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COVID-19
Zoonotic virus thought to have come from bats, isolated and named SARS-CoV-2
Thought that the virus is transmitted through droplets of saliva or nasal discharge
from coughing and sneezing.
Through contact with contaminated surfaces
Clinical presentation:
Presents with mild-moderate symptoms of respiratory illness and flu-like symptoms
Gastrointestinal symptoms can be present (Nausea, diarrhoea)
Silent hypoxia (especially in older adults)
Atypical presentations common in immunocompromised patients
Can present as haematological malformations (DIC is a manifestation of severe
covid)
Can manifest as cardiac symptoms (palpitations and chest tightness), myocardial
injury can be seen (raised troponin)
80% of people with COVID-19 are asymptomatic or have mild disease
Severe cases can develop into pneumonia or Acute Respiratory Distress Syndrome
(9-10 days after symptom onset)
Symptoms tend to develop 5-11 days after first exposure, known as the incubation
period.
Median time of death is 18 days after symptoms
Recovery to discharge is 22 days.
Patients usually recover after 2 weeks.
Pathophysiology:
COVID-19 1
, Can cause inflammatory insult to alveoli, resulting in alveolar destruction
This leads to lung changes, resulting in Acute Respiratory Distress Syndrome
(ARDS) - hypoxemic respiratory failure
It can also cause a cytokine storm, Cardinal features include persistent fever,
cytopenias and hyperferritinemia.
ARDS and Shock are the two main causes of death.
Risk Factors:
Older age >60
Comorbidities i.e hypertension, cardiovascular disease, obesity, diabetes or
respiratory disease (cystic fibrosis, severe asthma)
Patients on cancer treatments
Patients on immunosuppresion therapy
Diagnosis:
Suspect coronavirus if following met:
New continuous cough
Temperature 37.8
Loss of, or change in, normal smell (anosmia) or taste (ageusia)
Investigation strategies:
U&E’s → Raised creatinine
Other biochemistry → Raised CRP, Ferritin, LDH,
troponin
FBC → Lymphocytopenia, Low platelets
Clotting → Raised prothrombin time (PT) or INR,
Raised D-dimers, Fibrinogen (DIC)
LFT → Raised Bilirubin, Raised AST/ALT
ABG → hypoxia, Raised lactate
COVID-19 2
COVID-19
Zoonotic virus thought to have come from bats, isolated and named SARS-CoV-2
Thought that the virus is transmitted through droplets of saliva or nasal discharge
from coughing and sneezing.
Through contact with contaminated surfaces
Clinical presentation:
Presents with mild-moderate symptoms of respiratory illness and flu-like symptoms
Gastrointestinal symptoms can be present (Nausea, diarrhoea)
Silent hypoxia (especially in older adults)
Atypical presentations common in immunocompromised patients
Can present as haematological malformations (DIC is a manifestation of severe
covid)
Can manifest as cardiac symptoms (palpitations and chest tightness), myocardial
injury can be seen (raised troponin)
80% of people with COVID-19 are asymptomatic or have mild disease
Severe cases can develop into pneumonia or Acute Respiratory Distress Syndrome
(9-10 days after symptom onset)
Symptoms tend to develop 5-11 days after first exposure, known as the incubation
period.
Median time of death is 18 days after symptoms
Recovery to discharge is 22 days.
Patients usually recover after 2 weeks.
Pathophysiology:
COVID-19 1
, Can cause inflammatory insult to alveoli, resulting in alveolar destruction
This leads to lung changes, resulting in Acute Respiratory Distress Syndrome
(ARDS) - hypoxemic respiratory failure
It can also cause a cytokine storm, Cardinal features include persistent fever,
cytopenias and hyperferritinemia.
ARDS and Shock are the two main causes of death.
Risk Factors:
Older age >60
Comorbidities i.e hypertension, cardiovascular disease, obesity, diabetes or
respiratory disease (cystic fibrosis, severe asthma)
Patients on cancer treatments
Patients on immunosuppresion therapy
Diagnosis:
Suspect coronavirus if following met:
New continuous cough
Temperature 37.8
Loss of, or change in, normal smell (anosmia) or taste (ageusia)
Investigation strategies:
U&E’s → Raised creatinine
Other biochemistry → Raised CRP, Ferritin, LDH,
troponin
FBC → Lymphocytopenia, Low platelets
Clotting → Raised prothrombin time (PT) or INR,
Raised D-dimers, Fibrinogen (DIC)
LFT → Raised Bilirubin, Raised AST/ALT
ABG → hypoxia, Raised lactate
COVID-19 2
