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REVIEW ARTICLE
Year : 2020  |  Volume : 4  |  Issue : 2  |  Page : 45-57

COVID-19: What we all intensivists should know


1 Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
2 Department of Critical Care Medicine, PSRI Hospital, New Delhi, India

Correspondence Address:
Simant Kumar Jha
Flat No. 503, T-11, Taksila Heights, Sector-37C, Gurgaon - 122 001, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sccj.sccj_16_20

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Coronaviruses were identified as a viral family in the 1960s and are known to infect both humans and animals. Novel strain of coronavirus was identified when some cases of pneumonia began to arise in Wuhan province of China without any apparent cause. Later, this novel strain was called as coronavirus disease 2019 (COVID-19). Since 2002, coronavirus has been known to cause two widespread outbreaks in humans: severe acute respiratory syndrome coronavirus in 2003 and Middle East respiratory syndrome-CoV in 2012. The present crisis began to arise in late November of 2019 and then rapidly grew to become a pandemic. The present medical crisis resulted because high virulence of this virus simultaneously infected large number of patients. Although only a small proportion of COVID-19-infected patients require hospitalization, mortality is significantly higher in elderly and in patients with preexisting diseases. Patients with COVID-19 can present with an array of symptoms such as fever, dry cough, myalgia, vomiting, and loose motions. In later stages, it can progress to breathing difficulty. High virulence of COVID-19 puts the health-care workers (HCWs) at extreme risks of contacting this infection. COVID-19 is mainly diagnosed on the basis of clinical symptoms along with reverse-transcription polymerase chain reaction (RT-PCR). However, sensitivity of RT-PCR is 67% in the first 7 days and subsequently it falls to below 50% from the 2nd week onward. Total antibody has also been used to diagnose COVID-19. They have a lower sensitivity in initial days, but their sensitivity increases to 90% above from the 2nd week onward. Currently, management of COVID-19 is focused on supportive treatment as no drug till date has proven efficacy against novel coronavirus. Current trials have shown some promise with remdesivir. Although hydroxychloroquine rose to fame with earlier studies, its role in the management of COVID-19 was not established in further research. Current focus of the world to control this pandemic is on prevention through social distancing, use of face mask, regular hand washing, cough etiquette, and isolation of suspicious and confirmed cases. This article deals with nature, progression, and possible outcomes of this infection along with necessary steps that must be taken by a HCW to preventing himself from catching COVID-19.


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