SARS COV 2

SARS-COV 2 VIRUS

single-stranded positive-sense RNA

membrane protein (M)

spike protein (S)

envelope protein (E)

nucleocapsid protein (N) formed the capsid outside the genome and the genome is further packed by an envelope which is associated with three structural proteins: ___, ___, ___

COVID 19

causes _____ pandemic

Is the THIRD ZOONOTIC Human Coronavirus of the

century, following:

1. SARS-CoV.

2. MERS-CoV.

o Fever.

o Tiredness.

o Dry Cough.

Few patients experience aches and pains, nasal

congestion, runny nose, sore throat, or diarrhea.

MOST COMMON SYMPTOMS (WHO)

False. MILD SYMPTOMS that start gradually.

T/F. Patients usually have severe symptoms.

SERIOUSLY ILL

• Only around 1 of 6 patients manifest with DIFFICULTY breathing and become _____.

True.

T/F. Most patients recover without needing any special

treatment.

• Bamlanivimab PLUS Etesevimab - (AIIa).

• Casirivimab PLUS Imdevimab - (AIIa).

MONOCLONAL ANTIBODIES Treatment

Remdesivir - causes premature

termination of RNA Transcription (BIIa).

ANTIVIRAL Treatment

• Dexamethasone - (AI).

INTERLEUKIN-6 INHIBITORS

• Anti-inflammatory.

• Tocilizumab - (BIIa).

CORTICOSTEROID

• Anti-inflammatory.

o A - Strong.

o B - Moderate.

o C - Optional.

RATING OF RECOMMENDATIONS

o I - one or more randomized WITHOUT major limitations.

o IIa - other randomized trials or SUBGROUP ANALYSES of

randomized trials.

o IIb - NONRANDOMIZED trials or Observational Cohort

Studies.

o III - EXPERT Opinion.

RATING OF EVIDENCE

•For patients who are not at high risk for

disease progression, provide -

Supportive Care and Symptomatic

Management (Alll).

• For patients who are at high risk of

disease progression (as defined by the

FDA EUA criteria for treatment with anti-

SARS-CoV-2 monoclonal antibodies), use

one of the following combinations:

o Bamlanivimab PLUS Etesevimab -

(AIIa).

o Casirivimab PLUS Imdevimab -

(AIIa).

Panels' Recommendations to:

NOT Hospitalized, Mild to Moderate COVID-19

• There are insufficient data to recommend

either for or against the routine use of

REMDESIVIR.

• For patients at high risk of disease

progression, the use of REMDESIVIR

may be appropriate.

Panels' Recommendations to:

Hospitalized but DOES NOT Require Supplemental

Oxygen

• Use one of the following options:

o Remdesivir - for patients who

require MINIMAL supplemental

oxygen (BIIa).

o Dexamethasone PLUS Remdesivir

• for patients who require

INCREASING amounts of

supplemental oxygen (BIII).

o Dexamethasone - when

combination therapy with

Remdesivir cannot be used or is not

available (BI).

Panels' Recommendations to:

Hospitalized and REQUIRES Supplemental Oxygen

• Use one of the following options:

o Dexamethasone - (AI).

o Dexamethasone PLUS Remdesivir

• (BIII).

• For patients who were recently

hospitalized with rapidly increasing

oxygen needs and systemic inflammation:

o Add Tocilizumab to one of the two

options above - (BIIa).

Panels' Recommendations to:

Hosptialized and

Requires Oxygen

Delivery Through a

High-Flow Devise or

Non-Invasive

Ventilation

• Dexamethasone - (AI).

• For patients who are WITHIN 24 HOURS of admission to the ICU: