severe covid

please help us with CT findings and what to do next.patient was on oxygen supportfor 7 days (high flow upto 15litres NRB for about 3-4 days and slowly tapered off) and now discharged home.maintaining 96-97 on room air.on even small exertion O2 sats drops upto 90. This ct was taken 12 days after symptoms onset Was given 3 day pulse steroids therapy 1gram methylprednisolone and clexane 0.6ccbd Then followed by dexa 6mg od for 7 days and clexane 40mg od Also kept on antibiotics piptaz for first 7 days in hospital Now on dexa 3mg od and apixaban 2.5mg bd and ecosprin 75od cefixime 200mg bd echo normal.ECG shows tachycardia.heart rate also increasing with mild exertion oscillating between 80-130. otherwise normal.he is known hypertensive since one year and is on azilsartan 40mg since one year and his readings are under control. Steroid induced hyperglycemia devloped these days and he was given insulin when in hospital and now is on onderomet 2.5mg/500 bd in home. He is being checked regularly with blood work crp d dimer Hemogram-CBP ferritin etc . Please help about CT findings. And things and investigations and any changes needed in treatment please advise. Please help me with ct findings and what to do next in follow up and suggest ifany anti fibrotics need to be added .any investigations and things to be followed and prognosis and further followup advise please help 🙏🙏 Things to do in these next coming days and any specific suggestions for followup and recovery, please help 🙏🙏🙏🙏 Kindly help us🙏

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Severe case of lung fibrosis post covid Pt needs to be on antifibrotic drugs Tab pirfenidone 200mg 2tds Tab pulmoclear 1bd Tab ninteninib 150mg 1bd In my opinion he was fit candidate for Tocilizumab and plasma antibody infusion If pt is discharged adv re hospitalization and keep monitoring and 2 support If domestic treatment is given put him on oxygen concentrators 5to7 lit per hour

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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Appears to be a case of unresolved covid pneumonia ,adv tocilizumab & dexa along with antibiotics & ventilatory support , anticoagulation , , duration of illness is too short for pulmonary fibrosis to develop ,

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Post Covid Sequelae.. usual symptoms with 20-30% patients... 1. CT pulmo angio to rule out Pul Embolism 2. Inhalational Budesonide 800 mcg BD 3. Nebulise with Hypernib 7% Or Steam Inhalation BD 4. Awake proning 14-16 h a day 5.Incentive spirometry, inspiratory and expiratory both would definitely help to increase breating capacity and will also slow down fibrosis. As you have asked , Antifibrotics is always been a matter of hot debate. But certainty there is no definte role of antifibrotics in post covid fibrosis..

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Excellent approach Tree in bud Ground glass bilateral pneumonitis Pft Opinion of chest To r/0 pulmonary fibrosis

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Needs counselling calmness symphony music.... cherries berries... ginger saunth lime juice. Orange juice pomegranat es inhalation techniques.the pt. has to be mentally kept with out fear...this will help to be well fast..

SUGGESTIVE. OF ...FIBROSIS.... SECONDARY. TO POST. COVID. .. SEQULAE

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B/l ggo, fibrobronchitic changes noted.

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B/L Ground glass appearance May I suggest Tab. Nintidanib 150 bd Chest physiotherapy

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