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Summary COVID-19 clinical overview

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Describes COVID-19 pathophysiology, clinical presentation (general), Investigations, infection control methods in NHS and management of COVID-19 and complications.

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  • December 31, 2021
  • 5
  • 2021/2022
  • Summary

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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

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