COVID 19 has spread its tentacles all over India. Men or women, young or old, rich or poor are in the grip of this pandemic. The better side is that most of them do survive. Overall 97% of individuals with COVID-19 infection are likely to survive. However, there are certain guidelines if followed meticulously can pre-vent panic or prevent unnecessary hospitalisation or may help you to survive if you take appropriate care and get hospitalised early enough as per guidelines of Indian Council of Medical Research.
What is a suspect case of Covid-19?
Any person who has a cold, cough, fever, body ache, shortness of breath or has come in contact with a COVID patient is a suspect. Any person who has severe breathlessness, cough and fever and if this cannot be explained by alternative diagnosis is suspected to have COVID. What is a probable or a confirmed case? A suspect case is where the test for Covid-19 is inconclusive or a suspect case where the testing cannot be done. A patient whose laboratory test for COVID is positive is a confirmed case. A confirmed case may or may not have any symptoms. What are the most common symptoms of Covid-19? Fever, cough, fatigue, shortness of breath, expectoration, severe body ache, running nose sore throat are common symptoms. Even diarrhoea can be an important symptom. Loss of taste and smell are also common.
How does it present in older people?
Fatigue, reduced alertness, reduced mobility, diarrhoea, loss of appetite, delirium are common symptoms. The elderly may not have a fever. Children also do not report cough or fever as much as adults.
What are the risk factors for severe disease?
The risk increases with increasing age. The risk of serious illness is more if you are above 60 years. Non- communicable diseases like diabetes, hypertension, cardiovascular diseases, chronic lung diseases, cancer, immunosuppressed are associated with severe form of COVID infections and they need to be hospitalised early enough.
How is the severity judged clinirsily?
In mild illness, the oxygen saturation on pulse oximetry is above 95%. The blood pressure should be normal and the individual should be breathing normally.
What is the eligibility for home isolation and treatment?
The individual should be clinically assigned as very mild by the treating doctor. There should be a facility for self-isolation and quarantine for other family members. A communication line in between the patient and care provider should be available round the clock. The caregiver and con-tacts should have hydroxy-chloroquine prophylaxis as per protocol. Download Aarogya Setu App on mobile and it should remain active at all times.
When to seek medical attention if you are being treated at home?
Only if the treating medical officer advises, you should be treated at home. However, seek hospital care if you have persistent fever, breathless-ness or drop in oxygen saturation, severe fatigue or persistent loose stools. It is safer to be in contact with your doctor on the phone at least once a day for 14 days.
What should be the treatment at home?
Close monitoring of tem• temperature, pulse rate, Oxygen saturation at least once in 4 hours is adequate. Please chart them and inform your doctor on a daily basis. Paracetamol is given for fever and body aches. Hydroxychloroquine is considered for high-risk individuals such as age above 60 years, hypertension, diabetes, chronic diseases like kidney or liver diseases.
Is obesity a risk factor for severe COVID symptoms and poor outcomes?
Obese or overweight individuals have increased risk. Obese individuals have a chronic inflammatory state. There is an increased incidence of hypertension, diabetes in obesity. If your BMI is above 25 be more watch• full. In case you have very mild disease with no major risk factors you can be managed at home under the vigilance of a doctor. You need to have a thermometer and a pulse oximetry device. Have plenty of fluids and isolation in a separate room is mandatory. The choice of drugs like Hydroxychloroquine, Ivermectin, Fabipiravir or steroids, and investigations like CBC, D Dimer, CRP, Chest Xray or CT scan of the chest are best left to your treating doctor.
Author: Dr Jay Deshmukh
Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.