Concluded Case

High grade fever,chills,SOB, spo2:80% generalized weakness

50y/female 5days back got admitted to hospital with C/O high grade fever, chills, throat conjunction, body pain, generalized weakness, with mild SOB, and difficult in breathing.... On admission vitals are bp;128/70mmhg, PR:110, spo2: 89% on arrival without oxygen supply, on room temperatures NO HISTORY of DM, HTN, Non Alcoholic, Non smoker, No other complaints. VITALS AS OF NOW BP:130/90 PR: 102/ mint CHEST: clear, hyperventilating P/A: soft SPO2: 80% On room air with oxygen support 91% Currently patient is shifted to ICU, with elevated D-Dimer, interleukin 6, C-reactive protein, high neutrophils, high lymphocyte, all investigation are attached below, all report clearly suggest of Cytokine strom... My request to our great doctors to suggest there opinion, line of treatment and management on this cases for further evaluation..

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Concluded answer

Yes all inflammatory markers are increased in multifolds IL 6 is raised as leucocytosis Xray chest and ecg should be advised She is a c/o covid19 pneumonitis with hypoxia in cytokine storm stage needs to be treated effectively and aggressively Consider Inj Remdesivir 200mg stat followed by 100mg daily for 5days Inj dexamethasone 8hrly Inj Ceftriaxozone 1.1 gm bd Inj piperacillin+inj tazobactum 4.5 gm tds Inj enoxiparum Inj lasix 02 support Rest of treatment as investigations suggest

All Answers

Yes all inflammatory markers are increased in multifolds IL 6 is raised as leucocytosis Xray chest and ecg should be advised She is a c/o covid19 pneumonitis with hypoxia in cytokine storm stage needs to be treated effectively and aggressively Consider Inj Remdesivir 200mg stat followed by 100mg daily for 5days Inj dexamethasone 8hrly Inj Ceftriaxozone 1.1 gm bd Inj piperacillin+inj tazobactum 4.5 gm tds Inj enoxiparum Inj lasix 02 support Rest of treatment as investigations suggest

Thanx dr Kute Ankush
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HRCT chest advised to evaluate involvement of lungs to grade severity, although as per various blood investigation looks severe covid , management is Corticosteroid , oxygen support, anticoagulant like anoxaperine anticoagulant therapy, along with treatment of pneumonia if superadded bacterial infection eg Clarithromycin. openion with cardiologist is also required and other blood tests function test needed for management.

? SAR COV2 .. NEED'S .. HRCT THORAX .. RT..PCR..COVID-19 ..

Tnx Dr Shivraj Agarwal sir
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