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Learning Objectives
Learning Objectives
1. Introduction & History
2. Relevant Anatomy, Physiology
3. Aetiology
4. Pathophysiology
5. Pathology
6. Classification
7. Clinical Features
8. Investigations
9. Management
10. Prevention
11. Guidelines
12. Take home messages
Introduction & History.
•
Introduction & History.
• Coronavirus disease 2019 (COVID-19) is
defined as illness caused by a novel
coronavirus now called severe acute
respiratory syndrome coronavirus 2 (SARS-
CoV-2; formerly called 2019-nCoV),
• First identified amid an outbreak of
respiratory illness cases in Wuhan City,
Hubei Province, China.
Introduction & History.
• It was initially reported to the WHO on
December 31, 2019. On January 30, 2020,
the WHO declared the COVID-19 outbreak
a global health emergency. [2, 3] On March
11, 2020, the WHO declared COVID-19 a
global pandemic,
Aetiology
Aetiology
• Idiopathic
• Congenital/ Genetic
• Nutritional Deficiency/excess
• Traumatic
• Infections /Infestation
• Autoimmune
• Neoplastic (Benign/Malignant)
• Degenerative / lifestyle
• Iatrogenic
• Psychosomatic
• Poisoning/ Toxins/ Drug induced
Aetiology
• Idiopathic
• Congenital/Genetic
• Traumatic
• Infections /Infestation
• Autoimmune
• Neoplastic (Benign/Malignant)
• Degenerative
• Iatrogenic
Aetiology
• Severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2; formerly
called 2019-nCoV).
Aetiology of Aetiology
•
Aetiology of Aetiology
• Idiopathic
• Congenital/ Genetic
• Nutritional Deficiency/excess
• Traumatic
• Infections /Infestation
• Autoimmune
• Neoplastic (Benign/Malignant)
• Degenerative / lifestyle
• Iatrogenic
• Psychosomatic
• Poisoning/ Toxins/ Drug induced
Classification
Classification
• Asymptomatic
• Mild 81%
• Severe 14%
• Critical 5%
– ARDS
• Fatal 2.3%
Clinical Features
•
Clinical Features
• Demography
• Symptoms
• Signs
• Prognosis
• Complications
Demography
Demography
• Incidence & Prevalence
• Geographical distribution.
• Race
• Age
• Sex
• Socioeconomic status
• Temporal behaviour
Demography
• Incidence & Prevalence-
Demography
• Geographical distribution.
Demography
• Race.
Demography
• Age
Demography
• Sex
Demography
• Socioeconomic status
Demography
• Temporal behaviour
Symptoms
Symptoms
• Presentations of COVID-19 have ranged
from asymptomatic/mild symptoms to
severe illness and mortality.
• Mean incubation period to be 5.1 days 2
days to 2 weeks.
Symptoms
Common
• Fever
• Cough
• Myalgia
• Fatigue
Less-common
• Headache
• Sputum production
• Diarrhea
• Malaise
• Shortness of
breath/dyspnea
• Respiratory distress
Symptoms
• The most common serious manifestation of
COVID-19 appears to be pneumonia.
• A complete or partial loss of the sense of
smell (anosmia) has been reported as a
potential history finding . Its clinical
importance is questionable
Signs
Signs
• General Examination
• Systemic Examination
• Local Examination
Signs
• General Examination
Signs
• Systemic Examination
Signs
• Local Examination
Prognosis
Prognosis
• Morbidity
• Mortality rate
• 5 year survival in Malignancy
Investigations
Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies
• Tissue diagnosis
– Cytology
• FNAC
– Histology
– Germ line Testing and Molecular Analysis
• Diagnostic Laparotomy.
Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies
• Tissue diagnosis
– Cytology
• FNAC
– Histology
Investigations in Malignancy
•
Investigations in Malignancy
• For diagnosis
• For staging
• For Screening
• For Monitoring
Diagnostic Studies
Diagnostic Studies
Imaging Studies
• X-Ray
• USG
• CT
• Angiography
• MRI
• Endoscopy
• Nuclear scan
Management
Management
• Early Oxygen support
• No Steroids
• Conservative fuid management.
• Monitoring
• Co- Morbidities.
• Early communication
• Early mechanical ventilation
• No Lopinavir
• Hydroxychloroquine
• Azithromycin
• Tocilizumab
• Empiric Antibiotics
Mechanical Ventilation
• Low tidal volume 4-8ml/Kg
• Low plateau pressure <30cm of water
• High PEEP
• Permissive hypercapnoea
• Deep sedation
• Prone
• Target Spo2 90%
Prevention
Prevention
• Screening
• Risk reduction
Mythbusters
Myths Facts
Guidelines
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