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COVID pneumonitis with underlying COPD

81 years old male, known COPD, presents with high grade fever, cough n SOB for last 6 days. His CRP is normal. D dimer, FERRITIN awaited. Anaemia present otherwise normal hemogram. Chest auscultation revealed bilateral expiratory rhonchi n RT LZ CREPITATIONS. Spo2 95% on air. Normal Temperature, BP n Pulse. His SARS COV 2 RT PCR came positive. Kindly discuss further management plan for this patient.

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Changes of COPD emphysema with reticulonoduler opacities seen. Et basal inhomogenous heziness seen. Findings sugg of COPD emphysema with rt basal Infective focus. As covid 19 RT PCR positive, Consider broad spectrum antibiotics like azithromycin, with bronchodilators mucolytics oxygen support sos NIV. LABA LAMA combination. Symptomatic treatment otherwise. Consider HCQS as per ECG / QTc. Treating staff's care is most important.
I agree
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COPD case with COVID 19 is deadly combo. So patient should be followed meticulously and observe for spo2, PR and BP. Treatment should be Antibiotics like Azithro or Piperacilin- tazo combination with antiviral drug tamiflu 75 mg BD is must here. From my perspective HCQ cause more harm in this type of patient than benifit. I also in favor of daily or alternate day xray monitoring for confirmation of any drastic changes of pneumonia.
s
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1-Antibiotics- piperricillin-tazobactam, azithromycin..2-Tab tamiflu 75 mg BD...3-MDI FORACORT 12 hrly...4-Tab HCQS(after ecg done)...5-symptomatic treatment for cough and fever....look for BP ,RR ,SPO2....Send vitamin D levels....correct anaemia if present...send blood c/s...repeat x Ray after 5 days.
It is covid pulmonary lesion.needs close observation in icu.needs non invasive high pressure oxygenation very soon. Strong possibility of him landing in coagulopathy. May need anticoagulants. Anti covid drugs to be started soon
Send him to COVID decated Hospital/ tab azithromycin 500 1 OD ,Tab HCQ 400 1BD one day 1 followed by 200 1 bd for four days LABA LAMA should be continued multivitamin vitamin d
Its better to manage as per national covid 19 treatment protocol and for respiratory insufficiency fo for symptomatic approach as infection will be covered in national regimen
Age and COPD with COVID positive,better to hospitalised in COVID center. May land emergency with spreading of COVID to other staf
* COPD .. * EMPHYSEMA.. * COVID-19.. NEED'S.. MANAGEMENT AS PER ICMR. PROTOCOLS..
Tnx Dr Gyanendranath Tripathy
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I completely agree with@ Dr.@Sandeep Ghodekar ...
SUGGESTIVE OF COPD .EMPHYSEMA POSSIBLY COVID
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