Covid & Polio Flashcards
large family of viruses commonly found in humans and other species of animals (bats, camels, cattle, cats, white tailed deer, and hamsters)
coronaviruses
what is SARS-CoV-2
COVID-19
all coronaviruses likely originated in what animal
bats
MC transmission for covid
respiratory droplets
covid infection highest in what populations
young and middle aged adults
covid-19 mortality rates higher in what age group and why
> 50
lower levels of concomitant antibodies to benign cold-causing coronaviruses
predicts risk of critical illness in hospitalized COVID-19 patients.
uses x-ray abnormality, age, hemoptysis, dyspnea, unconsciousness, number of comorbidities, etc
COVID GRAM critical illness risk score
predicts the 24 hour risk of critical respiratory disease after hospital admission
uses respiratory rate, pulse ox, and oxygen flow rate
quick covid-19 severity index
what do you see on CBC for covid
lymphopenia, leukocytosis, thrombocytopenia
what do you see on LFT for covid
elevated AST and ALT
acute phase reactants (markers) for covid
CRP and D-Dimer
covid markers of increased mortality
increased serum troponin
IL-6
LFTs
serum Cr and CK
ferritin
procalcitonin
3 common tests used for diagnostic test of covid
- molecular (PCR)
- rapid antigen detection
- antibody (serologic) (IgG and IgM)
imaging for covid
- chest x ray
- chest CT
- Lung ultrasound
covid psychiatric complications
- anxiety
- depression
- substance use disorder
- PTSD
an individual <21 presents with fever, lab evidence of inflammation, and evidence of clinically severe illness requiring hospitalization, with multi system (>2) organ involvement
AND
no alternative plausible diagnoses
AND
positive for recent SARS-CoV-2 infection or exposure within 4 weeks prior to onset of symptoms
multisystem inflammatory syndrome
MIS-C (children)
individuals who have any of the various signs and symptoms of COVID-19 and do not need supplemental oxygen who have an oxygen saturation >94% on room air
mild to moderate illness
individuals who have SpO2 <94% on room air or needing supplemental oxygen
severe illness
individuals who have respiratory failure subcategorized as:
- needing high-flow oxygen or non-invasive ventilation
- needing mechanical ventilation and extracorporeal membrane oxygenation (ECMO)
critical illness
risk factors for severe covid-19 that needs hospitalization
- age >50 years
-unvaccinated or not up to date on covid vaccine - specific/multiple medical conditions
- immunocompromised
when should covid treatment be started
asap and within 5-7 days of symptom onset
covid treatment
Paxlovid (adults and children 12 and older and at least 40kg)
remdesivir (adults and children 28 days and older and at least 3kg)
molnupiravir (adults)
nirmatrelvir/ritonavir
paxlovid (viral protease inhibitor)
regulations for paxlovid
- mild to moderate covid-19
-12 or older
-at least 40 kg - high risk for progression to severe covid-19
approved by the FDA for the treatment of covid patients requiring hospitalization and supplemental oxygen (but not mechanical ventilation)
remdesivir (veklury)
RNA polymerase inhibitors
treatment of patients with severe disease (those who require supplemental oxygen and those who are mechanically ventilated or need ECMO)
dexamethasone
- an enterovirus that is highly contagious through the fecal oral route, especially during the first week of infection
- most often in children < 15 (esp infants and young children)
- still occurs in Afghanistan, Pakistan, syria, Africa
polio
signs and symptoms of polio
at least 95% are asymptomatic
if symptomatic:
- abortive poliomyelitis
- non paralytic poliomyelitis
- paralytic poliomyelitis
constellation of symptoms that affect polio survivors and is not infectious
post- poliomyelitis syndrome
- nonspecific symptoms
- fever, headache, vomiting, diarrhea, constipation, and sore throat lasting 2-3
abortive poliomyelitis
- fever, headache, vomiting, diarrhea, constipation, and sore throat lasting 2-3
AND - signs of meningeal irritation and muscle spasm occur in the absence of frank paralysis
non paralytic poliomyelitis
- flaccid asymmetric paralysis affecting mostly the proximal muscles of the lower extremities
- febrile period is present over 2-3 days
- sensory loss is very rare
- two forms (which may coexist): spinal poliomyelitis and bulbar poliomyelitis
paralytic poliomyelitis
- the syndrome presents with signs of chronic and new denervation
- most frequent symptoms are progressive muscle limb paresis with muscle atrophy, with fasciculations and fibrillation during rest activity
- restless leg syndrome
post poliomyelitis syndrome
how to test for polio
- throat washings (early)
- stools (early and late
- PCR of washings, stool, or CSF and also facilitate diagnosis
polio CSF findings
- normal or slightly increased pressure and protein
- glucose not decreased
- WBC count usually <500/mcL and are principally lymphocytes after the first 24 hours
polio treatment
Acute phase:
- hospitalize
- respiratory weakness or paralysis –> ICU
- pocapavir (capsid inhibitor antiviral agent)
polio prevention
- part of routine childhood immunization
- IPV vaccine
what ages should children get the 4 IPV doses
2 months
4 months
6-18 months
4-6 years
what to do for someone who has never been vaccinated against polio
3 doses of IPV
- first dose any time
- second dose 1-2 months later
- third dose 6-12 months after second
