Covid 19

CORONA VIRUS
Corona virus
 Corona virus comprises of a large family of viruses
that are common in human beings as
well animals (camels, cattle, cats, and bats).
 Sometimes corona virus from animals infect
people and spread further via human to human
and now with this COVID 19 (Corona disease
2019).
 The virus that causes COVID-19 is designated
severe acute respiratory syndrome corona virus 2
(SARS-CoV-2); previously, referred to as 2019-
nCoV
 Towards December 2019, this novel corona virus
was identified as a cause of upper and
lower respiratory tract infections in Wuhan, a
city in the Hubei Province of China. It rapidly
 spread, resulting in an epidemic throughout China
and then gradually spreading to other
parts of the world in pandemic proportions. It
has affected almost every continent in this
world, except Antarctica.
 In February 2020, the World Health Organization
designated the disease COVID-19, which stands
for corona virus disease 2019.
Mode of transmission
1. Droplet transmission
 The virus is released in the respiratory
secretions when an infected person coughs,
sneezes or talks.
 These droplets can infect others if they
make direct contact with the mucous
membranes.
 Infection can also occur by touching an
infected surface and followed by eyes,
nose or mouth.
 Droplets typically do not travel more than six
feet (about two meters) and do not linger in
the air. However, given the current uncertainty
regarding transmission mechanisms
 Airborne precautions are recommended
routinely in some countries and in the setting of
specific high risk procedures.
 Patients are thought to be most contagious
when they are symptomatic . Some spread
might be possible before symptoms appear, but
this is not thought to be a common occurrence
2. CONTACT TRANSMISSION
 It may be possible that a person can get
COVID-19 by touching a surface or object that
has the virus on it and then touching their own
mouth, nose, or possibly their eyes, but this is
not thought to be the main way the virus
spreads.
Incubation period
 The exact incubation period is not known.
 It is presumed to be between 2 to 14 days after
exposure, with most cases occurring within 5
days after exposure
Age Affected
 Mostly middle aged (>30 years) and
elderly.
 COVID-19 tends to cause more severe
illness in elderly population or in
patients with underlying medical
problems.
 Symptomatic infection in children
appears to be uncommon, and when it
occurs, it is usually mild
Clinical Presentation
Most common clinical features at the onset of
illness were:
1. Fever
2. Fatigue
3. Dry cough
4. Myalgias
5. Dyspnea
6. Pneumonia appears to be the most common
and severe manifestation of infection.
Other symptoms
1. Headache
2. Sore throat
3. Rhinorrhea
4. Gastrointestinal symptoms
DIAGNOSIS
1. PCR Testing (polymerase chain reaction)
 The nose swab PCR test for COVID-19 is the
most accurate and reliable test for
diagnosing COVID-19.
 A positive test means you likely have COVID-
19.
 A negative test means you probably did not
have COVID-19 at the time of the test.
 Sample collection is done using a swab to
collect respiratory material found in your
nose.
A swab contains a soft tip on a long, flexible
stick that is inserted into your nose.
There are different types of nose swabs
including nasal swabs that collect a sample
immediately inside your nostrils and
nasopharyngeal swabs that go further into
the nasal cavity for collection.
2. Rapid Diagnostic Test
a. Antigen test
This test detects bits of proteins on the
surface of the virus called antigens.
Antigen tests are typically considered rapid,
taking only 15 to 30 minutes but are less
accurate than a PCR test.
Rapid antigen tests are most accurate when
used within a few days of the start of your
symptoms, which is when the largest amount
of virus is present in your body.
b. Antibody test
This tests detects if you’ve had an immune
response (antibodies) to the virus.
This means that you’ve had the virus and
your body (immune system, specifically
antibodies) has mounted an attack to fight
it.
It typically takes about a week after being
infected for enough antibodies to develop to
be detected in your blood.
MANAGEMENT
 The therapeutic strategies to deal with the
infection are only supportive, and prevention
aimed at reducing transmission in the
community is our best weapon.
 ISOLATION (14 days)
1. Any person diagnosed with Covid 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
3. Has a history of travel to a COVID
affected region within the last 14 days.
4. 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.
PREPARATION OF ISOLATION ROOM
 Ensure that appropriate hand washing facilities and

hand-hygiene supplies are available.
 Stock the sink area with suitable supplies for hand

washing, and with alcohol-based hand rub, near the
point of care and the room door.
 Ensure adequate room ventilation.
 Post signs on the door indicating that the space is an

isolation area.
 All visitors should consult the health-care worker in
charge before being allowed into the isolation areas.
 Keep a roster of all staff working in the isolation
areas, for possible outbreak investigation and
contact tracing. Some centers have banned all
visitors.
 Remove all non-essential furniture and ensure that

the remaining furniture is easy to clean.
 Stock the PPE supply and linen outside the isolation

room or area (e.g. in the change room). Setup a
trolley outside the door to hold PPE. A checklist may
be useful to ensure that all equipment is available.
 Place appropriate waste bags in a bin. If possible, use a
touch-free bin. Ensure that used (i.e. dirty) bins remain
inside the isolation rooms.
 Place containers for disposal of sharps inside the

isolation room or area.
 Keep the patient's personal belongings to a minimum.
 Dedicate non-critical patient-care equipment (e.g.

stethoscope, thermometer, blood pressure cuff and
sphygmomanometer) to the patient, if possible.
Thoroughly clean and disinfect patient-care equipment
every time before using in next patient.
 Adequate equipment required for cleaning or
disinfection inside the isolation room should be
kept and room should be cleaned on a daily basis.
 Set up a telephone or other method of

communication in the isolation room or area to
enable patients, family members or visitors to
communicate with health-care workers. This may
reduce the number of times the workers need to
don PPE to enter the room or area.
WEARING AND REMOVING PERSONAL
PROTECTIVE EQUIPMENT (PPE)
Before entering the isolation room or area:
1. Collect all necessary items.
2. Ensure to perform hand hygiene with an
alcohol-based hand rub or soap and water;
3. Use PPE in the order that ensures adequate
placement of PPE items and prevents self-
contamination and self-inoculation while using
and taking off PPE.
Steps of putting personal protective equipments
Steps of removing personal protective equipments
LEAVING THE ISOLATION ROOM AREA
 Either remove PPE in the anteroom or, if there is
no anteroom, make sure that the PPE will not
contaminate either the environment outside the
isolation room or area, or other people.
 Remove PPE in a manner that prevents self-

contamination or self-inoculation with
contaminated PPE or hands.
 Remove the most contaminated PPE items first.

 Perform hand hygiene immediately after
removing gloves.
 Remove the mask or particulate respirator last
(by grasping the ties and discarding in a rubbish
bin)
 Discard disposable items in a closed rubbish
bin.
 Perform hand hygiene with an alcohol-based
hand rub (preferably) or soap and water
whenever ungloved hands touch contaminated
PPE items.
Drug Management
1. REMDESIVIR is an antiviral medication that
targets a range of viruses.
 Remdesivir works by interrupting production of
the virus. Coronaviruses have genomes made up
ribonucleic acid (RNA).
 Remdesivir interferes with one of the key
enzymes the virus needs to replicate RNA. This
prevents the virus from multiplying.
 Hepatoxic drug
2. Dexamethasone
 Is a corticosteroid used in a wide range of
conditions for its anti-inflammatory and
immunosuppressant effects.
 Dexamethasone was administered as an oral

(liquid or tablets) or intravenous preparation, at a
dose of 6 mg once daily for ten days, in one of the
arms.
3. ANTI BACTERIAL THERAPY
 antibiotics can be initiated to treat secondary
bacterial pneumonia.
4. ASCORBIC ACID
 It is an antioxidant and free radical scavenger that
has anti-inflammatory properties, influences
cellular immunity and vascular
 Positively affects the development and
maturation of T-lymphocytes, in particular NK
(natural Killer) cells involved in the immune
response to viral agents.
Preventive Measures for Covid virus
1. Clean your hands often. Use soap and water, or an
alcohol-based hand rub.
2. Maintain a safe distance from anyone who is coughing or
sneezing.
3. Wear a mask when physical distancing is not possible.
4. Don’t touch your eyes, nose or mouth.
5. Cover your nose and mouth with your bent elbow or a
tissue when you cough or sneeze.
6. Stay home if you feel unwell.
7. If you have a fever, cough and difficulty breathing, seek
medical attention.
8. Practice physical distancing by avoiding unnecessary
travel and staying away from large groups of people.

Covid 19

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CORONA VIRUS

4. Any health care worker with symptoms of

 Ensure that appropriate hand washing facilities and

 Stock the sink area with suitable supplies for hand

 Ensure adequate room ventilation.

 Post signs on the door indicating that the space is an

 Remove all non-essential furniture and ensure that

 Stock the PPE supply and linen outside the isolation

 Place containers for disposal of sharps inside the

 Keep the patient's personal belongings to a minimum.

 Dedicate non-critical patient-care equipment (e.g.

 Set up a telephone or other method of

 Remove PPE in a manner that prevents self-

 Remove the most contaminated PPE items first.

 Dexamethasone was administered as an oral

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