Coronavirus: Symptoms that patients exhibit, how to judge that they need admission

— By Dr KK Aggarwal

D Dimer is the only lab criteria for severity
No

Absolute lymphocytic count < 800 D Dimer > 100
CPK > 2X ULN
CPR > 100
LDH > 245
Trop I rising
Ferritin > 300

There are no standard Lab guideliens

Daily tests: CBC witnh differential lymphocytes, CMP, CPK
Risk stratification Q2-3 DAY PRN ( as needed): D Dimer, Feritn, ESR, CRP
Once: HBV, HCV, HIV, Influenza A/B, RSV, Resp Bio fire profiel, Tracheal aspitate if intubaued
COVID 19

All pneumonia pateints need admission
No. temperature > 38
Respiratory rate > 20
Heart rate > 100 with new confusion
Oxygen saturation < 94%

There are no clear cut red flags for COVID
No
Severe shortness of breath at rest
Difficulty in breathing
Pain or pressure in the chest’
Cold, clammy, pale and mottled skin
New confusion
Becoming difficult to rouse
Blue lips or face
Little or no urine output
Coughing up blood
Neck stiffness
Non blanching rash

Headache rule out COVID 19
It is present in 14% cases.

Fever with chills means flu
Chills are present in 12% cases

Cough with sputum rules out COVID 19
No, sputum may be present in 34% cases

Nasal congestion is common in COVID

No, It is present in only 5% of cases

Hydroxychloroquine can cause QT prolongation
No, it’s the combination with Azithromycin. [Input Dr Monica Vasudeva]

((The writer is President, CMAAO, HCFI and Past national President IMA))