MANAGEMENT OF COMORBID CONDITION ASSOCIATED WITH COVID 19

1. DR. KALPANA CHETIA
ASSOC. PROFESSOR
DEPT. OF MEDICINE, JMCH, JORHAT

2. GENERAL CONSIDERATION
 Novel corona virus can infect anybody irrespective of age, sex ,
occupation and socio economic status.
 Health worker personals are highly exposed and therefore incidence is
more among them.
 If we consider the socio economic the disease is affecting poor people
to person from royal family.
 The virus may infect any person with pre existing diseases called
comorbid conditions.
 The severity and mortality in patients with comorbid condition is very
high
 The condition is less severe in younger age group and also mortality is
less among them
 Mortality is high among patients more than sixty five yrs of age.


3. COMORBID CONDITIONS
 Cardiovascular diseases – hypertension, ischeamic
heart diseases, valvular heart diseases, congestive
cardiac failure , heart block, arrhythmias , diabetes
associated heart diseases etc . Myo carditis can occur
due to the disease itself .
 Renal diseases like ARF , CRF ETC. ARF can occur due
to the disease itself

4. COMORBID CONDITIONS
 Neurological diseases like CVA, parkinsonism ,
myasthenia gravis , dementia etc
 Additional diseases like anaemia, alcoholism, drug
addiction, malnutrition , immune deficiency diseases,
malignancy ,diabetes mellitus , COAD, Acute and
chronic liver diseases etc

5.  More attention should be paid to comorbidities in the
treatment of covid 19.
 These patients often die of their original co morbid
conditions .
 We therefore need to accurately evaluate all original co
morbidities of individuals with covid 19.
 We should pay full attention to the treatment of
original co morbidities of the individuals while
treating pneumonia .

6.  Covid 19 may also cause damage to other organs such
as heart, the liver, the kidneys as well as organ systems
such as blood and immune system.
 Patients eventually die of multiple organ failure ,
shock, ARDS , heart failure , arrhythmias and renal
failure.
 We should therefore pay attention to potential multi
organ injuries and protection and prevention thereof
in the treatment of codid 19

7. CORONA ROLE FOR MANAGEMENT
OF CO MORBID CONDITIONS
 C – All persons related to the health system should
work in cooperation. Works should be done highly
coordinated manner and we should cope up with the
prevailing condition.
 O – Observation – attention should be paid to organ
function in this critically ill patients and necessary
protective measure including mechanical ventilation ,
glucocordicoid , antiviral , symptomatic treatment
and anti shock therapy. Developing specific treatment
plans including antihypertensives, hypoglycemic
therapy and continuous renal replacement therapy .

8.  R- Regular monitoring of vitals , fluid input and
output charts, clinical , laboratory as well as
radiological monitoring , ecg monitoring , sugar
electrolyte monitoring. Monitoring is essential to
know the organ function status, developement of
shock and sepsis as well as developement of drug
toxicities. As the patients get drugs having cardiac
toxicities like HCQS.

9.  O- observation of out come like state of recovery or
state of detorioration.
 N – nutritional supplementation is also an important
part of treatment.
 A- Avoidance of negligence and avoidance of
contamination with proper use of PPE .

10. CONCLUSION
 Among laboratory confirmed cases of covid 19 patients
with any co morbidity yielded poorer clinical outcomes
than those without . A greater no of co morbidities
also correlated with poorer clinical outcomes.

11. THANK YOU