COVID

Question 1

Discuss initial test and specimen collection

Answer 1

NAAT is the preferred test (nucleic acid amlpicfiation) most commonly with reverse transcriptation PCR

Need a naspharyngeal swab, nasal swab specimen from both anterior nares +oropharyngeal swab

Question 2

List risk factors for severe illness

Answer 2

1) increasing age
2) multiple co-morbidities
- CVS disease
- DM
- COPD
- Cancer
- CKD
- solid organ or haematopeitic stem cell transplantation
3) Poor socioeconomic background and ex
4) Lab abnormaltiies
- lymphopenia
- thrombocytpenia
- elevated LFT
- elevated LDH
- increased inflammatory markers
- Elevated D-dimer
- Elevated PT
- elevated TNI
- elevated CK

Question 3

Discuss clinical manifestations

Answer 3

1) incubation period is generally within 14 days of exposure with most cases symptomatic after 4-5
2) initial symptoms
- cough 50%
- fever 43%
- myalgia 36%
- headache 34%
- dyspnoea 29%
- sore throat 20%
- diarrhoea 19%
- nausea and vomtiing 12%
- loss of smell or taste, abdo pain and rhinorrhea <10%

Question 4

Discuss complications that can arise from COVID infection

Answer 4

1) respiratory failure
- ARDS

2) Cardiac
- arrhythmia
- Myocarditis
- heart failure
- shock

3) VTE

4) Neuro
- encephalopathy

5) inflammatory complicaitons
- GBS
- multisystem inflammatory syndrome with clinical features similar to those of Kawasaki and TSS

6) secondary infections
7) hepatitis

Question 4

Discuss IX of Covid

Answer 4

Labs

• lymphopenia
• elevated transaminitis, LDH, inflammatory markers
• abnormal coag profile
• Positive Sars-Cov-2 RT-PCR, positive serology, positive antigen test

CXR

• consolidations
• ground class opacities
• bilateral peripheral and lower lung zone distribution

CT chest

• ground glass
• mixed consolidation
• adjacent pleural thickening
• interlobular septal thickening
• air bronchograms

Lung ultrsounds

Question 5

Discuss a infection control for covid

Answer 5

General approach

1) type of room
- patient should be placed in a well ventilated single occupancy woom with a closed door and dedicated bathroom
- if not possible patients with confirmed COVID 19 cna be hosued together
2) PPE
- Gowns, gloves, respiraor or medical mask, eye or face proection