COVID

Question 1

What type of virus is a coronavirus

Answer 1

• enveloped positive stranded RNA virus

Question 2

What is the primary target of COVID-19

Answer 2

• epithelial cells in the respiratory and gastrointestinal tract

Question 3

How severe can COVID-19 be

Answer 3

• mild symptoms = 80% of the population
• pneumonia
• actue respiratory distress syndrome

Question 4

what receptor does COVID-19 bind to

Answer 4

ACE2 receptor which allows viral entry

Question 5

what is the definition of pneumonia

Answer 5

• symptoms and signs consistent with an acute lower erspiraotyr tract infection associated with new radiographic shadowing for which there is no other explanation

Question 6

What is acute respiratory distress syndrome

Answer 6

• acute onset - less than 1 week of respiratory failure, bilateral infiltrates on chest X ray (not fully accounted for by pleural effusions, collapse or nodules) and hypoxaemia
• severity classified according to degree of hypoxaemia (PaO2/FiO2 ratio)

Question 7

What is hypoxaemia

Answer 7

reduction in blood oxygen

Question 8

define mild COVID-19

Answer 8

• symptoms consistent with COVID-19 diagnosis
• cases may be defined as moderate
• less severe clinical symptoms (low grade fever, cough, discomfort) with no evidence of pneumonia and not requiring ICU admission

Question 9

Define Severe COVID-19

Answer 9

• oxygen saturation less than 90% on room air
• RR = greater than 30 breath/minute
• signs of severe respiratory distress = accessory muscle use, inability to complete full sentences

Question 10

What is critical COVID-19

Answer 10

• defined by criteria for ARDS, sepsis or other conditions that require ICU admission

Question 11

How does COVID-19 transmission occur

Answer 11

• Droplets of saliva or discharge from the nose when an infected person coughs, or sneezes
• droplets land on objects and surfaces around the person
• other people then catch COVID-19 by touching these objects or surfaces

Question 12

when do symptoms appear

Answer 12

2-14 days after exposure

Question 13

what increases your risk of symptom severity and death

Answer 13

• older people greater than 65 years old

- individuals with underlying health conditions such as increase in BP, diabetes, COPD, and immunocompromised

Question 14

What are the symptoms of COVID-19

Answer 14

• fever
• shortness of breath
• cough
• anosmia

Question 15

Describe the progress of the disease

Answer 15

5 days
- Asymptomatic incubation period

Mild disease - 7-14 days

• fever, fatigue, dry cough
• ground glass opacities
• pneumonia

Severe - 7-14 days

• dyspnea
• existing illness
• ICU needed

critical and deceased - 12-20 days

• ARDs
• acute cardiac injury
• multi-organ failure

Question 16

What has the histopathology shown in COVID-19

Answer 16

• dsyregulation of pneumocystis
• hyaline membrane formation
• bilateral diffuse alveolar damage
• pressure of cellular fibromyoid exudate

Question 17

What happens as PaO2 decreases

Answer 17

• as the PaO2 decreases this causes
• intrapulmonary shunting (oedema and atelectasis)
• loss of lung perfusion regulation
• intravascular micro thrombi
• reduced lung compliance increased dead space
• increased consolidation
• CO2 retention
• anxiety and fatigue

Question 18

What three things drives the decrease in PaO2 in COVID-19

Answer 18

• intrapulmonary shunting
• loss of lung perfusion regulation - circulatory system doesn’t reduce blood flow to areas of the alveoli that have significant disease and cannot take part in ventilation
• intravascular microthrombi - increased in coagulation

Question 19

What is the effect of lyymphopneia in COVID-19

Answer 19

• in COVID there is a decrease in T cells, NK cells, lymphopenia
• this causes an increase in microbial infection by other organisms

Question 20

What is the effect of elevated cytokine production on severe syndromes

Answer 20

• cytokine storm

- this causes a multi organ failure

Question 21

what management of patient with COVID-19

Answer 21

• oxygen
• dethamethasone
• antivirals