Concluded Case

post covid tachypnea

45y female diabetic . covid positive on 20 April discharge on 30 April with o2 4l saturation 93. now d dimer 1.58 crp 2.66 without o2 saturation 95 bp 110/70 Diabetes controlled bt respiratory rate 35 -40pm pt complain sob..no cough chest clear Report attached ct done on 5 May post discharge Pt taken tab pirfenix 200 tds Tab moxiflox400 od Tab apixaban 2.5 bd Tab glimisave mv2 bd Plz give your opinion

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Concluded answer

Pt should be treated as post covid lung fibrosis under guidance of pulmonary medicine Pt may required steroid with strict glycemic control, inhalers both duoline and budocort, good chest physiotherapy, respirometry No need of any antibiotic or antiviral at all at present

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Pt is recovered with 02 saturation95% with stable vitals Hrct suggest extensive lung fibrosis with a patch of pneumonitis persistent on rt side If this hrct is post discharge than pt needs readmission or if old one than adv to repeat For treatment my advice to add pulmoclear and nintena Sos steroids Adv spirometry and steaming Check bsl and sp02 and bp frequently

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Very high CT severity score, very high respiratory rate, she needs admission in Covid ICU If insulin is used for treatment, it may help in saving life Please read my article for role of insulin in treatment of Covid 19 https://jmscr.igmpublication.org/home/index.php/archive/178-volume-08-issue-07-july-2020/9517-use-of-insulin-in-treatment-of-covid-19-a-proposal-to-explore-feasibility

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Pt should be treated as post covid lung fibrosis under guidance of pulmonary medicine Pt may required steroid with strict glycemic control, inhalers both duoline and budocort, good chest physiotherapy, respirometry No need of any antibiotic or antiviral at all at present

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CTSS WAS .. 20 / 25 .. RR .. 35 .. TACHYPNEA .. DM .. D DIMER..1.58 .. NEED'S.. HOSPITALIZATION..IN COVID CRITICAL CARE CENTER..

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Start Inj Medrol 80 mg iv od for 5 days Seroflo and Duoline rotacap inhalation Nebulize With steam & budacort Keep watching blood sugar

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VERY HIGH MODERATE SEVERITY SCORE . 20/25. CORADS > 5. CIRITCAL CASE.. CRP - STABLE.. BP - STABLE.. START INSULIN INJ... ADMIT - INTENSIVE CARE UNIT ??. RX- TAB - FAVIPIRAVIR 400 MG BD . TAB - CLARINOVA BD . TAB IVERMECTIN 12 MG BD . TAB - ZINDERVIT ( MULTIVITAMIN, MULTIMINERALS AND ANTIOXIDANTS) ...

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Insulin. Metrogyl. Antibiotics clexen Dexa

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Admit patient to COVID hospital

Patient discharged from covid hospital on 30 april
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ARDS Rx Fabiflu 800 Doxycycline 200mg 1BD Ivermectin 12mg 1OD Dolo 650 mg1BD Nebulization TDS Aptimust syrup Vit B complex, Vit C and Zinc

D Dimer is increased. Crotalus-hor 30 Bd

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