COVID-19

Williams Lake

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Symptoms:

  • Fever in 88%
  • Fatigue in 38%
  • Dry cough in 67%
  • Myalgias in 14.9%
  • Dyspnea in 18.7%
  • Headache
  • Sore Throat
  • Rhinorrhea
  • Gastrointestinal Symptoms

Diagnostic Criteria:

  1. A patient with acute respiratory tract infection (sudden onset of at least one of the following: cough, fever, shortness of breath) AND with no other aetiology that fully explains the clinical presentation AND with a history of travel or residence in a country/area reporting local or community transmission* during the 14 days prior to symptom onset;
  2. OR A patient with any acute respiratory illness AND having been in close contact with a confirmed or probable COVID-19 case in the last 14 days prior to onset of symptoms;
  3. OR A patient with severe acute respiratory infection (fever and at least one sign/symptom of respiratory disease (e.g., cough, fever, shortness breath)) AND requiring hospital isation (SARI) AND with no other aetiology that fully explains the clinical presentation.

Laboratory Findings:

  • WCC
    • White blood cell count can vary. It does not provide accurate information about COVID-19.
    • Leukopenia, leukocytosis, and lymphopenia have been reported. 
    • Lymphopenia is more common, seen in more than 80% of patients
    • Mild thrombocytopenia is commonly seen. However thrombocytopenia is considered as a poor prognostic sign.
  • D-Dimer
    • Elevation can predict poor prognosis
  • PRO-Calcitonin
    • Initially normal, increased in ICU patients later
  • CRP
    • Seems to track with disease severity and prognosis
    • In patients suffering from with severe respiratory failure with a normal CRP level an alternative diagnosis should always be sought

Testing:

  • Oropharyngeal - (Aptima Swabs and MCS swabs)
  • Nasopharyngeal
  • If initial testing is negative but the suspicion for COVID-19 remains, the WHO recom mends re-sampling and testing from multiple respiratory tract sites

Imaging:

  • CXR
    • The findings on CXR are not specific, and in the initial phases of the disease the studies could be normal. The most common features include lobar/ multi-lobar / bilateral lung consolidation.
  • CT
    • Early stage (0-4 days after the onset of the symptoms), in which ground glass opacities (GGO) are frequent, with sub-pleural distribution and involving predominantly the lower lobes. Some patients in this stage could have a normal CT.
    • Progressive stage (5-8 days after the onset of the symptoms), the findings usually evolved to rapidly involvement of the two lungs or multi-lobe distribution with GGO, crazy-paving and consolidation of airspaces.
    • Peak stage (9-13 days after the onset of the symptoms), the consolidation becomes denser and it was present in almost all of the cases. Other finding was residual parenchymal bands.
    • Absorption stage (>14 days after the onset of the symptoms), no crazy paving pattern was observed, the GGO could remain.
  • Lung Ultrasound
    • The findings include: Irregular pleural lines, sub-pleural areas of consolidation, areas of White lung and thick B lines [67]. It is a tool that could be used at bed side avoiding the need for shifting infected patients to a Radiology suite.
    • Learn more.
  • PFT
    • All kinds of pulmonary function tests should be avoided among patients with a strong suspicion of upper or lower Respiratory tract infection.

Treatments:

  • ISOLATION
    1. Any person diagnosed with SARS CoV 2 infection by means of laboratory testing at a government recommended testing laboratory.
    2. Anyone who has symptoms of fever and respiratory illness, and has a history of close contact of a person who has either been diagnosed as COVID-19, or has a history of travel to a COVID affected region within the last 14 days.
    3. Any health care worker with symptoms of fever and respiratory illness who has been involved directly in treating COVID- 19 patients, or has close contact with persons involved in treating COVID- 19 patients during the last 14 days.
  • PPE

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