Acute Respiratory Distress Syndrome (ARDS)
Emergency complications develops in ~20% of severe/critical COVID patients.
It results from excessive pathological immune response to viral pathogen.
The cytokine storm that follows is a form of virus induced haemophagic lymphohistiocytosis.
ARDS causes severe oxygen diffusion impairment.
The severity of ventilatory impairment can be quantified by PF Ratio; See link for PF Ratio calculation:
- Mild – PF ratio 200-300mmHg
- Moderate – PF ratio 100-200mmHg
- Severe – PF ratio <100mmHg
Many online calculators are available online, this is one such example:
Critical COVID
The following pages detail complications associated with critical COVID:
COVID Definitions
COVID 19 is broadly divided into 4 categories which are closely aligned with clinical presentation and level of care required.
Click on each to find out more:
Sepsis
Organ dysfunction caused by dysregulated host response to suspected or proven infection as evidenced by:
- Altered mental state
- hypoxia
- reduced urine output
- tacharrythmia
- peripherally shutdown
- low BP
- skin changes
- coagulopathy
- thrombocytopenia
- acidosis
- high lactate
- hyperbilirubinaemia
Septic Shock
Persistent hypotension refractory to volume resuscitation, often with serum lactate >2mmol/Land requires vasopressors to maintain MAP >65mmHg.
Severe COVID
Typically aged >55, immunosuppressed, co-morbidities
Presentation observations:
RR>24, HR>125bpm, Sp02 <92% on air
Biochemical analysis:
D-Dimer >1000ng/ml, trop I > 34ng/L, Ferritin >300ug/L, Lymphocytes <0.8×109/L
+/- Pneumonia = Radiographic changes e.g. pulmonary infiltrates/consolidation.
Non-severe COVID
Patients with uncomplicated upper respiratory tract viral infection, may have non-specific symptoms such as:
- fever
- fatigue
- cough (with or without sputum)
- anorexia
- malaise
- muscle pain
- sore throat
- dyspnoea
- nasal congestion
- headache or ansomia
Managed at home
Defining COVID
