Thread by @Manikandanraj92

Pneumonia findings in #COVID isn't due to the virus.Its the Antigen-Antibody reaction that is causing blockade of blood vessels in the lungs leading to opacity n affecting the exchange of Oxygen ultimately leading to Drop in Saturation.Understanding the pathogenesis is important

Hence usage of Heparin(Anticoagulant) to avoid blockage and Steroids(Dexa for Mild cases and Methylprednisole for severe cases) to stop the Autoimmune attack is important.

Both should be used at a right time but definitely in the first week of symptoms.

#COVIDEmergency

Steroids use in the first week with mild symptoms will prolong the disease period affecting the viral clearance from the body and cause deleterious effect.

Steroids is a wonder drug only when used at a right time.

#SteroidUse

Warning Signs at the end of 5th day.

1. Persistent Fever
2. Persistent Cough
3. Diarrhoea
4. Drop in SPO2 < 94%

Immediately need doctors care
CT chest, CRP, Ddimer, IL6.

#COVIDEmergency

People asking Why Diarrhoea?
2 reasons.
🔹️Our intestine has spike proteins receptors that it matches the spike protein in the virus.Both reacts.
🔹️ Autoimmune activity and Cytokine release will increase intestinal motility leading to diarrhoea

A Dangerous warning sign

Its the time at which we intervene.

If we find out the warning sign on day 5 or 6 and initiated Heparin + Steroid will give wonder results.

Remdesivir has no direct role, it stops the replication of the virus in people with high viral load.
Its of no use in established disease.

People ask why Antibiotics in a Viral Disease.

Antibiotics are used to treat Secondary infection in COVID in an already less immune patient.

Azithromycin and Doxycycline oral tab for Mild Cases

IV antibiotics for Moderate to severe cases as per protocol.

So to conclude

🔹️MILD CASE: Mild Symptoms with SPO2 >94 with or without Comorbidities

Home Quarantine with Oral tablets 5 days and Good Food for 14 days.

Monitor Saturation and Vital signs and Keep ur Sugars and BP under control if any.

#COVIDEmergency

🔹️Moderate Case:
Appearance of warning sign on day 5 or whichever is earlier
Prevent the Cytokine Storm

Admit do the CT chest, Blood Parameters (CBC- Neutrophil Lymphocyte ratio, D dimer, CRP, IL6)

Start Heparin and Low dose Steroid,Oxygen if needed
Monitor Sugars.

🔹️ Severe Case:
Drop in Saturation
Worsening Warning signs
Established Cytokine Storm

Needs HFNC, CPAP, BIPAP or Mech Ventilation.
High dose steroids,Antibiotics, Heparin.

Monitor Sugars again anticipate Heavy increase in sugars for a know diabetic.
#COVIDEmergency

🔹️ Zinc and Vitamin C are used as immune boosters and Vitamin D3 is also being recommended nowadays.

🔹️ High protein diet is advised. Prone Sleeping will increase Oxygenation at the base of the lungs..

#COVIDEmergency