Covid 19 or SARS-COV2 Management at home

Coronavirus structure with gene

 Covid 19 

First of all what we have to understand is:

- covid virus does not kill us directly.

- over activation of immune system kills.

Hospital Admission:

-Difficult to get bed.

-Expensive(rs 70000 to 5 lakh in a week

-Stressful condition.

First we have to understand about stages after infection:

1. Viral replication

2. Immune Activation and inflammation: In most of the cases covid will end up at this stage ie NATURAL CURE

3.Immune Hyper Activation and hyper-inflammation ie Cytokine storm occurs at this stage in case of virus could not kill through Natural cure or second stage.

Cytokine Storm Activation

4.Respiratory Failure

5. Multi Organ Failure or Dysfunction due to cytokine storm

6. Death

How to Identify the stages?

- Stage 1 (Viral Replication):- It approximately lasts for 1 week- usually asymtomatic--Stage 2(Immune Activation):- mild symptoms or sometime asymptomatic(mild symptoms includes:- fever, cough and sore throat, bodyache, loss of smell, mild breathing difficulties, diarrhoea

What You need to do?

You need to find out lab nearby:

Lab Test:- CBC,CRP, D-Dimers

-oxygen Saturation(spO2) - use oximeter

Oximeter Showing SpO2



-Temperature- use thermometer

Digital Thermometer


-Count Respiratory rate

Age wise normal respiratory rate


Medication to be taken at this stage( 2nd Stage)

-Paracetamol 500 mg TDS for 5 days( or 1gm if high grade fever)

-Budesonide inhaler(eg Foracort) 800 mcg twice a day

-Vitamin C and D

-Zinc tab

When to step up Management?

-CRP more than 5 times upper normal limit

-D- dimer more than 2 times upper normal limit

- CBC :- Neutrophil/ Lymphocyte ratio more than 3  

                    Then add Dexamethasone (6-12 mg daily)

                                   or Methylprednisolone( 30-40 mg)twice a day for 5-10 days

Side Effects of Methylprednisolone or Dexamethasone

- Blood Sugar level might increase

-It may also cause gastritis

#use glucometer to check blood sugar 6 hourly 

Glucometer

#Inject Soluble Insulin according to Sugar level

-150-200 mg/dl - 2 unit of insulin

-200-250 mg/dl- 4 unit of insulin

-250-300 mg/dl- 6 unit of insulin

-300-350 mg/dl- 8 unit of insulin

#Tab Pantoprazole 40 mg twice daily to avoid gastritis

Stage 3( hyper-inflammation)

- if SpO2 less than 93 

-if respiratory rate more than 25

#Add oxygen to maintain SpO2 more than 93 and Enoxaparin 40 mg Subcutaneous once daily.

How to Deliver oxygen?

-Nasal Canula(2-6 L/min) 

-Simple Face mask

Face Mask

#Prone Position Increases Oxygenation Due to this the precious Oxygen requirement will be less.

- Possible to manage at home up to this stage.

Critical Decision at home

#Dexamethasone or methylprednisolone is the game changer.

-It must be started at the proper stage.

-when inflammatory markers increases(CRP, D-dimer, N:L ratio) then Prompt use steroid .

#do not wait for SpO2 to fall.

 

#Dexamethasone or methylprednosolone Starting too early can increase viral load so disease becomes more severe, Starting too late can lead to lungs damage beyond manageable at home.

(SO USE YOUR BRAIN)

Stage 3( Cytokine Storm)

-Over active immune system.

-Further reduction of SpO2.

-Further increase in respiratory rate.

Note: this is for an educational purpose only any harm due to these medication and information shall not be liable

Thanks