corona virus disease 2019 or covid19 is a critical conditon affecting the whole body, primarily targeting lungs by causing patholoigies such as ARDS and Pneumonia. there are different variants presented till date and most recent one is omicron with Ro=7 while delta variant has the Ro=6. ultimately it affect the alveolar sac causing the inflammation followed by consolidation, during the whole process different other organ system also get affected due to ventilation perfusion mismatch thus leads to tachycardia followed by multiple organ damage which ultimately causes MOF (multiple organ failure), COVID19 is diagnosed according to history and physical examination of patient presented by the given symptoms, and provided vitals. Nasopharyngeal swab test as well as RT-PCR is counted as Gold standard, though sensitivity is less than NAAT (nucleic acid amplification test) which has more sensitivity but is very expensive for the population. diagnosis is then followed by general blood test to rule out other condition and and critical scenario of the body, finally imaging technique such as CXR, CT-chest or US can be done to find and evaluate lungs and its functioning. finally this presentation will guide you to know the current prevention and treatment option.

1. BY:-
ALOK HRIDAY MISHRA
MD 7A1
COVID-19
(SARS COV-2)
BSU
January 2022

2. TOPIC TO COVER
 INTRODUCTION
 EPIDEMIOLOGY
 PATHOPHYSIOLOGY
 SIGN AND SYMPTOMS
 DIAGNOSIS
 IMAGING
 PREVENTION
 TREATMENT

3. INTRODUCTION
 CORONA VIRUS DISEASE 2019 or SARS COV-2 that is severe acute
respiratory syndrome is responsible for pandemic responsible for causing
ARDS or Pneumonia in infected indiviudal.
 Previoiusly similar outbreak such as SARS and MERS already occurred.
 It is passed from BATS to an intermediate host which is believed in this case
is Pangolin leading to genetic mutation in such as way that now it can infect
human too.
 The outbreak first appeared in wuhan, CHINA in december 2019.
 Till this date world is under restriction and lockdown, few countries have
completed vaccinations against this virus, few countries even won against
this virus, but as it keep on mutating it is believed to last much longer than
expectd.

4. EPIDEMIOLOGY
 CFR(CASE FATALITY RATE)
 SARS=10%, MERS=35%
 COVID19=3.7% (average global approx.)
 COVID 19 from the day of outbreak went undergo
several mutation till date, which made it much
more dangerous.
 VOC (variant of concern)
ALPHA, BETA, GAMMA, DELTA, OMICRON*
 New variant in france

5.  Ro or Re value:- total number of person can be
infected from already infected individual at the given
time.
 Covid 19 in 2019 Ro=1.4-2.4
 Influenza Ro=1
 Exponential curve
 New varints : delta Ro=6 and omicron =7
one might have asked this question, when will this
pandemic over?
Ro= 0 or <1

6.  Series interval (Si): time taken by the newly infected person
from the already infected individual to show off symptoms.
 Shorter
the Si more
deadly
it is considered.
 covid 19
SI= 6 days,
influenza=3 days
 Incubation
period of
covid 19= 4-14 days or max upto 24 days.

7. PATHOPHYSIOLOGY
 Three means of transmission:
feco-oral, air, respiratory droplets
 Asymptomatic or symptomatic.
 Virus reaches pneumocyte type 2
 Spike protein on viral surface
 ACE-2 receptors
 +ssRNA
 Translation
 RNA dependent RNA polymerase
 Viral assembly
 Killing pneumocyte to release newly formed viral particle

8.  Penumocyte destroyed
 Cytokine released
(IL-1,6,8 TNF)
 Cytokine storming
 Vasodilation
 Capillary
permeability increased
 Alveolar edema
 Collapsing
pressure increase
 Alveolar collapse
 Decreased air
exchange rate
 Decreased ventilation
perfusion rate
 HYPOXAEMIA

9.  Within alevolar sac,
fluid+protein+cellular debris+immue cells
 Consolidation
 Decrease more gas exchange
 Pyrogenic cytokines IL-1,6 causes hypothalamus to
increase set point causing high fever
 Productive cough
 Dyspnea
 Compensatory mechanism
 Tachycardia and tachypnea
 Viral sepsis
 Hypotension
 Multisystem dysfunction followed by multisystem failure

11. SIGN AND SYMPTOMS
 FEVER (HIGH)
 PRODUCTIVE COUGH
 DYSPNEA
 CHEST TIGHTNESS
 LABOURED BREATHING
 FATIGUE
 HEADACHE
 ANOSMIA
 SORE THROAT

12. IN LATE STAGE:-
 NAUSEA AND VOMITING
 DIARRHEA
IN OTHER SYSTEM INVOLVEMENT:-
 OLIGORRHEA
 TACHYCARDIA
 TACHYPNEA
UPON SEPSIS:-
 HYPOTENSION
AND WARM EXTREMEITIES

13. DIAGNOSIS
 HISTORY AND PHYSICAL EXAMINATION
 Gold standard:-Naso-oropharyngeal swab followed
by RT-PCR
 NAAT (Nucleic ACID Amplification Test):- very
expensive but very sensitive test
 CBC- lymphopenia
 CMP:- LFT (increases liver enzymes)
BMP(increase BUN and Creatine)
 Increase PCT(Procalcitonin) in superinfection

14.  General non specific markers:-
CRP
ESR
IL6
LDH
D-dimer
Ferratin
For heart:-
Troponin I and T
CK-MB

15. IMAGING
 CXR- consolidation and ground glass opacities

16.  CT* of Chest:- crazy paving pattern

17.  Ultrasound:- pleural line thickening
kerley B line
consolidation

18. PREVENTION AND TREATMENT
 HAND WASH
 SANITIZING FOMITES
 FACE MASK
 AVOID GATHERING
 DISTANCING
 VACCINATION

19. Tx:-
 Antiviral- within 5 days of onset of symptoms
- paxlovid, Remdesivir, favipiravir
 Corticosteroid:- anti-inflammatory
- Dexamethasone
 (Ivermectin and chloroquine or hydroxychloroquine) not used
now.
 Paracetamol
 Vit C
 Vit D i.e. Calcifediol
 CCBs
 Immunotherapy: -plasma
 ACE-2 blockers (understudy)
 O2 supplementation
 Bronchodilators:- to dilate and open respiratory pathways
- levasalbutamol + ipratropium
 ENJOY, KEEP CALM, BE HAPPY