COVID-19

Background

• Also known as "2019 Novel Coronavirus"
• First detected in Wuhan, China

Specific Coronavirus Sub-Types of Clinical Importance

• MERS-CoV
• SARS-CoV
• SARS-CoV-2 (COVID-19)

Clinical Features

Broad Testing Recommendations

The CDC has expanded testing beyond the initial travel to china recommendations

• Test any person who has fever or respiratory illness AND had close contact with a known COVID-19 patient
• Test any person who has fever or respiratory illness AND a history of travel to CDC-classified high risk areas or areas with recent significant community spread
• Test any person who has severe respiratory illness AND is being admitted to the hospital
• Test any hospitalized person who has respiratory illness AND no alternative diagnosis
• Consider testing any person who has respiratory illness AND lives in a residential facility such as a nursing home or recently returned from a cruise

Differential Diagnosis

• Influenza
• Pneumonia
• Sinusitis

PPE

During Intubation

• N95 or PAPR
• Surgical Mask over N95
• Goggles that surround eyes with facial contact, face shield, or full joint-replacement-hood with visor
• Bunny suit, preferably with hood or disposable fluid-proof gown
  • If no hooded suit available, sterile disposable cap
• 2 pairs gloves, 1 under sleeves of bunny suit or gown and 1 over, under-layer gloves would ideally be long cuffed

Clinical Assessment

The video below indicates the proper order for donning and doffing PPE for clinical evaluation of a patient {{#widget:YouTube|id=exV5hEG62CY}}

Evaluation

• BIOFIRE RESP PANEL Corona Virus assay does NOT detect this subtype - DO NOT USE

Management

Airway Managment

Due to the risk of viral spread via droplets, early intubation is preferred over noninvasive ventilation

Mild Cases

• Supportive care is mainstay of therapy for patients with mild viral symptoms
• Most patients will do well enough for discharge home
• Discuss with Dept of Public Health, who will guide testing and, if discharging, help patient remain in isolation at home

Disposition

• Usually home, but decision needs to be made in conjunction with the local Public Health Dept
• If admitting, needs to be placed in negative pressure isolation room with airborne and droplet precautions

See Also

• Coronavirus
• Harbor:Infectious Disease Threats

External Links

• https://www.cdc.gov/coronavirus/2019-ncov/