Covid-19

Exam Cram

• Responsible for the pandemic from 2020

• Management (2024)

  • • Oxygen requirement: dexamethasone 6mg OD 10d (recovery trial)

    • Remdesivir, tocilizumab, molnupiravir and paxlovid also used by different trusts

Discussion

Remdesivir

Indication:

1. Treatment of covid pneumonitis (hypoxia)

2. Prevention of covid pneumonitis 

Remdesivir for treatment of covid can only be started in an individual who is hypoxic. 

For prevention, remdesivir should be started within 72hrs of onset of symptoms. 

Corticosteroids

One of the difficulties in covid-19 is how the disease changed and the our bodies changed having been vaccinated. The acute covid-19 hypoxia in young individuals associated with the earlier strains I have not seen since 2022. This has been replaced with the co-morbid frail population whose hypoxia with covid-19 is more because of their lack of reserve. These patients in 2024 don't currently have CXR changes of pneumonitis. This had led some to hypothesise the appropriateness of steroids in all hypoxia covid-19 patients. However, without further data, steroids in hypoxic patients are currently a core standard of care. 

Written in 2024