COVID-19: Current Perspectives
Keywords:
COVID-19, SARS-CoV-2, Remdesivir, Glucocorticoids, Tocilizumab, Convalescent plasma, Hydroxychloroquine
Abstract
COVID-19 has caused disruption, damage and death at an unprecedented scale. Knowledge about this disease is constantly evolving. The mode of transmission is believed to be primarily through droplet spread during face to face contact. In addition to the classical symptoms of fever, fatigue and breathlessness, loss of sense of smell and taste, skin manifestations and anorexia/ nausea/ diarrhea are emerging as new symptoms. The virus is now known to cause complications of almost all organ systems including blood vessels, heart, lung, kidney, brain and liver. The pediatric multi system inflammatory syndrome (PIMS) is a well-defined entity. Diagnosis is still by RT PCR in respiratory secretions. Obesity, genetic susceptibility have emerged as additional risk factors for severe disease. Evidence supports use of oxygen, anticoagulation, steroids and remdesivir in treatment of severe COVID-19. Steroids should not be given to non-hypoxic patients. Hydroxychloroquine, lopinavir ritonavir and azithromycin are no longer recommended for treatment. The jury is still out for tocilizumab and convalescent plasma. Patients can now be de-isolated 10-20 days after onset of symptoms for mild and severe disease respectively and demonstration of negative swabs is no longer essential. Vaccine development is underway.
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Clin Infect Dis. 2020; ciaa 601. doi:10.1093/cid/ciaa601.
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40. Chawla D, Chirla D, Dalwai S, et al. Perinatal-Neonatal Management of COVID-19 Infection - Guidelines of the Federation of Obstetric and Gynecological Societies of India [FOGSI], National Neonatology Forum of India [NNF], and Indian Academy of Pediatrics [IAP]. Indian Pediatr. 2020; S097475591600154.
41. Api O, Sen C, Debska M, et al. Clinical management of coronavirus disease 2019 [COVID-19] in pregnancy: recommendations of WAPM-World Association of Perinatal Medicine. J Perinat Med. 2020;/j/jpme.ahead-of-print/jpm-2020-0265/ jpm-2020-0265.xml.
42. Dhochak N, Singhal T, Kabra SK, Lodha R. Pathophysiology of COVID-19: Why Children Fare Better than Adults?. Indian J Pediatr. 2020; 87[7]:537-546.
43. Whittaker E, Bamford A, Kenny J, et al. Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2. JAMA. 2020;e2010369.
44. Wölfel R, Corman VM, Guggemos W, et al. Virological assessment of hospitalized patients with COVID-2019. Nature. 2020; 581[7809]:465-469.
45. Deng W, Bao L, Liu J, et al. Primary exposure to SARS-CoV-2 protects against reinfection in rhesus macaques. Science. 2020; eabc5343. doi:10.1126/science.abc5343
46. Lu J, Peng J, Xiong Q, Liu Z, Lin H, Tan X, et al. Clinical, immunological and virological characterization of COVID-19 patients that test re-positive for SARS-CoV-2 by RT-PCR. [Preprint] Medrxiv. 2020. Available at: https://www.medrxiv. org/content/10.1101/2020.06.15.20131748v1
47. Phelan AL. COVID-19 immunity passports and vaccination certificates: scientific, equitable, and legal challenges. Lancet. 2020; 395[10237]:1595‐1598.
48. Boulware DR, Pullen MF, Bangdiwala AS, et al. A Randomized Trial of Hydroxychloroquine as Post exposure Prophylaxis for Covid-19. N Engl J Med. 2020; 383[6]:517-525.
49. Indian Council of Medical Research. Revised advisory on the use of Hydroxychloroquine [HCQ] as prophylaxis for SARSCoV- 2 infection. Dated 22/5/2020. Available at https://www.icmr.gov.in/pdf/covid/techdoc/V5_Revised_advisory_on_ the_use_of_HCQ_SARS_CoV2_infection.pdf. Accessed on
August 1,2020.
50. COVID-19 vaccine tracker. Available at https://www.raps. org/news-and-articles/news-articles/2020/3/covid-19-vaccine- tracker. Accessed on August8,2020.
Published
2020-08-28
How to Cite
Dr Tanu Singhal. (2020). COVID-19: Current Perspectives. The Indian Practitioner, 73(8), 35-42. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/1031
Section
Special Article
