What modifications we can bring in our clinical setup to prevent our staff & patients from COVID 19?

 PATHOPHYSIOLOGY OF AKI IN COVID- 19 PATIENTS. AKI appears to involve a complex process driven by virus-mediated injury, cytokine storm, AngII pathway activation, dysregulation of complement, hypercoagulation, and microangiopathy interacting with common and known risk factors for AKI . There is paucity of data regarding clinical and laboratory characteristics of AKI in patients with COVID-19. We urge that further studies describing and analyzing the clinical course of patients with COVID-19 include appropriate indices of kidney function and diagnosis of AKI in their analyses, including kidney injury markers, urine microscopy, quantified urine protein, urine output, and urine electrolytes. Markers of macrophage activation, coagulation, microangiopathy, and complement activation, as well as kidney imaging and need for KRT (with relevant details), are important data needed to further our understanding of AKI pathophysiology associated with COVID-19. Rates of reversibility of, or partial improvement in, kidney function and any kidney biopsy results (including immunofluorescence and electron microscopy) should be reported. In the rush to report medical complications of COVID-19, we are missing valuable clinical information. Speculation about specific interventions would not be appropriate until we obtain appropriate information. We advocate for a complete and standardized appraisal of the clinical and laboratory picture so that preventative and therapeutic strategies for AKI can be appropriately designed and implemented.

30 year old male, 10 day history of diarrhoea and reduced oral intake, presented with lethargy and ongoing abdominal cramps. No respiratory symptoms, but O2 sats noted to be on the lower side, exertional O2 sats dropped to 86%. No past medical history of note, normal white cell count, not lymphopenic, urea 18.9 mmol/L, creatinine: 489 µmol/L, amylase 600 (30-118), ALT: 65, CRP: 100, Trop I 267 (0-46). Chest X-ray as shown. What do you think the patient is suffered from?

41 year old male presents to the ED with SOB x5 days. He was in contact with a COVID+ patient. He reports fever highest 102.3. States he has body aches and chills. Denies cough or sore throat. Places on 6L/min via NC and sats increased to 91%. History of Hypertension Hypothyroidism Morbid obesity Prediabetes. what do you suggest?

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.

AYUSH System approach in COVID-19 by AYUSH Ministry Source-https://www.ayush.gov.in/docs/125.pdf