This document discusses post-COVID 19 syndromes, their features, and management. It covers a wide range of potential sequelae affecting the lungs, heart, brain, kidneys, endocrine system, and other organs. Management involves monitoring for and treating persistent symptoms through specialized post-COVID clinics with a multidisciplinary care approach. Common long-term issues include fatigue, respiratory symptoms, cardiac involvement, neurological or psychiatric symptoms, and general functional decline.
How to manage a case of acute exacerbation of COPD according to GOLD guidelines. Sincere thanks to Dr. Amardeep Toppo who has prepared most of this presentation.
How to manage a case of acute exacerbation of COPD according to GOLD guidelines. Sincere thanks to Dr. Amardeep Toppo who has prepared most of this presentation.
The latest guidelines on the management of a COPD patient ( Stable COPD, patient with an exacerbation of COPD), latest modalities of treatment of a COPD patient
Interstitial lung disease is a general category that includes many different lung conditions. All interstitial lung diseases affect the interstitium, a part of the lungs' anatomic structure.
Some of the types of interstitial lung disease include:
Interstitial pneumonia: Bacteria, viruses, or fungi may infect the interstitium of the lung. A bacterium called Mycoplasma pneumonia is the most common cause.
Idiopathic pulmonary fibrosis : A chronic, progressive form of fibrosis (scarring) of the interstitium. Its cause is unknown.
Nonspecific interstitial pneumonitis: Interstitial lung disease that's often present with autoimmune conditions (such as rheumatoid arthritis or scleroderma).
The latest guidelines on the management of a COPD patient ( Stable COPD, patient with an exacerbation of COPD), latest modalities of treatment of a COPD patient
Interstitial lung disease is a general category that includes many different lung conditions. All interstitial lung diseases affect the interstitium, a part of the lungs' anatomic structure.
Some of the types of interstitial lung disease include:
Interstitial pneumonia: Bacteria, viruses, or fungi may infect the interstitium of the lung. A bacterium called Mycoplasma pneumonia is the most common cause.
Idiopathic pulmonary fibrosis : A chronic, progressive form of fibrosis (scarring) of the interstitium. Its cause is unknown.
Nonspecific interstitial pneumonitis: Interstitial lung disease that's often present with autoimmune conditions (such as rheumatoid arthritis or scleroderma).
A cardiologists perspective to current scenario in light of corona pandemic in india and world wide. cardiac procedures , heart disease , aceinhibitors , arni , heart failure , troponin, nt probnp
Neurological Manifestations of COVID-19 InfectionSudhir Kumar
COVID-19 primarily affects respiratory system, however, it can affect other systems too, including nervous system. This presentation offers details about neurological symptoms and disorders seen in patients with COVID-19.
The impact of COVID 19 on R.TX is unclear
Risk factors in R.TX: Comorbidities, residual graft dysfunction, long term immunosuppression
There are a very few case series in renal transplant recipients from mild to severe infection
Aim: Equipoise between infection and rejection
We don’t know the best approach for immunosuppressive drugs in these patients
Having more than two year experiences, presently anticoagulant is an essential component of management of COVID 19
Its role is recommended in moderate to severe to critically ill patients with different opinion in the dosage
Giving anticoagulants in asymptomatic or mild cases is still need to be validated though there are suggestions in favor.
There is recommendation for post discharge patients who had clinically suspected/established thromboembolism events
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
11. CT Chest & CT Pulm Angiogram in
COVID-19 Survivor
12. British Thoracic Society Respiratory follow up
Psychiatric Asessment
Thromboembolic sequelae diagnosis
Criteria for evaluation Based on the severity of acute COVID-19
Level of Care recieved (ICU or HDU)
Chest X-ray in all patients at 12 weeks
Consider PFTs , 6MWT, Sputum sampling & Echocardiogram
• Assessment of progression or recovery at 6 and 12 months
Pulse Oximetry, 6MWTs, PFTs , HRCT Chest
CT pulmonary angiogram as appropriate
• Corticosteroids May be beneficial in a subset of patients with
post-COVID iflammatory lung disease
• Lung transplantation Done but Unproven
• Antifibrotic therapies Clinical Trials
Management of Pulmonary Sequelae
13. Respiratory Follow-up Algorithm for Patients of COVID-19
Pneumonia Cared for in ICU, HDU or with Severe Disease
Peter M George et al. Thorax 2020;75:1009-1016
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14. • Continued hyperinflammatory and hypercoagulable state
• Mechanisms of thromboinflammation
Endothelial injury Complement activation
Platelet activation Platelet–leukocyte interactions
Neutrophil extracell traps Pro-inflamm cytokines release
Hypoxia Disruption of coagulant pathways
• Similar to thrombotic microangiopathy syndromes
• Thromboembolic events noted in <5% in post-acute COVID-19
• 2.5% cumulative incidence of thrombosis at 30 d following discharge
Segmental pulmonary embolism
Intracardiac thrombus
Thrombosed arteriovenous fistula
Ischemic stroke & Central Sinus Venous Thrombosis
Management
• Extended thromboprophylaxis Oral anticoagulants & LMWH
• For pts with risk factors immobility
persistently elevated d-dimers
high-risk comorbidities such as cancer
• Therapeutic anticoagulation Iimaging-confirmed VTE for ≥3 months
Hematologic Sequalae of COVID 19
21. • Decreased glomerular filtration rate in 35% of pts at 6 months
• Resolution of AKI in the majority of COVID-19 patients
• Requirement of RRT for severe AKI indicates high mortality
• COVID-19-associated nephropathy (COVAN) in Africans
• Patients with persistent impaired renal function benefit from
early and close follow-up in AKI survivor clinics
Renal Sequelae of COVID 19
22. • New or worsening control of existing diabetes mellitus
•Subacute thyroiditis and bone demineralization
• Post COVID Diabetic ketoacidosis without known DM
Subacute thyroiditis & thyrotoxicosis
• Etiology Direct viral injury
Immunological and inflam damage
Adverse effects of Treatment
• Referral to endocrinology Newly diagnosed diabetes
Suspected HPA suppression
Hyperthyroidism
Endocrine Sequelae of COVID 19
23. • Diarrhoea 1-10%
• Nausea and Vomiting
• Mild Abdominal pain
• Post-infectious irritable bowel syndrome and dyspepsia
• Prolonged viral fecal shedding
• Potential alteration of the gut microbiome
• Enrichment of opportunistic organisms
• Depletion of beneficial commensals
• Gut–lung axis : Gut microbiota alter course of respiratory
infections
Dermatologic Sequelae of COVID 19
• Hair loss 20% of COVID-19 survivors
• Skin Rash 10 %
Gastrointestinal Sequelae of COVID 19
24. Nutrition & Rehabilitation Issues in Post COVID
19
• Decline in quality of life (EuroQol visual analog scale) in 44.1%
• Decline in Health-related quality of life and functional capacity
• Muscle wasting, feeding difficulties and frailty – poor outcome
• Malnutrition has been noted in 26–45% of patients
• Assess for Swallowing function Nutritional status
Measures of functional independence
• Early rehabilitation programs are safe and effective
• High risk for post-acute COVID-19 syndromes
Severe illness during acute COVID-19 and/or
Required care in an ICU
Most susceptible to complications
elderly
multiple organ comorbidities
Post-transplant
Active cancer history
Highest burden of persistent symptoms
25. • Fungal sinusitis
• Cheek/eye pain
• Headache
• Proptosis or bulging of eye ball
• Double vision or Diplopia
• Blurred vision
• Total vision loss
• Altered sensorium
• Blackish discharge from nose
• Palatal discolouration
ENT Sequelae in Post COVID 19
26.
27. • Diagnostic criteria: <21 years old with
fever, elevated inflammatory markers
multiple organ dysfunction
current or recent SARS-CoV-2 infection and
exclusion of other plausible diagnoses
• Typically affects children >7 years
• Higher incidence in African, Afro-Caribbean or Hispanic
• Complications coronary artery aneurysm
Encephalopathy
Stroke
Seizures
Multisystem Inflammatory Syndrome
in Children (MIS-C)
28. Post COVID- 19 Clinics
Integrated Multi- disciplinary Care
30. • Care for patients with COVID-19 does not
conclude at the time of hospital discharge
• Lookout for Post COVID sequelae is vital
• Multi -disciplinary comprehensive care
maintains and improves quality of life