it's been 20days how can me manage further ?
Post COVID19 status with B/L consolidation under evaluation Covid19 positive on 19/10/20 COVID19 negative on 2/11/20 Present vitals BP:110/80,PRsats:90%with 6lit/min 02 Chief Complaints C/0 dyspnea since 5days C/0 cough since 1week History Not a k/c/o DM,HTN,PTB No significant medical history Investigations Blood cultures Negative Ddimer 1000 Sr.ferritin 900 IL6 300 Management COVID19 treatment given according to standard protocol,given tocilizumab,plasma therapy,bipap support,broad spectrum antibiotics....
Thank you all.Will continue same along with dabigatran ,intermittent NIV with bronchodilators and update latest Chest xray here soon.
Xrays are showing typical c/o covid19 pneumonitis with pleural effusion b/l minimal All parameters ie inflammatory markers are raised pt is on 6lit 02 support suggest 02 saturation is very poor Pt needs to be in ICU only Inj predenisolone 30mg tds iv Inj vit c iv Inj insulin s/c Inj Ceftriaxozone 1gm bd Inj lasix Inj enoxiparum 6000units sc 02 by nasal tubing Adv for hrct How much plasma antibody has been infused maximum we can go for 4units Inj Remdesivir is being given or not if not given start 400mg in 12oml daily we can go up to 7to 11 injectables This pt is critical At this stage to give ivermectin is questionable but if decided than give him 24 mg od for 3days and followed weekly if pt responds Add ir continue tab zinc 50mg od tab vit d 4000units od Tab pirfenidone 400mg tds Tab pulmoclear 1bd Despite of all this cocktail and efforts you need to explain his relatives of hos prognosis
Standard management for Covid pneumonia has been done , but with unsatisfactory results. Plasma therapy can be continued. Cardiomegaly can be investigated . Possibility of COVID induced myocarditis / coronary thrombosis with post MI cardiac failure. Troponin and ECHO can be checked. Addition of diuretics, Azmada may help.
? COVID-19..WITH.. ASSOCIATED COMPLICATIONS.. NEED'S.. * HOSPITALIZATION..IN ..ICU.. COVID CENTERS.. * LIFE SUPPORTIVE MEASURES.. * STEROIDS.. * REMDESEVIR.. * BS..ANTIBIOTICS COVERAGE.. * INJECTION.. LASIX .. VITAMIN C.. INSULIN.. * PLASMA THERAPY..
Wait and watch. Continue oral steroids Inhaled bronchodilators steroids Mucolytics Dabigatran Oxygen support.
Cardiomegaly with massive lung tissue damages with pleural effusion
Thank you all.Will continue same along with dabigatran ,intermittent NIV with bronchodilators and update latest Chest xray here soon.
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