COVID-19

Question 1

What is COVID-19?

Answer 1

Potentially severe acute resp infection caused by novel coronavirus severe acute repository syndrome coronavirus 2 (SARS-CoV-2)

Question 2

How many people does COVID-19 affect?

Answer 2

402 million cases globally and 5.7 million deaths

Question 3

What are symptoms and signs of Covid-19?

Answer 3

1. Fever
2. Cough
3. Dyspnoea
4. Altered sense of smell/taste
5. Headache
6. Sore throat

Question 4

What are possible DDx for COVID-19?

Answer 4

1. Community acquired pneumonia
2. Infelunza infection
3. Common cold
4. Aspiration pneumonia
5. MERS
   Etc

Question 5

What investigations are used for COVID-19?

Answer 5

1. RT-PCR
2. Pulse ox
3. ABG
4. Cardiac biomarkers
5. Blood and sputum cultures

Question 6

What bloods are taken in COVID-19?

Answer 6

1. FBC
2. Metabolic panel
3. Caogulation screen

Question 7

What serum levels do you measure in COVID-19?

Answer 7

1. Lactate dehydrogenase
2. CRP
3. ESR
4. IL level
5. Procalcitonin
6. Ferritin
7. Amyloid A level
8. Creatine kinase and myglobin

Question 8

What are these serum levels like in covid?

Answer 8

all may be elevated

Question 9

What is CXR like in Covid?

Answer 9

ground glass opacity and consolidation

Question 10

What are blood and sputum cultures like in COVID-19?

Answer 10

negative for bacteria

Question 11

What are cardiac biomarkers like in COVID?

Answer 11

may be elevated

Question 12

What does coagulation screen show in COVID?

Answer 12

1. elevated D dimer
2. prolonged PT
3. elevated fibrinogen
4. prolonged INR

Question 13

What does metabolic panel show in COVID-19?

Answer 13

• elevated liver enzymes
• elevated total bilirubin level
• renal impairment
• hypoalbuminaemia
• electrolytes derangement

Question 14

What does FBC show in COVID-19?

Answer 14

1. lymphopenia
2. leukocytosis
3. leukopenia
4. thrombocytopenia
5. decreased eosinophils
6. decreased haemoglobin

Question 15

What is management of mild/moderate COVID-19?

Answer 15

-Home isolation
-Antipyretic/analgesia
Consider:
1. Monoclonal antibody
2. Antiviral

Question 16

What is the management of severe COVID-19?

Answer 16

• Hospital admission
• Oxygen therapy
• VT prophylaxis

Question 17

What can you consider in severe COVID-19?

Answer 17

1. Antibiotics
2. Corticosteroid
3. Antiviral
4. IL-6 inhibitor
5. JAK inhibitor
6. Monoclonical antibody

Question 18

What are possible complications of covid-19?

Answer 18

1. Thrombosis
2. Cardiovascular complication
3. AKI
4. Long covid
5. Cardiac arrest
6. Neurological complications
   Etc.

Question 19

What is the leading cause of death in COVID-19?

Answer 19

1. Leading cause of death is resp failure from ARDS

2. Mortality from ARDS in COVID-19 is 39%

Question 20

What is COVID-19 patho?

Answer 20

RNA virus, multiple variants

SARS-CoV-2 attaches to ACE2 receptor on target host cells

Question 21

Where is ACE2 expressed?

Answer 21

highly expressed in:

1. upper and lower respiratory tract
2. myocardial, renal epithelial, enterocytes and endothelial cells of multiple organs

Question 22

What does RT-PCR show for COVID-19?

Answer 22

positive for SARS-CoV-2 viral DNA

Question 23

How do you treat mild/moderate Covid-19?

Answer 23

Bed rest, paracetamol, ibuprofen, maintain hydration, monitor O2 sats

Question 24

How do you treat severe COVID-19?

Answer 24

Hospital admission, oxygen therapy, VTE prophylaxis, dexamethasone, remdesivir, IL-6 inhibitor eg. tocilzumab OR Janus kinase (JAK) inhibitor eg. barictinib
2. consider ICU admission for ventilation, ECMO etc