DR KK AGGARWAL throws light on the common queries that people have related to the coronavirus pandemic
During the recent times there are is lot of confusion and questions in people’s mind related to coronavirus. Here are the answers to few of them.
Difference between cleaning and disinfecting.
These guidelines are focused on household settings and are meant for the general public.
Cleaning refers to the removal of germs, dirt, and impurities from surfaces. It does not kill germs, but by removing them, it lowers their numbers and the risk of spreading infection.
Disinfecting refers to using chemicals, for example, EPA-registered disinfectants, to kill germs on surfaces. This process does not necessarily clean dirty surfaces or remove germs, but by killing germs on a surface after cleaning, it can further lower the risk of spreading infection.
Can the virus go up to eight metres?
Many people believe the novel coronavirus can be transmitted only short distances in respiratory droplets from a sneeze or cough. But a National Academy of Sciences letter and papers published in The New England Journal of Medicine and JAMA suggest it’s possible that the novel coronavirus can hang in the air for hours and remain infectious. This means people could spread the virus just by breathing normally, and the virus could even be propelled as far as eight metres by a sneeze. However, some skeptics remain unconvinced that the respiratory particles can transmit infection.
When hydroxy chloroquine and azithromycin combination should not be given?
Withhold the drugs in patients with baseline QT prolongation or with known congenital long QT syndrome; monitoring cardiac rhythm and QT interval and withdrawing hydroxychloroquine and azithromycin if QTc exceeds 500 msec; correcting hypokalemia to levels greater than 4 mEq/L and hypomagnesemia to more than 2 mg/dL; and avoiding other QTc-prolonging agents when possible.
Can one have unilateral pneumonia in COVID-19?
No.Asymmetrical lung involvement is common, but it is rare for only one lung to be affected.
What are two patterns of oxygen requirement?
First, those with mild-to-moderate hypoxia, who improve slowly over time. Second, those with rapidly escalating oxygen needs, who proceed quickly to intubation.
How do we know the status of asymptomatic infections?
A new study has begun recruiting at the National Institutes of Health in Bethesda, Maryland, to determine how many adults in the United States without a confirmed history of infection with SARS-CoV-2, have antibodies to the virus.
The presence of antibodies in the blood indicates a prior infection. In this “serosurvey,” researchers will collect and analyze blood samples from as many as 10,000 volunteers to provide critical data for epidemiological models. The results will help illuminate the extent to which the novel coronavirus has spread undetected in the United States and provide insights into which communities and populations are most affected.
What is blood purification device to treat COVID-19?
The US FDA issued an emergency use authorisation (EUA) for a blood purification system to treat patients 18 years of age or older with confirmed COVID-19 admitted to the intensive care unit (ICU) with confirmed or imminent respiratory failure.
The authorised product works by reducing the amount of cytokines and other inflammatory mediators, i.e. small active proteins in the bloodstream that control a cell’s immune response by filtering the blood and returning the filtered blood to the patient. The FDA added that the proteins that are removed are typically elevated during infections and can be associated with a cytokine storm that occurs in some COVID-19 patients. This leads to severe inflammation, rapidly progressive shock, respiratory failure, organ failure and death.
After lungs which is the main organ involved?
Kidney is one of the other major organs involved.
A Negative Ultrasound Is the Most Useful.
There are situations where lung ultrasound can be considered definitive.
For instance, if we see a patient with mild signs of the disease, just fever, and lung ultrasound shows nothing, lung ultrasound rules out pneumonia.
This patient may have COVID-19 of course, but they do not have pneumonia, and they can be treated at home, awaiting the result of the swab test. And this is useful because you can reduce the burden in the emergency department.
On the other hand, there are patients with acute respiratory failure in respiratory distress. If the lung ultrasound is normal, you can rule out Covid-19 and you need to use other diagnostic procedures to understand the problem.
What are lung ultrasound scores?
A score of 0 is given when the pleural line is continuous and regular, with the presence of A-lines, denoting that the lungs are unaffected.
An area is given a score of 3 when the scan shows dense and largely extended white lung tissue, with or without consolidations, indicating severe disease.
Intermediate cases: On the Butterfly algorithm, the suggestion is to look for B-lines, caused by fluid and cellular infiltration into the interstitium, and to weigh that against the need for supplementary oxygen.
The Italian team, in contrast, says a score of 1 is given when the pleural line is indented, with vertical areas of white visible below.
A score of 2 is given when the pleural line is broken, with small to large areas of consolidation and associated areas of white below.
Can covid cause GBS?
Physicians in China are reporting what they believe is the first case of COVID-19 initially presenting as acute Guillain-Barre syndrome (GBS). The patient was a 61-year-old woman returning home from Wuhan during the pandemic.
GBS is an autoimmune neuropathy, which could be triggered by various infections, corresponding author Sheng Chen, MD, PhD, Shanghai Jiao Tong University School of Medicine, China,
It may be an association and not a causal relationship.
The case study was published online April 1 in Lancet Neurology.
Can COVID 19 present as acute hepatitis?
A woman presented to the emergency department with high liver enzyme levels and dark urine. She developed fever on day two of care, and then tested positive for the new coronavirus, researchers at Northwell Health, in Hempstead, New York, report.
The authors say the case, published online in the American Journal of Gastroenterology, is the first documented instance of a patient with Covid-19 presenting with acute hepatitis as the primary symptom before developing respiratory symptoms.
The writer is President CMAAO, HCFI and Former National President IMA