Clinical Treatment Options COVID

 Part IV

Clinical

Treatment options 2019-2020

Taken from an earlier excerpt

1: Treatment is mainly supportive including ICU support such as ventilatory support for those with respiratory or multi organ failure. Aerosol generating procedures such nebulisation and others should be best avoided if possible. Determine alternate factors involving general bodily deterioration is a critical factor, ruling out all other possible causes of death.

2: Who needs Admission

Patients who have hypoxia or respiratory distress, or severe systemic / constitutional symptoms or organ failure or those with significant comorbidities or pregnancy or immunocompromised patients etc should be kept in close medical observation which includes ICU. Refer to previous guidelines regarding what to constitute as an emergency.

3: HCQ & Azithromycin:

interstitial pneumonitis, lobar Pneumonia &/ARDS are common lung parenchyma issues due to virus itself & also due to the immune fight against the virus.

HCQ & Azithromycin are immunodulator which help reduce this damage and this is one of the reasons they have shown some promising results in preliminary studies and are also used in some parts of the world.

4: Anti viral antibodies present in the set of those who have recovered from the infection may also help neutralising infection and can be an option for those who have severe infection.

5: Viral genome has some resemblance to HIV RNA, hence anti HIV drugs such as Ritonavir etc are also under trial with variable results.

6: Cardiac markets and cardiac monitoring are important for inpatients as Myocarditis is another complications causing death.

7: CPR or mechanical ventilation or any aerosol generating procedure should only be done after putting on level 3 PPEs.

Early discussion about resuscitation plan can save CPR as often severe COVID disease may not be suitable for CPR etc.