COVID 19
DEFINITION OF COVID-19
A highly contagious respiratory disease caused
by the SARS-CoV-2 virus. SARS-CoV-2 is thought
to spread from person to person through droplets
released when an infected person coughs, sneezes,
or talks. It may also be spread by touching a surface
with the virus on it and then touching one’s mouth,
nose, or eyes, but this is less common. The most
common signs and symptoms of COVID-19 are
fever, cough, and trouble breathing. Fatigue, muscle
pain, chills, headache, sore throat, runny nose,
nausea or vomiting, diarrhea, and a loss of taste or
smell may also occur. The signs and symptoms may
be mild or severe and usually appear 2 to 14 days
after exposure to the SARS-CoV-2 virus. Some
people may not have any symptoms but are still
able to spread the virus. Most people with COVID-
19 recover without needing special treatment. But
other people are at higher risk of serious illness.
Those at higher risk include older adults and people
with serious medical problems, such as heart, lung,
or kidney disease, diabetes, cancer, or a weak
immune system. Serious illness may include life-
threatening pneumonia and organ failure. Research
is being done to treat COVID-19 and to prevent
infection with SARS-CoV-2. Also called
coronavirus disease 19.
I. COVID-19 VARIANTS
There are thousands of different types - or
variants - of Covid circulating across the world.
One of them, known as Delta or B.1.617.2, appears
to be spreading quickly in many countries including
the UK, where it has become the dominant variant.
The UK classes Delta as a "variant of concern" -
these are kept under the closest watch by health
officials.
Other current variants of concern also include:
 Alpha (B.1.1.7), first identified in the UK but
which spread to more than 50 countries
 Beta (B.1.351), first identified in South Africa
but which has been detected in at least 20 other
countries, including the UK
 Gamma (P.1), first identified in Brazil but
which has spread to more than 10 other
countries, including the UK
Viruses mutate all the time and most changes are
inconsequential. Some even harm the virus. But
others can make the disease more infectious or
threatening - and these mutations tend to dominate.
TRANSMISSION OF COVID19
Person-to-Person Transmission
Experts believe the virus that causes COVID-19
spreads mainly from person to person. There are
several ways this can happen:
 Droplets or aerosols. This is the most common
transmission. When an infected person coughs,
sneezes, or talks, droplets or tiny particles called
aerosols carry the virus into the air from their nose
or mouth. Anyone who is within 6 feet of that
person can breathe it into their lungs.
 Airborne transmission. Research shows that the
virus can live in the air for up to 3 hours. It can get
into your lungs if someone who has it breathes out
and you breathe that air in. Experts are divided on
how often the virus spreads through the airborne
route and how much it contributes to the
pandemic.
 Surface transmission. A less common method is
when you touch surfaces that someone who has
the virus has coughed or sneezed on. You may
touch a countertop or doorknob that's
contaminated and then touch your nose, mouth,
 or eyes. The virus can live on surfaces like plastic  Containment of the infection with viral
and stainless steel for 2 to 3 days. To stop it, clean clearance in about 80% of patients in 10-14
and disinfect all counters, knobs, and other days
surfaces you and your family touch several times o It takes 5–6 days on average for symptoms to
a day. appear once a person is infected with the virus,
but it can take up to 14 days.
 Involvement of the conducting airways
o Upper respiratory tract and migration into the
lower respiratory tract
SIGNS AND SYMPTOMS  Invasion and infection of the type 2
Most common symptoms: Pulmonary alveolar epithelial cells via ACE-
 fever 2
 cough  CYTOKINE STORM
 tiredness  An severe inflammatory response to
 loss of taste or smell COVID-19 infection is followed by the
Less common symptoms: production of a high number of pro-
 sore throat inflammatory cytokines, a phenomenon
 headache known as "cytokine storm." The SARS-
 aches and pains CoV-2 virus triggers a hyperactive
 diarrhoea immunological response in the host,
 a rash on skin, or discolouration of fingers resulting in an excessive inflammatory
or toes red or irritated eyes response.
Serious symptoms: o Chemo-attraction For Neutrophils, CD4 and
difficulty breathing or shortness of breath CD8 cells along with B cell differentiation
loss of speech or mobility, or confusion
chest pain o Host defence and attempt of viral clearance
PATHOPHYSIOLOGY

 Virus entry into the Host  Viral replication and Release of viral

 Binding of the Inhaled SARS-CoV2 to the particles with resulting apoptosis of the host

ciliated secretory cells in the nasal cells

epithelium via ACE-2 o Continuing Viral replication

o SARS-CoV-2 enters the upper respiratory tract  With infection of the adjacent healthy

through respiratory aerosols and binds to nasal alveolar epithelial cells, with loss of

epithelial cells. The ACE-2 receptor is the both type 2 and type 1 pneumocytes

primary host receptor for viral entrance into  Diffuse Alveolar Damage with Resulting

cells, and it is shown to be highly expressed in ARDS

adult nasal epithelial cells.  Patient Diagnosed with COVID-19

 Viral replication and Local propagation with

a limited immune response  Mild Disease:
o Symptoms of upper respiratory tract infection.
o Fever
  Moderate Disease: produces these antibodies — proteins that are
o Symptoms of Pneumonia critical for fighting and clearing out the virus.
 Severe Disease:
Preventive Measures
o Respiratory Distress requiring Mechanical
Keep yourself and others safe: Do it all!
Ventilation
Protect yourself and those around you:

 Get vaccinated as soon as it’s your turn and

follow local guidance on vaccination.
 Keep physical distance of at least 1 metre

Diagnostic/Laboratory Test from others, even if they don’t appear to be

sick. Avoid crowds and close contact.
PCR test. Also called a molecular test, this COVID-
 Wear a properly fitted mask when physical
19 test detects genetic material of the virus using a
distancing is not possible and in poorly
lab technique called polymerase chain reaction
ventilated settings.
(PCR). A fluid sample is collected with a nasal
 Clean your hands frequently with alcohol-
swab or a throat swab, or you may spit into a tube to
based hand rub or soap and water.
produce a saliva sample. Results may be available
 Cover your mouth and nose with a bent
in minutes if analyzed onsite or a few days — or
elbow or tissue when you cough or sneeze.
longer in locations with test processing delays — if
Dispose of used tissues immediately and
sent to an outside lab. PCR tests are very accurate
clean hands regularly.
when properly performed by a health care
 If you develop symptoms or test positive for
professional, but the rapid test can miss some cases.
COVID-19, self-isolate until you recover.
Antigen test. This COVID-19 test detects certain
Wear a mask properly
proteins in the virus. Using a nasal swab to get a
fluid sample, antigen tests can produce results in To properly wear your mask:
minutes. Others may be sent to a lab for analysis. A
 Make sure your mask covers your nose,
positive antigen test result is considered accurate
mouth and chin.
when instructions are carefully followed, but there's
 Clean your hands before you put your mask
an increased chance of false-negative results —
on, before and after you take it off, and after
meaning it's possible to be infected with the virus
you touch it at any time.
but have a negative result. Depending on the
 When you take off your mask, store it in a
situation, the doctor may recommend a PCR test to
clean plastic bag, and every day either wash
confirm a negative antigen test result.
it if it’s a fabric mask or dispose of it in a
Antibody testing, also known as serology testing, is trash bin if it’s a medical mask.
usually done after full recovery from COVID-19.  Don’t use masks with valves.
Eligibility may vary, depending on the availability
Make your environment safer
of tests. A health care professional takes a blood
sample, usually by a finger prick or by drawing The risks of getting COVID-19 are higher in
blood from a vein in the arm. Then the sample is crowded and inadequately ventilated spaces where
tested to determine whether you've developed infected people spend long periods of time together
antibodies against the virus. The immune system in close proximity.
Outbreaks have been reported in places where
people have gather, often in crowded indoor settings
and where they talk loudly, shout, breathe heavily
or sing such as restaurants, choir practices, fitness
classes, nightclubs, offices and places of worship.
To make your environment as safe as possible:
 Avoid the 3Cs: spaces that are closed,
crowded or involve close contact.
 Meet people outside. Outdoor gatherings are
safer than indoor ones, particularly if indoor
spaces are small and without outdoor air
coming in.
 If you can’t avoid crowded or indoor
settings, take these precautions:
 Open a window to increase the amount of
natural ventilation when indoors.
 Wear a mask (see above for more details).
Keep good hygiene
By following good respiratory hygiene you protect
the people around you from viruses that cause
colds, flu and COVID-19.
To ensure good hygiene you should:
 Regularly and thoroughly clean your hands
with either an alcohol-based hand rub or
soap and water. This eliminates germs that
may be on your hands, including viruses.
 Cover your mouth and nose with your bent
elbow or a tissue when you cough or sneeze.
Dispose of the used tissue immediately into
a closed bin and wash your hands.
 Clean and disinfect surfaces frequently,
especially those which are regularly
touched, such as door handles, faucets and
phone screens.
MED. SURG MANAGEMENT
Coronavirus Treatment at Home
 If your symptoms are minor and you think
you'll be able to heal at home, you should:
 Rest. It can help you feel better and has the
potential to speed up your recuperation.
 Remain at home.
 Do not go to work, school, or any other
public location.
 Drink plenty of water. When you're ill, you
lose more water. Dehydration can
exacerbate symptoms and lead to additional
health issues.
 Monitor.
 Call your doctor straight away if your
symptoms worsen.
 Do not visit their office without previously
contacting them. They may instruct you to
stay at home or take extra precautions to
safeguard staff and other patients.
 Ask your doctor about over-the-counter
medications like acetaminophen, which can
help reduce your fever.
 The most important thing to remember is to
avoid infecting others, particularly those
over 65 or with severe health issues.
COVID Treatment in a hospital
If condition is severe, medical personnel will look
for indicators that the disease is creating more
significant issues. They could:
 Check the levels of oxygen in your blood
with a clip-on finger monitor
 Listen to your lungs
 Give you a COVID-19 test. This involves
putting a 6-inch cotton swab up both sides of
your nose for about 15 seconds.
 Give you a chest X-ray or CT scan
Two tiny tubes placed just inside your nose can
provide more oxygen. Doctors will link you to a
ventilator, which is a machine that can breathe for
you.
To prevent dehydration, you may also receive fluids Provide information – educate the patient and
through an IV in your arm. Your respiration will patient’s family members of the transmission of
also be carefully monitored by doctors. The COVID-19, the tests to diagnose the disease,
objective is for your infection to clear up and your disease process, possible complications, and ways
lungs to recover sufficiently to allow you to breathe to protect oneself and one’s family from
normally again. coronavirus.

NURSING INTERVENTION

Monitor vital signs – particularly temperature and

respiratory rate, as fever and dyspnea are common
symptoms of COVID-19.

Monitor O2 saturation – normal O2 saturation as

measured with pulse oximeter should be 94 or
higher; patients with severe COVID-19 symptoms
can develop hypoxia, with values dropping low
enough to warrant supplemental oxygen.

Manage fever – use appropriate therapy for

hyperthermia, including adjusting room
temperature, eliminating excess clothing and
covers, using cooling mattresses, applying cold
packs to major blood vessels, starting or increasing
intravenous (IV) fluids as allowed, administering
antipyretic medications as prescribed, and readying
oxygen therapy in the event of respiratory problems
resulting from the metabolic demands for oxygen
during a fever.

Maintain respiratory isolation – isolation rooms

should be well-marked with limited access; all who
enter the restricted-access room should use personal
protective equipment, such as masks and gowns.

Enforce strict hand hygiene – to reduce or prevent

transmission of coronavirus, patients should wash
hands after coughing, as should all who enter or
leave the room.