Covid HDU perspective Flashcards
What are the risk factors for Covid?
- Obesity
- Hypertension
- Type 2 diabetes mellitus
- Non-vaccinated
- Immunosuppressed- haematological malignancies and organ transplantation
What is the common presentation of Covid?
- Myalgia, headache, fever
- Dry cough
- Hypoxia
- Tachpnoea
- loss of smell and taste
- GI upset
- Infective contact
- Chest is often clear
What investigations should be carried out in covid cases?
•Bloods - lymphocytes, CRP, transaminitis
What are the treatments for covid?
- Antivirals - remdesivir
- Anti-inflammatories - dexamethasone, toxilizumab/sarilumab
- Supporting the immune response - romepreve
- Anticoagulation
What is Remdesivir?
- An inhibitor of RNA polymerase with in vitro inhibitory activity against SARS-CoV-1
- Benefits are unclear
What is the theory behind using steroids in covid treatment?
- Most viruses can not cause damage without the host immune system
- Dampening down the immune system may therefore help
What are tocilizumab and sarilumab?
•Monoclonal antibodies that inhibit interleukin 6 which is release in repose to infection and stimuates the inflammatory pathways as part of acute phase response
What is Baricitinib?
JAK inhibitor with anti-inflammatory properties
What is ronapreve?
Monoclonal antibodies that act by binding to the virus spike proteins, neutralising its ability to infect cells
Which patients is ronapreve useful for?
Those that have not mounted an antibody response
What is the supportive treatment of covid?
- Avoid dehydration and over hydration. (dehydration can lead to clots)
- Target saturations with fixed oxygen devices, prone positioning
- Anticoagulation (enoxaparin)
- CPAP
What is CPAP?
- Continuous positive airway pressure
- Reduced need for intubation but mortality is unchanged
- More complication s
What is the benefit of invasive ventilation?
- Meet oxygenation targets not met by other means
- Reduces O2 demand
- allows more time for recovery to occur
- Allows you to prone a patient very easily
What are the associated risks with invasive ventilation?
- Ventilator associated pneumonias
- Ventilator induced lung injury
- Prolonged recovery, wasting of muscles
- long term impacts: delirium, stress of being intubated and unconscious
What is ECMO?
- Extracorporeal membrane oxygenation
- Oxygenates the blood outside of the body
- Used when unable to safely oxygenate or ventilate a patient by other means
