouz Momeni ◽  
...  
Keyword(s):  
Troponin I ◽  
Clinical Symptoms ◽  
Final Diagnosis ◽  
Pulmonary Perfusion ◽  
Common Symptom ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray ◽  
Perfusion Scan ◽  
D Dimer

Background: Pulmonary thromboembolism (PTE) is a leading cause of maternal mortality. However, diagnosis of PTE can be challenging during pregnancy, and there is no consensus regarding the best diagnostic approach. Objectives: The current study aimed to evaluate the applicability of clinical symptoms and diagnostic tests in ruling in or ruling out PTE during pregnancy. Methods: In this one-year, cross-sectional, descriptive study, we evaluated pregnant or postpartum (six weeks postpartum) women suspected of PTE, who were admitted to the internal medicine intensive care units (ICUs) of hospitals (Namazi and Shahid Faghihi hospitals), affiliated with Shiraz University, Shiraz, Iran, during August 2016-July 2017. The participants underwent electrocardiography (ECG), serum troponin-I and D-dimer measurements, chest X-ray, color-doppler sonography (CDS) of the lower extremity venous system, transthoracic echocardiography, pulmonary perfusion scan, or pulmonary computed tomography angiography (CTA). The participants’ clinical manifestations were also assessed. Results: A total of 103 women, with the mean age of 30.37 ± 5.35 years, were included in this study. Seventy-seven women underwent pulmonary CTA or pulmonary perfusion scan. PTE was documented in nine cases. Dyspnea was the most common symptom. The respiratory rate, cough, dizziness, and fever on admission had significant correlations with the final diagnosis of PTE (P = 0.01, 0.03, 0.007, and 0.04, respectively). The ECG study of one case with PTE showed right axis deviation, while the ECG findings of the other eight cases showed no specific pattern. The chest X-ray findings had no significant correlation with the final diagnosis of PTE. Overall, 38 women underwent CDS, one of whom presented with deep vein thrombosis. The serum D-dimer level was positive in three cases with documented PTE (normal in one patient with PTE), and the serum troponin-I level was positive in one case with the final diagnosis of PTE (normal level in two patients with PTE). Conclusions: Based on the findings, clinical symptoms and biochemical tests alone are not reliable for ruling in or ruling out PTE during pregnancy, and CTA and pulmonary ventilation/perfusion scan should be performed for these cases.

scholarly journals An emerging marker predicting the severity of COVID-19: Neutrophil-Lymphocyte Count Ratio

2020 ◽  
Author(s):  
Minping Zhang ◽  
Enhua Xiao ◽  
Jiayi Liu ◽  
Yeyu Cai ◽  
Qizhi Yu
Keyword(s):  
Neutrophil Count ◽  
Lymphocyte Count ◽  
Clinical Symptoms ◽  
Characteristic Curve ◽  
C Reactive Protein ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Count Ratio ◽  
Severe Group ◽  
D Dimer

Abstract Background: To analyze clinical features and laboratory indicators and identify the markers of exacerbation in COVID-19. Methods: We reviewed clinical histories of 177 patients with confirmed COVID-19. The patients were categorized into mild group (153 patients) and severe group (24 patients). The baseline demographic and laboratory indicators of all patients were collected, including the neutrophil-lymphocyte count ratio (NLCR) and C-reactive protein to albumin ratio (CAR). Receiver operating characteristic curve (ROC) analysis was performed to search for indicators predicting exacerbation in COVID-19 patients, and acquiring the area under the curves (AUCs), sensitivity, specificity and cut-off value. Results: The age of the severe group were significantly older than those of the mild group (P <0.01). Fever was the typical symptom in all COVID-19 patients. Cough and fatigue were manifested in mild group, yet severe patients were more prominent in dyspnea. The laboratory indicators showing that the mild group mainly had an elevated C-reactive protein; the severe group had a decreased lymphocyte count and lymphocyte ratio. WBC, neutrophil count, neutrophil ratio, D-dimer, AST, ALT, LDH, BUN, CRP levels increased. Furthermore, compared to mild group, WBC, neutrophil count, neutrophil ratio (Neut%), D-dimer, total bilirubin, albumin, AST, ALT, LDH, BUN, creatine kinase, CRP, CAR, NLCR were significantly higher, the lymphocyte count, lymphocyte ratio, and APTT were significantly lower in severe group (P<0.05). The ROC indicating that NLCR, Neut%, CAR, CRP, and LDH were better at distinguishing mild and severe patients. The AUCs of NLCR was larger than others (NLCR>Neut%>CAR>CRP>LDH: 0.939>0.925>0.908>0.895>0.873), which suggested that NLCR was the optimal maker; a cut-off value for NLCR of 6.15 had 87.5% sensitivity and 97.6% specificity for predicting exacerbation in COVID-19 patients. Conclusions: The different types of COVID-19 had significant differences in age, clinical symptoms and laboratory indicators, and severe patients might be easier to suffer from the multiple organ damage. An elevated NLCR may indicate that the disease was progressing towards exacerbation. It was essential to dynamically monitor the serum NLCR levels which contributed to evaluate the patient's condition and efficacy. NLCR could be used as a novel, highly specific and sensitive marker for predicting severity of COVID-19 patients.

scholarly journals Targeting the Endothelium in the Treatment of COVID-19 Early Clinical Stages: Results of a Randomized Placebo-Controlled Trial

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 667-667
Author(s):  
Alejandro Gonzalez-Ochoa
Keyword(s):  
Placebo Group ◽  
Hospital Care ◽  
Controlled Trial ◽  
Serum Levels ◽  
Supplemental Oxygen ◽  
Thromboembolic Events ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Clinical Stages ◽  
D Dimer

Abstract Background: SARS-CoV-2 can induce several vascular endothelial-dependent systemic complications and treatment targeting endothelial cells has been suggested. Sulodexide is a heparin and glycosaminoglycan compound that has pleiotropic properties within the vascular endothelium that can prove beneficial in COVID-19 patients. Aims: We aimed to evaluate the effect of sulodexide when used in the early clinical stages of COVID-19. Methods: In an outpatient setting, we conducted a randomized placebo-controlled trial. Key inclusion criteria were patients within three days of COVID-19 clinical onset and being deemed at high risk (&gt; 50%) of severe clinical disease progression. The risk was assessed using the COVID-19 Health Complication (C19HC) calculator, which clusters the importance of various chronic comorbidities into a percentage value. After inclusion, patients were randomly assigned to receive an oral dose of sulodexide (500 LRU twice a day) or a placebo for 21 days. We performed follow-ups to assess the study endpoints via remote communication with participants or household members every seven days or as deemed necessary. Participants continued the standard of care under the supervision of their healthcare provider's primary physician. The need for hospital care was the primary outcome. Also evaluated, were the need for supplemental oxygen support, D-dimer and C reactive protein (CRP) serum levels, thromboembolic events, and mortality. Physicians responsible to determine the need for hospital care or supplemental oxygen at home were blinded to group allocation. This trial was conducted throughout the regional lockdown caused by the first wave of COVID-19 which caused some unforeseen limitations during the trial. Differences in means were calculated using the Student's t-test, while differences in percentages were assessed using the χ 2 test. Before and after serum levels in the same patients were analyzed using two paired t-tests. If the data were not normally distributed, a Wilcoxon test was used. A Kaplan-Meier curve was used to graphically compare time-to-endpoint for hospital admission and mortality. Results: 312 patients were included in the intent to treat analysis. At 21 days follow-up, 23 of 155 patients required hospitalization in the sulodexide group compared to 38 of 157 in the placebo group [relative risk (RR), 0.6; 95% confidence interval (CI), 0.38-0.97; p=0.037]. The benefit persisted with a per-protocol analysis (RR 0.6, p=0.031). Fewer patients required oxygen support in the sulodexide group [39 of 155 vs. 56 of 157; RR, 0.61; 95% CI, 0.38 to 0.9; p=0.04], and for fewer days (9 ± 7.2 in the sulodexide group vs. 11.5 ± 9.6 in the placebo group; p=0.02). Mean D-dimer levels at week 2 were significantly higher in the placebo group than in the sulodexide group (p &lt; 0.01). 28 of the 155 patients (18%) in the sulodexide group showed a D-dimer value &gt; 500 ng/dl, compared to 59 out of 157 (37.5%) in the placebo group (RR of 0.48; 95% CI of 0.31 to 0.67; p &gt; 0.01). Mean C-reactive protein levels at week 2 were lower in the sulodexide group than in the placebo group (p &lt; 0.01). There was no between-group difference concerning, hospital length of stay, thromboembolic events, major bleeding, or mortality. Conclusions: Early intervention on COVID-19 patients with sulodexide resulted in a reduced need for supplemental oxygen and hospital care. The synergistic activity of sulodexide's antithrombotic and non-antithrombotic effects on different biological targets may play an essential role in limiting disease progression. Added a low risk of bleeding or significant side effects, sulodexide might be an alternative to other oral anticoagulants which makes it a valuable medication in the outpatient treatment of COVID-19. Disclosures Gonzalez-Ochoa: Alfasigma: Consultancy, Research Funding; servier: Consultancy.

scholarly journals COVID 19: A Strange Worldwide Pandemic

2021 ◽  
Vol 58 (2) ◽  
pp. 719-729
Author(s):  
Dr. Sneha Lodhi
Keyword(s):  
Best Practice ◽  
Virus Disease ◽  
Ground Glass Opacity ◽  
Supplemental Oxygen ◽  
Local Site ◽  
Time Period ◽  
Chest X Ray ◽  
Hypoxic Respiratory Failure ◽  
Respiratory Tract Illness ◽  
Body Ache

Corona virus disease (COVID -19)   is a severe acute respiratory syndrome which cause respiratory tract illness. The pandemic caused by virus originated in Wuhan. Later declared as a pandemic by WHO. It causes symptom like common cold, fever, body ache, cough and loss of taste sensation which are commonly seen in most of the patient. Older and one with comorbidity are at high risk to get infected. The average time period from exposure to symptoms is 5 days. Many asymptotic cases where reported which shows no symptoms but show viral load on RT-PCR. Patients are considered covid-19 positive based on clinical features & radiological findings. On chest x-ray  it shows ground-glass opacity. More than 75 percent of patients hospitalized require supplemental oxygen. Treatment for individual with COVID -19 include best practice for supportive management of acute hypoxic respiratory failure. Immediate hospitalization of positive patient if spo2 drops below 95 percent . Diagnosis is made by detection of SARS cov-2 via reverse transcription polymerase chain reaction testing, although false positive result may occur in up to 20 to 60 % patients. Suspected cases are quarantine for 14 days. Preventive measures include hand washing, social distancing etc. Recently COVISHEILD & COVAXIN is approved for emergency use. Reaction of vaccination include fever ,body ache, swelling at local site, pain, malaise, joint pains. 

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