When a disease called coronavirus began to appear, the doctors ran into problems because they did not have any information about this family. At the moment, the situation has moved only a little, because there is little knowledge, there are only some statements about prevention, the vaccine has not been invented.
All scientists know that with such an infection, a disease such as pneumonia is most manifested, a significant number of patients have reported the development of acute respiratory distress syndrome. Cases of renal failure, pericarditis, and disseminated intravascular coagulation have also been detected.
Types of clinical samples for research on the presence of coronavirus
For doctors to establish the presence of coronavirus, it is necessary to take an analysis from different places. Let’s get acquainted with this Information.
If a person coughs and secretes phlegm, he can conduct an analysis there. The report is transported when freezing with dry ice if it takes more than a day.
Bronchoalveolar lavage, with this method, makes a solution that enters the lungs and bronchi, after which the extracted mixture from the respiratory tract is carefully studied. It is also frozen if the transport is more than a day.
A tracheal aspirate is such a festering fluid that is taken from the trachea to be examined for the presence of the virus.
The nasopharyngeal aspirate is the same festering fluid that is taken from the nose.
A combined smear from the nose and pharynx, the material for the analysis, is discharged from the mucous membrane of these organs.
Whole blood is a fluid in which all the formed elements of the blood, leukocytes, thrombocytes, erythrocytes are looked at if any of these elements is excreted most.
When all tests are taken, and the virus is confirmed, the coronavirus caused will be based on the identification of unique viral RNA sequences using the reverse transcription-polymerase chain reaction at the same time.
Several blood samples should also be collected. The first test is taken in the first week of the disease. The second time, a blood test is taken after two weeks. The analysis will be stored as long as possible.
A general clinical blood test and a series of biochemical tests with monitoring of the gas composition of the blood should also be included in the complex of laboratory examination of patients. If an infection is detected, then leukopenia, lymphopenia, thrombocytopenia, and elevated levels of lactate dehydrogenase are always observed.
A differential diagnosis should be carried out for all diseases that occur with the respiratory syndrome. Identification of pathogens of other acute respiratory infections should not exclude testing.
Important indicators for determining infection
Our Ministry of Health decided which indicators are needed to quickly and accurately diagnose, and whether there are serious complications, whether it will progress.
- A patient who has suspected coronavirus. First, an examination is carried out for the presence of any infection. Measure the temperature; if it is above 38 ° C, then try to find out the reason for such a sharp increase. Is there a cough? Did the person have pneumonia? Whether he was in a country where there was an outbreak of the virus or in any neighboring country ten days before the onset of clinical symptoms. Examination of a patient for community-acquired pneumonia is carried out following the current examination standards. To perform a coronavirus test, it is not necessary to expect the results of a study for other SARS.
- Poor pneumonia. For the presence of pneumonia, children and adults who have a loud cough and fever, with too much breathing, will be tested.
- Severe sepsis. Sepsis accompanied by organ dysfunction, hypoperfusion (lactic acidosis), or hypotension. Organ dysfunction can be manifested by acute oliguria impaired renal function, hypoxemia, increased activity of hepatic transaminases, coagulopathy, thrombocytopenia, a change in mental state, intestinal obstruction, or hyperbilirubinemia.
- Septic shock. Hypotension induced by sepsis (SBP <90 mm Hg), despite infusion therapy with adequate volumes of fluids as a resuscitation measure, and signs of hypoperfusion.
Clinical management and treatment of patients with infection
If a virus is suspected, patients are exposed hospitalization in an infectious diseases hospital in compliance with all preventive measures.
Hospitalizations are subject to:
- Persons with a fever who visited the country 14 days before the onset of the first symptoms of the disease or who had close contact with the patient.
- Those people who were in a medical institution (as a patient, employee, or visitor) where cases of the MERS-CoV virus are epidemiologically related.
Treatment of the disease is carried out according to the treatment regimen for patients with influenza. Hospitalized patients with infection should be placed in boxes or separate rooms. If necessary, intensive care of patients is delivered to the nearest intensive care unit or intensive care unit. All patients who do not have serious concomitant metabolic diseases (e.g., diabetes mellitus) and other acute conditions should receive food according to the 15th dietary table. An unconscious patient and those on mechanical ventilation should receive appropriate parenteral nutrition in the treatment regimen; patients with infection should include support for pathogenetic therapy and prevention of complications and adverse outcomes.
Etiotropic tablets should be prescribed as early as possible (in the first hours/days of illness).
As a broad-spectrum antiviral drug, ribavirin can be recommended as a pill, which has been successfully used in the treatment of SARS infections in China, Singapore, and other countries. In the absence of signs of respiratory failure and symptoms of laryngospasm, an inhalation solution of ribavirin may be used.
In 2004, in the cell culture and on the model of Syrian hamsters, data were obtained on the activity of the drug Arbidol (Umifenovir) in relation to coronavirus – the causative agent of SARS (SARS. Since coronavirus has an affinity for coronavirus that caused an outbreak of SARS, the results allow us to consider Umifenovir as a potential prevention and treatment of human infections. The drug is recommended to be used four times 200 mg per day every 6 hours.
In the early stages of the disease, neuraminidase inhibitors and interferon inducers (meglumine acridone acetate, tilorone) can be used.
The products of lung elastin proteolysis are the inducers of the terminal stages of the “cytokine storm.” In this regard, it is advisable to use proteolysis/protease inhibitors:
- Aprotinin (Kontrikal) – in / on (slowly), jet or the drip of 10000-20000 ATPE (contents of 1-2 ampoules) per day within 5-7 days.
To enhance the antiviral effect, the use of antioxidant therapy is indicated, which can also perform a cytoprotective function.
The appointment of flavonoids and vitamins is recommended:
- Rutoside (Rutin, Ascorutin) – 1-2 tablets 3-4 once a day;
- Dihydroquercetin (dihydroquercetin tablets, Diquertin, Dihydroquercetin NTG, Araglin D);
- Vitamin E – 100-300 mg / day;
- Vitamin C – 50-100 mg 3-5 times a day after meals.
Studies are currently underway to find potentially useful drugs for MERS CoV infection. In this regard, the antiviral 26 the action of several already known drugs used for other diseases.
All patients with this infection will be prescribed the same treatment as those who are sick with pneumonia. Also, antibacterial drugs will be used in the procedure. All medicines will be used only by those that are at the Ministry of Health.
Prevention Measures patient
- The patient must be insulated in a box infectious diseases hospital.
- Medical personnel must use the fund’s personal protective equipment; hand hygiene must be observed. Hand hygiene in medical facilities can be made by washing with soap under running water.
- Health status of health workers should be monitored within 14 days after the last contact with the patient. Patient visits by relatives and friends should be limited, and should also be minimized the number of personnel having direct communication with the patient.
- After a potentially infected patient leaves boxing, you need to spend the final disinfection and ventilation of the box for 1-2 hours for air exchange. To prevent the entry of infection into the territory. When traveling to countries in case of if necessary, it is recommended to use protective masks and refrain from visiting crowded places and contact with sick people with a high fever.
- Raw foods should be avoided—food products derived from camels (milk, meat). When symptoms of a respiratory illness appear to wear a mask and immediately apply for health care, with fever or flu symptoms when returning from a trip, you should immediately consult a doctor by providing Information about the countries visited and the length of stay.
There is currently no cure for any coronavirus. Doctors can treat respiratory problems. Also, do prophylaxis by treating symptoms, for example, lowering the temperature.
At home, in the presence of symptoms of a cold, we recommend: take care of good sleep, stay quiet and calm, relax more, make sure you stay warm and not freeze, drink plenty of water, as water removes all unnecessary toxins from the body, if the room has dry air, it is better to take a drug that will moisturize it.