Demystifying COVID-19: Understanding the Disease, Its Diagnosis and Treatment

413 Pages·2021·10.168 MB·English

by  Ozgur Karcioglu, Selman Yeniocak, Mandana Hosseinzadeh

Demystifying COVID-19:
Understanding the Disease, Its
Diagnosis and Treatment
Authored by
Ozgur KARCIOGLU
Department of Emergency Medicine
University of Health Sciences
Istanbul Education and Research Hospital
Fatih, Istanbul, Turkey
Selman YENIOCAK
Department of Emergency Medicine,
University of Health Sciences,
Haseki Education and Research Hospital,
Fatih, Istanbul, Turkey
&
Mandana HOSSEINZADEH
Department of Emergency Medicine
Cerkezkoy Community Hospital
Tekirdağ, Turkey
Demystifying COVID-19: Understanding the Disease, Its Diagnosis and Treatment
Authors: Ozgur KARCIOGLU, Selman YENIOCAK & Mandana HOSSEINZADEH
ISBN (Online): 978-1-68108-778-8
ISBN (Print): 978-1-68108-779-5
ISBN (Paperback): 978-1-68108-780-1
© 2021, Bentham Books imprint.
Published by Bentham Science Publishers – Sharjah, UAE. All Rights Reserved
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CONTENTS
PREFACE ................................................................................................................................................ i
CONSENT FOR PUBLICATION ................................................................................................ ii
CONFLICT OF INTEREST ......................................................................................................... ii
ACKNOWLEDGEMENTS ........................................................................................................... ii
CHAPTER 1 CONTAGION OF THE PANDEMICS: THE SITUATION IN THE WORLD ...... 1
FATALITY AND MORTALITY DIFFERENCES BETWEEN COUNTRIES ....................... 4
WHICH COUNTRIES HAVE THE HIGHEST NUMBER OF CASES? ................................ 4
TO NORMALIZE OR NOT TO NORMALIZE, IT IS THE MAIN QUESTION! ................. 6
CONTAGIOUSNESS OF CORONAVIRUS ............................................................................... 10
IN WHAT WAYS IS CORONAVIRUS TRANSMITTED? ...................................................... 10
Where is The Contamination Happening? .............................................................................. 11
Is It Airborne? ......................................................................................................................... 11
Air Conditioning + 1 Patient = 10 Patients: Who is Guilty? .................................................. 11
How is The Air Conditioner Cleaned? .................................................................................... 14
How Should We Clean Our Air Conditioner? ........................................................................ 14
CONCLUSION ............................................................................................................................... 14
REFERENCES ............................................................................................................................... 15
CHAPTER 2 HOW CAN A COUNTRY DEFEAT COVID-19? VALUE OF R0, RT AND RE 17
WHAT ARE R0, RT, AND RE? .................................................................................................... 19
INCUBATION PERIOD ................................................................................................................ 20
PRINCIPLES OF SURVEILLANCE AND STRUGGLE WITH THE PANDEMIC: HOW
COUNTRIES DIFFER FROM EACH OTHER? ....................................................................... 20
HOW EFFECTIVE IS HOME STAY, SOCIAL / INDIVIDUAL ISOLATION IN
PREVENTING THE SPREAD OF COVID-19? ......................................................................... 20
BELGIUM HAS A VERY DIFFERENT CASE SITUATION .................................................. 21
HERD IMMUNITY AND THE 'SECOND WAVE' PROBLEM: MYTH OR TRUTH? ....... 24
IS THE ‘ORDINARY CITIZEN’ ALSO GUILTY? WHICH MISTAKES DID THEY DO
IN THE PANDEMIC AND ‘NORMALIZATION’? ................................................................... 25
HOW DOES THIS DISEASE END? ............................................................................................ 26
THE SPANISH FLU EXPERIENCES OF 1918: DOES HISTORY LIGHT OUR WAY? .... 27
Why is It Called ‘Spanish Flu’? .............................................................................................. 27
Is It Different From Other Flu Syndromes? ............................................................................ 27
WHAT HAPPENED IN THE USA? ............................................................................................. 28
Mass Graves Were Opened in The Usa in September 1918 Due To Massive Death Toll ..... 28
REFERENCES ............................................................................................................................... 29
CHAPTER 3 COMORBID DISEASES AND COVID-19: COPD, SMOKING, OBESITY,
DIABETES, CANCER, AND KIDNEY FAILURE ............................................................................. 31
THE RELATIONSHIP BETWEEN COVID-19 FATALITY RATE AND
COMORBIDITIES ......................................................................................................................... 31
PULMONARY DISEASES AND COVID-19 .............................................................................. 34
Could COVID-19 Infection also Cause COPD-AA? .............................................................. 34
Are Patients with COPD or Asthma at High Risk for Contracting COVID-19? .......... 35
Are Patients with COPD at High Risk for Severe COVID-19 and Death? .................. 35
How are The Follow-up and Treatment of COPD and COPD-AA Cases During The
Pandemics? ................................................................................................................... 35
Are Systemic Corticosteroids (CST) Used in COPD-AA During Pandemic? ............... 35
Are There Any Changes For Asthma Patients? ...................................................................... 36
How is an Asthma Attack Treated While Infected with COVID-19? ............................ 36
Is the Use of Nebulizers Recommended in The Treatment of Asthma/COPD During
The COVID-19 Outbreak? ............................................................................................ 36
Does Smoking and COPD Development Alter Expression of ACE2 Receptors? .................. 36
Does Smoking Affect Clinical Course? ......................................................................... 36
Is Smoking also Effective in Influenza? ........................................................................ 37
Is COVID-19 More Severe in Smokers? ....................................................................... 38
What are The Key Findings of Systematic Reviews and Meta-analyzes with High
Level of Evidence? ........................................................................................................ 38
What is “Smoker’s Paradox” (SP), are There any Justifications? ............................... 38
OBESITY AND COVID-19 ........................................................................................................... 39
Numerical Data showing the Relationship between Obesity and COVID-19 ........................ 40
DIABETES AND COVID-19 ......................................................................................................... 42
In a Diabetic Patient Hospitalized in The COVID-19 Process, There will be 5 Essential
Steps of Management .............................................................................................................. 43
CANCER AND COVID-19 ............................................................................................................ 44
Why are Cancer Patients More Disadvantaged in Terms of COVID-19? .............................. 44
Are There any More Special Risk Groups among People with Cancer? ................................ 45
Can Cancer be Diagnosed During The Pandemic Period, and can Interventions be
Performed as Before? .............................................................................................................. 45
Are there Specific Difficulties in Diagnostic Interventions for COVID-19? ......................... 46
Are There Specific Difficulties for Cancer Patients Regarding Care and Treatment? ........... 46
Is there any Difference Regarding the Psychological Conditions of Cancer Patients in this
Period? .................................................................................................................................... 46
THE RISK OF REACTIVE OR MAJOR DEPRESSION WILL BE FURTHER
INCREASED ................................................................................................................................... 47
What are the General Messages? ............................................................................................ 47
RENAL FAILURE (RF), ACUTE KIDNEY INJURY (AKI) AND COVID-19 ....................... 47
LUNG-KIDNEY AXIS (LKA): A NEW PATHWAY FOR KIDNEY DAMAGE? ................. 48
CONCLUSION ............................................................................................................................... 49
REFERENCES ............................................................................................................................... 49
CHAPTER 4 RISKS AND LOSSES OF HEALTHCARE WORKERS IN THE PANDEMIC
ERA ........................................................................................................................................................... 54
PHENOMENA PROVEN TO INCREASE THE RISK OF COVID-19 TRANSMISSION IN
HCW ............................................................................................................................................... 55
Is COVID-19 Risky for HCW? ............................................................................................... 55
How much Risk COVID-19 Impose on HCW? ...................................................................... 56
HEADLINES FROM VARIOUS COUNTRIES ........................................................................ 56
THE SITUATION IN TURKEY ................................................................................................... 57
SITUATIONS INCREASING THE RISK OF INFECTION TO HCW ................................... 58
Findings ................................................................................................................................... 59
Precautions and Measures ....................................................................................................... 59
Personal Protective Equipment ............................................................................................... 60
Sequence of Control Measures ............................................................................................... 62
Infection Protection and Control Measures ............................................................................ 62
Psychosocial Problems in HCW During The Pandemics ....................................................... 65
What kind of Interventions can be Pursued to Support The Resilience and Mental Health of
Frontline HCW During The Pandemic? ................................................................................. 66
IS THERE ANY GOOD NEWS TO CONVEY? ......................................................................... 67
CONCLUSION ............................................................................................................................... 68
REFERENCES ............................................................................................................................... 69
CHAPTER 5 WHAT KIND OF DISEASE IS THIS? SIGNS AND SYMPTOMS, PREDICTORS
OF CLINICAL COURSE AND MANAGEMENT .............................................................................. 71
DO PATIENTS WHO ARE DIAGNOSED NECESSARILY HAVE SYMPTOMS? ............. 72
ASYMPTOMATIC AND SYMPTOMATIC… IS THERE A 3RD WAY? .............................. 73
Can A Mild-looking Patient Worsen Quickly? ....................................................................... 75
WHICH MARKERS CAN WE USE TO PREDICT CLINICAL WORSENING? ................. 76
RADIOLOGICAL CRITERIA ..................................................................................................... 78
TYPICAL CASE ............................................................................................................................. 79
HOW ARE COVID AND COUGH RELATED? ........................................................................ 81
Cough In Terms of Contagiousness ........................................................................................ 81
Pharmacological Methods To Relieve Cough ........................................................................ 82
GASTROINTESTINAL COMPLAINTS AND FINDINGS IN THE COURSE OF COVID-
19 ...................................................................................................................................................... 82
CORONA FACTS: WHICH IS CORRECT? .............................................................................. 84
CONCLUSION ............................................................................................................................... 89
REFERENCES ............................................................................................................................... 89
CHAPTER 6 DIAGNOSIS OF COVID-19: WHICH TESTS TO DO? LABORATORY AND
RADIOLOGICAL ADJUNCTS TO RECOGNITION ....................................................................... 92
LABORATORY TESTS ................................................................................................................ 93
Cytokines and Related Findings ............................................................................................. 96
Laboratory Values Can Also Highlight The Stages of The Disease ....................................... 96
Do Antibody Tests Give Accurate Results In The Early Period After Infection? .................. 100
CHEST IMAGING - RADIOLOGICAL EXAMINATIONS .................................................... 101
Which Should We Choose? X-ray, CT, USG, or MR? .......................................................... 101
CASE EXAMPLE AND TIME COURSE OF THE DISEASE .................................................. 107
CONCLUSION ............................................................................................................................... 111
REFERENCES ............................................................................................................................... 112
CHAPTER 7 CARDIOVASCULAR DISEASE, MYOCARDITIS, INFARCTIONS, AND
COVID-19 ................................................................................................................................................ 115
KEY FINDINGS FROM DIFFERENT DATABASE STUDIES ............................................... 115
ARE ETHNIC DIFFERENCES IMPORTANT FOR COVID-19? ........................................... 116
HT AND COVID-19 ....................................................................................................................... 117
MYOCARDIAL INJURY SEVERITY AND MORTALITY ..................................................... 119
How Much Myocardial Damage Occurs in COVID-19? ....................................................... 119
In Whom Does Myocardial Damage Occur and How Do We Identify It? ............................. 120
Any Pathological Finding? ..................................................................................................... 120
Global View of Myocardial Infarction (STEMI / NSTEMI) After COVID-19 ..................... 121
Did The Pandemic Affect Heart Attacks? .............................................................................. 122
What Should Be Done? ........................................................................................................... 125
COVID-19 and Myocardial Damage, Myocarditis ................................................................. 125
Fulminant Myocarditis (FM) ........................................................................................ 126
Symptoms and Signs in Myocarditis ............................................................................. 127
Ancillary Studies ........................................................................................................... 128
THROMBOTIC EVENTS, BLEEDING, COAGULOPATHIES, AND COVID-19 ............... 132
Cytokine-Mediated Alveolar Inflammation Triggers the Formation Of Microthrombi In The
Pulmonary Vasculature, Which Can Culminate Into Thrombi Or Embolism In Severe Cases 133
Increased D-dimer, PT, aPTT, CRP, ESR, and PCT Levels Noted on Presentation were
Found To Be Associated With Death In Covid-19 Patients (Al-Samkari et al., 2020) .......... 134
Additional Note: Mean Values Of Fibrinogen, Ferritin, Pct Are Also Higher In Patients
With Thrombosis .................................................................................................................... 134
Pathological Mechanism ......................................................................................................... 135
CONCLUSION ............................................................................................................................... 138
REFERENCES ............................................................................................................................... 138
CHAPTER 8 GASTROINTESTINAL SIGNS AND SYMPTOMS IN THE COURSE OF
COVID-19 ................................................................................................................................................ 143
INTRODUCTION .......................................................................................................................... 143
HOW IMPORTANT IS GIS IN THE PATHOPHYSIOLOGY OF THE VIRUS? ................. 144
Which GI Findings Do We Mention About? .......................................................................... 144
Children and GI Complaints ................................................................................................... 148
Inflammatory Bowel Diseases (IBD) and COVID-19 ............................................................ 149
Hepatic Damage and COVID-19 ............................................................................................ 149
CONCLUSION ............................................................................................................................... 151
REFERENCES ............................................................................................................................... 152
CHAPTER 9 IS OUR PSYCHOLOGY AFFECTED BY THE PANDEMIC? HOW? .................. 155
WHAT ARE STRESS REACTIONS? WHAT CAN WE DO? .................................................. 155
WHY ARE WE STRESSED DURING THIS PERIOD? ........................................................... 155
ADVERSE EMOTIONAL, PHYSICAL, OR COGNITIVE RESPONSES THAT ARISE IN
RESPONSE TO THE EFFECTS OF THE COVID-19 PANDEMIC INCLUDE .................... 156
COVID-19 and our Psychology: What do the Researchers Say? ........................................... 157
COVID-19 and Dealing with Stress ....................................................................................... 158
Coping with Stress .................................................................................................................. 159
Awareness of Emotions .......................................................................................................... 161
Social Relations ...................................................................................................................... 162
Try not to Disturb your Routine and Sleep Patterns ............................................................... 163
Do Hobbies Work? ................................................................................................................. 163
What Does Physical Activity Bring us? .................................................................................. 163
Bias and Stigmatization .......................................................................................................... 164
CONCLUSION ............................................................................................................................... 164
REFERENCES ............................................................................................................................... 164
CHAPTER 10 COVID-19 AND OUR BRAIN: WHAT'S NEW? ..................................................... 166
INTRODUCTION .......................................................................................................................... 166
HOW CAN COVID-19 AFFECT THE BRAIN AND NERVOUS SYSTEM? ......................... 168
WHAT KIND OF DAMAGE DOES COVID-19 CAUSE IN THE BRAIN? ............................ 168
WHAT KINDS OF NEUROLOGICAL SIGNS AND SYMPTOMS DO COVID-19 CAN BE
EVIDENT? ...................................................................................................................................... 169
DOES IT HAVE LONG-TERM EFFECTS ON THE CNS? ..................................................... 170
EFFECTS OF COVID-19 ON PEOPLE WITH NEUROLOGICAL DISORDERS ............... 170
DOES COVID-19 INCREASE THE RISK OF STROKE? ........................................................ 171
MANY PATIENTS MENTION LOSS OF SMELL / TASTE ................................................... 171
IS THERE AN ASSOCIATION BETWEEN ANOSMIA AND RESPIRATORY FAILURE? 172
DOES COVID-19 TRIGGER BRAIN TISSUE INFLAMMATION (ENCEPHALITIS)? ..... 173
WHAT ARE THE TREATMENT METHODS AFTER COVID-19 INFLICTS THE CNS? 175
CONCLUSION ............................................................................................................................... 175
REFERENCES ............................................................................................................................... 175
CHAPTER 11 COVID-19 PNEUMONIA AND ARDS: THE REAL KILLER? ............................ 179
DEFINITION .................................................................................................................................. 179
CLINICAL FEATURES ................................................................................................................ 181
DIAGNOSIS .................................................................................................................................... 182
THE MOST COMMON CT FINDINGS ON PRESENTATION (ADAPTED FROM PAN
ET AL, 2020) ................................................................................................................................... 184
DIFFERENTIAL DIAGNOSES .................................................................................................... 190
OTHER SITUATIONS TO BE DISTINGUISHED .................................................................... 190
SERUM ANTIBODY DETECTION ............................................................................................ 191
LABORATORY FINDINGS ......................................................................................................... 191
RISK FACTORS FOR SEVERE DISEASE ................................................................................ 192
ARDS ............................................................................................................................................... 193
Treatment of Pneumonia and ARDS ...................................................................................... 197
Hypoxia Management in Severe and Critical COVID-19 Patient ................................ 197
Specific Drug Treatments ....................................................................................................... 199
CONCLUSION ............................................................................................................................... 202
REFERENCES ............................................................................................................................... 203
CHAPTER 12 PREGNANCY, COVID-19, AND CHILDREN: DANGEROUS TRIO? ............... 207
WHAT ARE THE CHARACTERISTICS OF PREGNANT WOMEN WITH COVID-19? 208
Should there be a Different Warning for Pregnant Healthcare Workers? .............................. 208
Could the Pregnant Women with Covid-19 Transmit the Disease to the Baby? .................... 208
How is Protection from Covid-19 during Pregnancy? ............................................................ 209
What are the General Treatment Methods in Pregnant Women? ........................................... 209
Are the Drugs used in the Treatment of Covid-19 Harmful during Pregnancy? .................... 210
Can the Woman with COVID-19 Breastfeed her Baby? ........................................................ 210
Is there Anything to Pay Attention to After Birth? ................................................................. 210
Can Children Take COVID-19 Medications Used by Adults? ............................................... 211
COVID-19 IN CHILDREN: IT IS NOT A FAIRY TALE, IT IS A REALITY ....................... 212
Are the Children “Carriers of COVID-19”? ........................................................................... 213
Are the Signs and Symptoms in Children Different from Adults? ......................................... 213
Is COVID-19 more Risky for Children with Asthma or Allergies? What are the Risks? ...... 215
Are the Laboratory Findings Different in Children? .............................................................. 216
Which Children get COVID-19? ............................................................................................ 216
How is the Covid-19 Virus Transmitted to Children? ............................................................ 217
Should Masks and Gloves be used for Children who are Going Out Necessarily? ................ 217
Since The Mortality Rate in Children is Close to Zero, Covid-19 has Nothing to do with
Children, Right? ...................................................................................................................... 217
Should Children be Locked up at Home? ............................................................................... 218
Does the Baby's Breastfeeding Affect the Covid-19 Clinical Course? .................................. 218
How is the Diagnosis Made? .................................................................................................. 219
Imaging Principles for Pediatric COVID-19 Suspected Cases ............................................... 219
Can Sequential Cxr be Requested? ......................................................................................... 220
Can CXR be Ordered After Recovery? .................................................................................. 220
Discharge Criteria ................................................................................................................... 221
How Can we Tell Kids About COVID-19? ............................................................................ 222
CONCLUSION ............................................................................................................................... 225
REFERENCES ............................................................................................................................... 226
CHAPTER 13 COVID-19 AND THE ELDERLY: IS IT DIFFERENT FROM THE YOUNG? 229
WHAT KIND OF SYMPTOMS SHOULD RAISE SUSPICION OF COVID-19 IN THE
ELDERLY? ..................................................................................................................................... 230
IS THERE ANY DIFFERENCE BETWEEN OTHER EPIDEMICS AND COVID-19 IN
THIS REGARD? ............................................................................................................................ 230
IS COVID-19 DIFFERENT IN THE ELDERLY? ...................................................................... 230