11A: Covid Flashcards
What are CoVs?
Corona viruses - large family of single-stranded RNA viruses
What are other examples of CoVs?
MERS and SARS
Describe the appearance of CoVs
Crown-like due to spikey glycoproteins on the outside
What % of the population are healthy carriers of CoV?
2%
What % of all acute respiratory infections are caused by CoVs?
5-10%
When will upper and lower respiratory tract infections likely form with CoVs?
Upper - immunocompetent people
Lower - immunocompromised people
Describe how the COVID-19 virus invades?
- Glycoproteins on the outside of the virus attach to ACE 2 receptor
- ACE 2 brings into pneumocyte cells
What three things does the COVID-19 virus trigger?
- Synthesis and release of more virus into the blood
- Inflammatory response
- Immune system increase of WBC, prostaglandins, leukotrienes
What systems are impacted by COVID-19?
- Pulmonary
Also: GI, MSK, neuro, integumentary
What is the pulmonary impact of COVID-19?
Causes fluid to build up between the alveoli and capillary - interstitial space
Why is the build up of fluid problematic?
Interferes with gas exchange
What can happen as the disease progresses and leads to ARDS?
Inflammation inside of alveoli - fluid becomes pulmonary edema
What are the general initial symptoms of COVID-19?
Fever, malaise, dry cough, headache, dyspnea, GI issues, taste/smell
What vital changes will happen with initial development of COVID-19?
Increased RR, HR, and BP
What will show up on a CT with initial COVID-19?
- Inflammatory infiltrations
- Patchy or segmental GGOs
- Multiple lobes in bilateral lungs
What are GGOs?
Ground glass opacities
How will COVID-19 and pneumonia appear different on imaging?
COVID = bilatreal
Pneumonia = unilateral
Describe mild COVID-19
No/mild respiratory impairment - can be moderate but does not require hospitalization
Describe severe COVID-19
- Dyspnea
- Hypoxia
- > 50% lung involvement with 24-48 hrs
- RR > 30
- SpO2 < 93
- PaO2/FiO2 < 300
Describe critical COVID-19
- Respiratory failure
- Shock
- Multiorgan dysfunction/failure
What are 5 characteristics of cytokine storm?
- Immune cells rapidly multiple and invade lungs and heart
- Blood leaks into interstitial space
- Blood begins to clot
- Decreased BP
- Organs fail due to lack of O2
What neuro issues are associated with COVID-19?
- Confusion, delirium
- Viral encephalopathy
- Stroke from increased BP
What complication can cytokine storm lead to?
Platelet aggregation and thrombosis - DVT and clotting issues
Why is skin integrity an issue with COVID-19?
Bedrest
What are the three types of isolation precautions?
- Contact
- Droplet
- Airborne
What are contact precautions for?
Infections, diseases, or germs that spread by touching the patient or items in the room
What are example of diseases that require contact precautions?
MRSA, VRE, diarrheal illness, open wounds, RSV
What PPE is indicated for contact precautions?
- Gloves
- Possibly gowns
What are droplet precautions for?
Disease or germs spread in tiny droplets caused by coughing or sneezing?
What are examples of diseases that require droplet precautions?
Pneumonia, influenza, whooping cough, bacterial meningitis
What PPE is indicated for droplet precautions?
- Gloves
- Gown
- Surgical mask
- Maybe glass if splash risk to eyes
What are airborne precautions for?
Diseases or very small germs that are spread through the air from one person to another
What diseases would require airborne precautions?
TB, measles, chickenpox
What PPE is indicated for airborne precautions?
- Gloves
- Gown
- N95 or higher level respirator
- Face shield
What type of precautions are indicated for COVID-19?
Airborne - but it spreads by droplet
How long does COVID-19 stay in the air and under what conditions?
1-3 hours in close spaces - viral count decreases in concentration
Where should you don and doff PPE?
Outside if possible, at least 6-10 ft from pt
What are key points for donning PPE?
- All skin at wrists is covered
- N95 mask seal is intact
- Gown tied tight
What are key points for doffing PPE?
- Take gown off from shoulders first
- Gloves inside out
- Hand hygiene
- Store mask corectly
When is the greatest risk of spread of disease?
During doffing process
How should you clean eyewear?
- Clean inside of lens
- Clean outside of lens
- Clean frames
- Let disinfectant dry
- Run water over lenses
