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Covid-19

WOH Series Part 1: COVID-19 and Lungs

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The new coronavirus pandemic can cause infected lung complications such as pneumonia and, in more severe cases, acute respiratory distress syndrome (ARDS), and/or an hyperinflammatory state that can cause life-threatening effects to the lungs and other organs. This article will explore how COVID-19 first makes its way into the lungs and the possible lung complications it can cause in patients.

The virus that causes COVID-19 is SARS-CoV-2, which is part of the coronavirus family. The virus travels down your airways and can infect the upper or lower part of your respiratory tract, and the lining can become irritated and inflamed. In some cases, the infection can reach down into your tiny air sacs called alveoli, where oxygen and carbon dioxide are exchanged in your blood.

The advancement of the virus can restrict a person’s ability to take in oxygen. According to the World Health Organization (WHO), the most common diagnosis in severe cases of COVID-19 can cause patients to develop pneumonia. 

Pneumonia

Pneumonia is a lung infection in which the alveoli are inflamed. In pneumonia, the lungs become filled with fluid and inflamed, which leads to breathing difficulties. For some individuals, breathing problems can become severe enough to require treatment at the hospital with oxygen or even a ventilator.

Pneumonia caused by COVID-19 tends to affect both lungs, making air sacs in the lungs fill with fluid, limiting the lungs ability to take in oxygen and causing shortness of breath, cough, and other symptoms.

Most people can recover from pneumonia without any permanent lung damage, but pneumonia associated with COVID-19 may have lasting effects. It could take months to recover from breathing problems from lung injury even after the infection has passed.

Acute Respiratory Distress Syndrome (ARDS)

As COVID-19 pneumonia advances, more of the air sacs become filled with fluid leaking from the tiny blood vessels in the lungs. Eventually, shortness of breath begins and can lead to acute respiratory distress syndrome (ARDS), a form of lung failure. Patients with ARDS are often unable to breathe on their own and may require ventilator support to help circulate oxygen in the body. Whether it occurs at home or the hospital, ARDS can be fatal. People who survive ARDS and recover from COVID-19 may have lasting pulmonary scarring.

Hyperinflammation

Another complication of COVID-19 can lead tohyperinflammation. Hyperinflammation occurs when an infection enters and spreads through the bloodstream, causing tissue damage anywhere it reaches. The lungs, heart, and other body systems work together, and in hyperinflammation, the interoperability between the organs collapses. Entire organ systems may start to break down due to internal bleeding, in bacterial-induced sepsis, cardiovascular shock and death may ensue. A relatively rare condition in children referred to as Pediatric Multisystem Inflammatory Syndrome has recently emerged. The condition appears to be associated with COVID-19 infection but presenting with different symptoms and delayed by a week or more. Hyperinflammation represents an exaggerated immune response and thus occurs in young children, teenagers, and otherwise healthy adults. 

Superinfection

When someone is diagnosed with COVID-19, the immune system is working tirelessly to fight off the intruder. This can leave the body more susceptible to infection with another bacterium or virus on top of the COVID-19 — a superinfection. More infection can result in additional lung damage. Epidemiologists are concerned this is a distinct possibility during the Northern Hemisphere fall-winter flu season in late 2020.

The recovery process after a serious case of COVID-19 takes time for the lungs to heal properly. The injury to the lungs leaves scarring and takes three months to a year or more for the lungs to function pre-COVID-19 levels, according to Panagis Galiatsatos, M.D., M.H.S., an expert on lung disease at Johns Hopkins Bayview Medical Center.

Sources:

  1. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/what-coronavirus-does-to-the-lungs
  2. https://www.webmd.com/lung/what-does-covid-do-to-your-lungs#1
  3. https://www.webmd.com/lung/coronavirus-strains#1
  4. https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf
  5. https://www.hopkinsmedicine.org/health/conditions-and-diseases/sepsis
  6. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30691-7/fulltext
  7. https://www.hopkinsmedicine.org/profiles/results/directory/profile/4626291/panagis-galiatsatos
  8. https://www.hopkinsmedicine.org/johns_hopkins_bayview/

Covid-19

New Study Finds Children Can Spread COVID-19 as Much as Adults

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A new study from South Korea has discovered that children between the ages of 10 and 19 can spread COVID-19 just as much as adults. The extensive study, published by the Centers For Disease Control and Prevention, states that household transmission of the virus “was high” for those between 10 and 19 years old

Household transmission rates were lower for patients aged 0 to 9. Researchers examined reports for 59,073 contacts of 5,706 coronavirus patients in South Korea between January 20 and March 27. Dr. Ashish Jha, director of the Harvard Global Health Institute, told The New York Times that this study is one of the best to date concerning the coronavirus and transmission of the disease.

The results arrive as school officials across the nation determine whether or not to reopen schools for the upcoming year. The South Korean study said that the researchers’ findings of coronavirus transmission during school reopenings emphasize the need for a time-sensitive epidemiologic study to safeguard public health policy.

The study also indicated the effectiveness of contact tracing, especially in light of future waves of SARS-CoV-2, that will rely heavily upon social distancing and personal hygiene as primary factors for preventative measures. Awareness of the role hygiene and infection control measure plays is vital to reducing the household spread, and using masks in the home for family members who are at high risk for contracting the coronavirus needs further research.

Michael Osterholm, an infectious disease expert at the University of Minnesota, told The New York Times, that there will be transmission rates of the virus if schools reopen and include that in plans for preventing and limiting the contraction of the virus. 

Sources: 

  1. https://www.health.com/syndication/children-aged-10-19-spread-coronavirus-just-as-much-as-adults-new-study-finds
  2. https://wordofhealth.com/2020/06/27/young-californians-attribute-in-coronavirus-spike/
  3. https://wwwnc.cdc.gov/eid/article/26/10/20-1315_article
  4. https://www.hsph.harvard.edu/ashish-jha/
  5. https://www.nytimes.com/2020/07/18/health/coronavirus-children-schools.html
  6. https://wordofhealth.com/2020/04/02/is-social-distancing-helping-californians/
  7. https://wordofhealth.com/2020/06/17/how-to-fix-this-type-of-n95-mask-to-limit-the-spread-of-the-coronavirus/
  8. https://www.cidrap.umn.edu/about-us/cidrap-staff/michael-t-osterholm-phd-mph

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Covid-19

Video Laryngoscope Released in the U.S. for Faster Intubation During COVID-19

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Healthcare facilities worldwide are on the front lines during the ongoing COVID-19 pandemic by providing treatment for patients. Those who are in critical condition in intensive care units need intubation, but this process can be complicated by obtaining an airway precisely. Each patient varies; some can take a minute or more during intubation, potentially leading to fatal consequences. 

Nihon Kohden is launching its NK AWS-S200 video laryngoscope in the United States under the Pentax brand outside the United States. This device is designed to achieve intubation faster and on the first try. Furthermore, the company claims the product “can help protect clinicians while intubating patients suffering from COVID-19 or other respiratory infections”.

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The NK AWS-S20 features a high-definition color display targeting cross-hairs that help deliver the working end into the airway. A functioning channel allows for the endotracheal tube to be pushed while viewing the airway properly. 

There is a built-in-channel to guide the endotracheal tube and continuously observe the intubation process. The video laryngoscope can decrease the risk of oral and pharyngeal injury, such as mild mucosal bleeding and sore throat.

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Nihon Kohden mentioned that the NK AWS-S200  allows healthcare professionals to intubate challenging patients quicker than other competitor’s devices. The company expressed the device can help clinicians intubate patients with even difficult airways in  22.9 seconds, well below the 30-second threshold suggested for intubations and up to 33 seconds faster than other devices. 

Genoveffa Devers, DNP, MSHA, RN, CPHQ, VP of clinical and strategic alliances at Nihon Kohden stated the importance of tools to establish an airway quickly and efficiently as possible for healthcare providers. She added that the NK AWS-S200 video laryngoscope is designed to attain this while maintaining clinicians’ safety by limiting contact trying to visualize the vocal cords and larynx. 

Using the firm’s disposable NK PBLADE blades, which are available in four different sizes, help clinicians reduce cross-contamination between patients and those providing treatment.

In addition, when administering CPR, the video laryngoscope can be used to intubate patients without delaying life-saving treatment. 

Sources: 

  1. https://www.medgadget.com/2020/07/nihon-kohden-releases-video-laryngoscope-in-u-s-for-faster-intubation-during-covid.html
  2. https://www.webmd.com/lung/intubation-explained
  3. https://www.nihonkohden.com/

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Covid-19

‘COVID Symptom Study’ App Tracks Various COVID-19 Symptoms

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A new smartphone COVID-19 app that tracks symptoms has gathered information from more than 4 million people worldwide and gives doctors the ability to examine the different symptoms patients are experiencing with the virus. The mixture of various symptoms people are exhibiting with COVID-19 is unexpected.

According to Dr. Troy Pennington of Arrowhead Regional Medical Center in Colton, there are various forms of COVID-19 symptoms in patients. The application is called the COVID Symptom Study, was designed by healthcare professionals and scientists at Massachusetts General Hospital, The Harvard T.H. Chan School of Public Health, King’s College London and Stanford University School of Medicine, working beside ZOE, a health science company. Users can input their health information and get statistics on those participating around their region. 

Researchers grouped patients into six different clusters. The first cluster of patients are those experiencing mild symptoms who had flu-like symptoms, according to Pennington. The symptoms included body aches, possibly a sore throat, mild shortness of breath, and mostly mild symptoms, but no fever.

The second cluster of patients displayed similar symptoms, but with a fever. The third group of patients included gastrointestinal issues. Pennington added that there was a GI component with mild diarrhea or even an upset stomach. 

The fourth cluster of patients added severe fatigue, while the fifth added confusion as part of their symptoms. The sixth cluster consisted of patients experiencing the most severe symptoms, including abdominal and respiratory problems. This group had all of the common attributes of flu-like illness, but it had a very significant GI component with persistent abdominal pain and diarrhea. 

Pennington stated some of his patients at Arrowhead Regional Medical Center had exhibited even more peculiar symptoms such as unusual rashes and rashes that also looked like hives or chickenpox. Another patient was complaining of number fingers and toes. 

According to the study, the only common symptoms in all six clusters were headaches and loss of smell.

The COVID Symptom Study app has allowed physicians to get a closer look at COVID-19 symptoms patients experience to help healthcare professionals identify and treat patients accordingly. 

Sources: 

  1. https://abc7.com/covid-19-covid-symptoms-coronavirus-is-upset-stomach-and-diarrhea-a-symptom-of/6345955/
  2. https://wordofhealth.com/2020/07/11/pink-eye-symptom-of-covid-19/
  3. https://covid.joinzoe.com/us
  4. https://wordofhealth.com/2020/05/14/how-does-covid-19-affect-the-lungs/

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