CT score 25/25

55 yr old female presented with saturation below 50..with oxygen . 5 days back no RTPCR OR Imaging done... Imnjectible steroid antibiotics nebulisation with budesonide formetrol enoxaparin colchicine.... Supporting mm... ( Comorbidity CAD...) . CRP 77 Now saturation is 85....HRCT DONE LAST DAY as follows



Most critical c/o covid19 pneumonitis bilaterally with critical score of 25/25 and spo2 50% Needs to be intubated and put on ventilator 10lit 02 support Inj Remdesivir 200mg stat followed by 100mg daily for 10days Inj piperacillin+inj tazobactum 4.5 gm tds Inj dexamethasone 8hrly Inj Ceftriaxozone 1.1 gm bd Inj enoxiparum Inj lasix Inj insulin Constant monitoring Pt is hypoxic and critical if affordable add Inj Tocilizumab Plasma antibody 4units

Thanx dr Pushkar ji Bhomia

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Very badly affected lungs Outcome is unpredictable, with sudden deterioration and cardiorespiratory failure is common Giving anti-inflammatory medication - steroids, Remdesivir, and gentle oxygen support is vital These patient do not tolerate invasive ventilation and crash after intubation, even BIPAP ventilation - if high pressure are set, it may cause damage to lung Therefore low pressure BIPAP support, may help in maintaining saturation

Thank you doctor

B/ L PNEUMONITIS( COVID virus Infection ) Needs further investigation and intensive care unit treatment Put pt under ventilator and all drugs recommended by the ICMR and symptomatic treatment. Good nutritious balanced liquid diet or iv fluid. Plasma Antibodies can be infused if possible.

Thanks Dr Pushkar Bhomia

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Poor out comes Serve b/L Pneumonitis start Inj. LMWX .04ml S/c BD, Inj. remdesivir 200 mg stat then followed up 100mg od, Inj. Targocid 400 mg BD, Inj. Solumedrol 125mg - BD, Inj. Lasix High Flow Oxygen Therapy & Bipap, if not respose then Plan For Inj. Bevacizumab 400mg Stat. or Plasma Therapy 3 Unit.. Best wishes For Management... updated plz...

B/L Pneumonitis ? COVID infection Ad RT PCR for COVID Condition of patient is low Advised admit patient to COVID hospital

Ild Ards Opinion of chest specialist Oxygen Abg Remedesivir Ivermectol Lmwh Steriod Il6 if positive Cytolimizubab

Ct score 25/25. Bilateral patchy areas with ground glass opacities seen. Prominent Bronchovascular markings also noted. Covid. Severe line of treatment should be followed

Rx Fabiflu 800 Doxycycline 200mg 1BD Ivermectin 12mg 1OD Dolo 650 mg1BD Nebulization TDS Aptimust syrup Vit B complex, Vit C and Zinc

Diagnosis. : COVID -19. B/l. Pneumonitis .. Severly affected lungs With ct score 25/25 Adv invg : cbp. Crp. D dimer. il6. Ferretin ldh. Rft Rtpcr Management. Rx Inj. Piptaz 4.5g. TID INJ . Clexane 60. BD. ( as of d dimer ) Inj . Methylprednisolone Inj . MAGNEX FORTE 1.5g BD INJ . Lasix INJ . Vit c TID Look further for inj. Tocilizumab Tab. Doxycycline 100mg bd 10days Tab . Ivermectin 12mg. Od TAB ZINC 50 od Tab . Vit d 60k daily once for 4 days stop Add bronchodilators etc. and maintain spo2 Above 90 Repeated investigations required to monotor condition ...