India
healthysoch
Dr K K Aggarwal
President CMAAO, HCFI and Past National President CMAAO
New Delhi, March 26, 2020 :
D Dimer is the only lab criteria for severity : No
Absolute lymphocytic count < 800
D Dimer > 100
CPK > 2X ULN
CPR > 100
LDH > 245
Trop I rising
Ferritin > 300
There are no standard Lab guidelines :
Daily tests: CBC witnh differential lymphocytes, CMP, CPK
Risk stratification Q2-3 DAY PRN ( as needed): D Dimer, Feritn, ESR, CRP
Once: HBV, HCV, HIV, Influenza A/B, RSV, Resp Bio fire profiel, Tracheal aspitate if intubaued
COVID 19
All pneumonia pateiunts need admission :
No. temperature > 38
Respiratory rate > 20
Heart rate > 100 with new confusion
Oxygen saturation < 94%
There are no clear cut red flags for COVID : No
Severe shortness of breath at rest
Difficulty in breathing
Pain or pressure in the chest’
Cold, clammy, pale and mottled skin
New confusion
Becoming difficult to rouse
Blue lips or face
Little or no urine output
Coughing up blood
Neck stiffness
Non blanching rash
Headache rule out COVID 19 : It is present in 14% cases.
Fever with chills means flu : Chills are present in 12% cases
Cough with sputum rules out COVID 19 : No, sputum may be present in 34% cases
Nasal congestion is common in COVID : No, It is present in only 5% of cases
Hydroxychloroquine can cause QT prolongation : No, it’s the combination with Azithromycin. [Input Dr Monica Vasudeva]