Hydroxychloroquine with or without ritonavir/lopinavir and azithromycin use in acute COVID-19 Increased troponin levels, decrease in LVEF Severe disease, high viral load, pneumonia during hospitalization Ongoing clinical trials to determine potential pharmacological candidates, use current recommended guidelines for most likely differential diagnosisĬMR: myocardial inflammation, myocarditis, pericarditis, cardiac fibrosisĮchocardiogram: impaired LVEF, pericarditis, myocarditis, other cardiac anomalies Pulmonary rehabilitation : pulmonary function improvements Maximum initial dose 0.5 mg/kg oral prednisolone: FVC, radiological and symptomatic improvementĢ403 mg daily pirfenidone: FVC, 6WMT, and disease progression improvementġ50 mg of twice daily nintedanib: FVC improvement Initial evaluation 4-6 weeks with pulmonary function testing and 6MWT Lower limit 6MWT, higher CT severity score, increased D-dimer or urea nitrogenĪdvanced age, male, history of cigarette smoking Severe disease, ICU admission, or severe hospital stay ,ĬT: ground-glass opacities and fibrotic changes Abbreviations and Acronyms: 6MWT ( 6-minute walk test), ARDS ( acute respiratory distress syndrome), ICU ( intensive care unit), IL ( interleukin), KD ( Kawasaki disease), MIS-A ( multisystem inflammatory syndrome in adults), MIS-C ( multisystem inflammatory syndrome in children), VTE ( venous thromboembolism events)ĦMWT, 6-minute walk test ACE, angiotensin-converting enzyme AKI, acute kidney injury APOL1, apolipoprotein L1 aPTT, activated partial prothrombin time ARB, angiotensin receptor blocker ATE, arterial thromboembolism BNP, brain natriuretic peptide CBC, complete blood count CMP, complete metabolic panel CMR, cardiac magnetic resonance COVID-19, coronavirus disease 2019 CRP, C-reactive protein CT, computed tomography DI, D-dimer increment DKA, diabetic ketoacidosis ECG, electrocardiogram ESR, erythrocyte sedimentation rate FVC, forced vital capacity ICU, intensive care unit IVIG, intravenous immunoglobulin LDH, lactate dehydrogenase LVEF, left ventricular ejection fraction MIS-C, multisystem inflammatory syndrome in children MPIV, methylprednisone intravenous OCD, obsessive compulsive disorder PCR, polymerase chain reaction POTS, postural orthostatic tachycardia syndrome PT, prothrombin time PTSD, post-traumatic stress disorder RAAS, renin angiotensin-aldosterone system SARS-CoV-2, severe acute respiratory syndrome VTE, venous thromboembolism. The presence of long-term effects presents another reason for vaccination against COVID-19. This review serves as a guideline for effective management based on current evidence, but clinicians should modify recommendations to reflect each patient's unique needs and the most up-to-date evidence. Interdisciplinary monitoring with holistic management that considers nutrition, physical therapy, psychological management, meditation, and mindfulness in addition to medication will allow for the early detection of post-acute COVID-19 sequelae symptoms and prevent long-term systemic damage. The preliminary evidence on the pulmonary, cardiovascular, neurological, hematological, multisystem inflammatory, renal, endocrine, gastrointestinal, and integumentary sequelae show that COVID-19 continues after acute infection. All studies discussed in this text are from adult populations unless specified (as with multisystem inflammatory syndrome in children). Only peer-reviewed studies in English published by Jwere considered for inclusion. A PubMed search was completed using variations on the term post-acute COVID-19. Recent literature on the long-term health consequences of COVID-19 discusses the need for a comprehensive understanding of the multisystemic pathophysiology, clinical predictors, and epidemiology to develop and inform an evidence-based, multidisciplinary management approach. Our understanding of COVID-19 is constantly progressing, giving better insight into the heterogeneous nature of its acute and long-term effects. From December 2019 to July 2021, this virus has infected nearly 200 million people and led to more than 4 million deaths. Coronavirus disease 2019 (COVID-19) is the third deadly coronavirus infection of the 21st century that has proven to be significantly more lethal than its predecessors, with the number of infected patients and deaths still increasing daily.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |