Covid Flashcards
What is COVID-19
It is an infectious disease/virus that is primarily spread through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. The virus binds to the epithelial cells in the nasal cavity and begins to replicate. It then moves down the respiratory tract and along the conducting airways causing a more robust immune response
Aetiology of COVID-19
emerged towards the end of 2019 in Wuhan, China
For approximately 80% of people the virus is mild and restricted to the upper airways and the conducting airways.
Pathology of COVID-19
- 20% will progress to next stage and develop pulmonary infiltrates and sometimes a severe disease
- Predominately affects the gas exchange unit of the lung and alveolar type II cells which can cause alveolar damage.
- Predominately viral pneumonia associated with COVID-19 but approx 10% develop bacterial pneumonia
Stages of COVID-19
Early - 0-2 days, normal CT or early consolidation predominantly in the right lung
Intermediate - 5-10 days- Progressive consolidation
Late - more than 10 days- showing increased areas of consolidation with areas of collapse and potentially pulmonary fibrosis
Symptoms of Acute Respiratory Distress Syndrome (ARDS)
- Acute hypoxemia
- Breathlessness
- Increased WOB
- Diffuse lung inflammation effecting the lungs gas exchange surface and the alveolar- capillary network
- Often acute onset bilateral opacities
Management of COVID-19 with ARDS
- Mechanical Support
- Proning
- Thrombolytic management
- Nutritional support
- Renal Support
COVID-19 presentation
- Hypoxia
- Often pyrexia but not always
- Not always breathless despite hypoxia (silent hypoxia)
- Cough
- Delirium
- Vulnerable to rapid deterioration
- Tachycardia
- Fatigue
- Desaturation on exertion
COVID-19 Inpatient therapy
Respiratory care including oxygen therapy
Consider assisted breathing- CPAP
Proning, positioning
Anxiety management
Sitting out of bed for short periods as able
Bed/ chair exercises
Energy conservation (pacing, prioritising, planning)
Management of any MSK problems
Dietary support
Psychological support
