COVID-19 (RESP)

Question 1

What is COVID-19?

Answer 1

A potentially severe acute respiratory infection caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Question 2

How does COVID-19 transmission occur?

Answer 2

Primarily via respiratory droplets

Question 3

How long is the average incubation period for COVID-19?

Answer 3

5 days

Question 4

What are the clinical features of COVID-19? (8)

Answer 4

• fever
• cough
• dyspnoea
• altered sense of smell/taste
• headache
• sore throat
• nasal congestion/rhinorrhoea
• fatigue

Question 5

What are the first-line investigations for COVID-19? (4)

Answer 5

• real-time reverse transcription polymerase chain reaction (RT-PCR) - isolated from a nasopharyngeal swab
• rapid antigen test
• pulse oximetry
• CXR - if suspected pneumonia

Question 6

What are some differential diagnoses for COVID-19? (10)

Answer 6

• community-acquired pneumonia
• influenza
• common cold
• RSV virus in children <5
• aspiration pneumonia (clinically indistinguishable, RT-PCR negative for SARS-CoV-2)
• pneumocystis jirovecii pneumonia (immunocompromised)
• Middle East respiratory syndrome (MERS)
• avian influenza A (H7N9) - contact with infected birds
• pulmonary TB (night sweats, weight loss)
• febrile neutropenia

Question 7

What is the management plan for mild-to-moderate COVID-19? (3 + 3)

Answer 7

• isolation + monitoring
• symptom management and supportive care
• antipyretic/analgesic
• (antimicrobials)
• (antiviral - nirmatrelvir/ritonavir, molnupiravir, remdesivir)
• (monoclonal antibody)

Question 8

What is the management plan for severe COVID-19? (4 + 5)

Answer 8

• hospital admission
• oxygen therapy
• venous thromboembolism (VTE) prophylaxis
• symptom management and prophylactic care
• (antimicrobials)
• (corticosteroid - dexamethasone)
• (antiviral - remdesivir)
• (IL-6 inhibitor - tocilizumab / sarilumab)
• (JAK inhibitor - baricitinib)

Question 9

What is the management plan for critical COVID-19? (10)

Answer 9

• intensive/critical care unit admission
• VTE prophylaxis
• high-flow nasal oxygen / NIV
• invasive mechanical ventilation
• inhaled pulmonary vasodilator
• ECMO
• corticosteroid (dexamethasone)
• antiviral (remdesivir)
• IL-6 inhibitor - tocilizumab / sarilumab
• JAK inhibitor - baricitinib

Question 10

What are some complications of COVID-19? (10)

Answer 10

• post-intensive care syndrome
• thrombosis
• cardiovascular complications
• AKI
• long COVID
• myocarditis/pericarditis (post vaccination)
• acute liver injury
• neurological complications
• cardiac arrest
• pregnancy-related complications

Question 11

What is the leading cause of death from COVID-19?

Answer 11

Leading cause of death is respiratory failure from ARDS