Pathological Findings and Management of COVID-19 Patients: A Brief Overview of Modern-day Pandemic

Abstract

Today the world is facing one of the deadliest pandemics caused by COVID-19. This highly transmissible virus has an incubation period of 2 to 14 days. It acts by attaching to the angiotensin-converting enzyme (ACE2) with the help of glycoprotein spikes, which it uses as a receptor. Real-time polymerase chain reaction (PCR; rt-PCR) is the gold standard diagnostic test, and chest X-ray and computed tomography (CT) scan are the other main investigations. Several medications and passive immunization are in use to treat the condition. We searched using PubMed and Google Scholar using keywords such as COVID-19, coronavirus, and their combination with pathological findings, clinical features, management, and treatment to search for relevant published literature. After the removal of duplications and the selection of only published English literature from the past five years, we had a total of 31 papers to review. Most of the COVID-19 affected patients have mild pneumonia symptoms, and those with severe disease have comorbidities. Patients with COVID-19 had pathological findings, like ground-glass opacities, consolidations, pleural effusion, lymphadenopathy, and interstitial infiltration of inflammatory cells. Radiological changes show lung changes such as consolidations and opacities, and the pathological findings were infiltration of inflammatory cells and hyalinization. Patients with mild symptoms should self-quarantine, whereas those with severe acute respiratory distress syndrome (ARDS) are treated in the hospital. Medications under trial include antivirals, antibacterials, antimalarials, and passive immunization. Supportive treatment such as oxygen therapy, extracorporeal membrane oxygenation, and ventilator support can also be used. The symptoms shown by patients are very mild and selflimiting. There is no definitive treatment, although a combination of hydroxychloroquine and azithromycin have shown good results, and passive immunization also shows promising results, their safety profile is yet to be studied in detail.

A syndromic surveillance tool to detect anomalous clusters of COVID-19 symptoms in the United States

“…Metrics currently used to describe the progress of COVID-19 are based primarily on cases confirmed by laboratory tests, numbers of patients hospitalized and in intensive care, and counts of the number of deaths 1 , 2 . The data for each of these metrics, however, is temporally inconsistent and often delayed due to incubation time of the virus (2–14 days), the time from the onset of symptoms until clinical care is obtained, the time from test to confirmed test result, and, in the more severe cases, the time from hospital admission to death 2 , 3 . It is estimated existing epidemiological accounts of COVID-19, when measured in counts of confirmed cases or deaths, provides a snapshot of infections acquired 2–4 weeks previously 4 .…”

Respiratory Distress with Minimal Exertion: A Case of 2019 Novel Coronavirus (COVID-19) Pneumonia

“…8 CT chest findings in COVID-19 patients demonstrate bilateral ground glass opacities-most likely peripheralinitially and progress to multilobar consolidations. 9,10 The patient presented in this case had the typical laboratory and chest CT findings for COVID-19.…”

The possible techniques that used to improve the bioavailablity, pharmacological activity, solubility and permeability of anti-viral drugs: Insight for COVID-19 antiviral drugs

“…The first assessment of patients in the emergency room is based on how serious their symptoms seem to be. The majority of patients only complain of moderate symptoms, such as a high temperature, a persistent dry cough, general aches and pains, and sometimes shortness of breath [6] . In addition, some individuals may show up with sepsis or multi-organ failure on top of acute respiratory failure or acute respiratory distress syndrome.…”