Coronavirus Treatment: When To See A Doctor?

Dr Samrat D Shah, MD, Internal Medicine Specialist, Bhatia Hospital

So if I have an upper respiratory infection, should I go to my private doctor? Am I COVID 19 positive? Am I having flu? Am I safe and treatable?

These are the questions which come to the mind of people after contracting URTI. Protocol needs to be laid for those infected patients, which depends on this quadruple symptoms:

  • Comorbid condition: Type 2 DM, known heart disease, cancer patients, immunosuppressed patients, end stage lung or liver or kidney disease
  • Travel history: Positive in endemic area – red flag for highly endemic, orange for moderate endemic and green for safe countries.
  • High grade fever
  • Shortness of breath

These patients can be further categorised as:

  • Mild – If only history of fever, cold and cough; without positive travel history and no shortness of breath and no comorbid conditions
  • Approach: Advise them to stay at home for a couple of days; See the doctors, if symptoms worsen
  • Severe: Positive for all above quadruple symptoms
  • Approach: Advised to go to emergency rooms of any govt authorised hospital for proper management to prevent the complications – pneumonia, ARDS, sepsis, multiorgan failure
  • Moderate: Patients who have high grade fever, Comorbid conditions, but no shortness of breath no positive history of travel in highly endemic areas.
  • Approach: Subject those patients for a routine blood profile – if complete blood count shows leukopenia (30-45 percent of China COVID 19 had it) with lymphocytopenia (85 percent of COVID 19 China patients had it according to statistics) ….most important prognostic market is your NLR ( neutrophils to lymphocytes ratio ) 3.13 is the cut off …. if NLR is more than 3.13 with age more than 50 straight admission to icu and if NLR is less than 3.13 age less than 50 can be isolated at home.

Other important test is to screen out other viral and bacterial infections by doing a simple throat swab by polymerase chain reaction ( rapid biofire) which is done in all good private hospitals… this is only one time you would thank if patient turns out to be positive for flu , than it rules out corona virus, if negative than it could be corona virus

Presently no specific drug is available for corona virus, somewhat effective would be the nucleotide analogue – Remidesivir which was once used for viral hemorrhagic fevers like Ebola , shows some potential against SARS COV 2 in vitro.

Facebook Comments