| Hot Topic |
AUGUST , 2021 | THE HEALTH
23
Severe Covid-19 leads to sepsis !
Those who develop sepsis will need ICU close monitoring to prevent it developing into Covid-19 septic shock
WE HAVE been living with the pandemic for the past year and still trying to adapt and live our lives as normally as we can . SARS-CoV-2 , the most glamorous viral RNA of this century , is a virus from the family of coronavirus that causes the common cold symptoms which resembles its cousin the influenza virus . Both can cause a pandemic .
What is the different between influenza and Covid-19 ?
The influenza virus causes seasonal flu and usually involves the upper respiratory tract , ie . the nose and throat . There are different types of influenza virus which is Type A-D . However , the Influenza A viruses are the only influenza viruses that are known to cause flu pandemics .
Pandemics can occur when a new and very different type of influenza A virus emerges and has the ability to spread efficiently between people . Influenza type C infections generally cause mild flu and do not usually cause human flu epidemics . The other types of influenza virus are not really clinically significant .
The difference though between Covid-19 and the influenza virus is that influenza causes flu disease that eventually resolves without much consequences . On the other hand , Covid-19 causes a prolonged stay in the hospital , ICU and may cause death in those who are susceptible .
What are the clinical categories of Covid-19 ?
In the Covid-19 disease , there are five clinical stages identified . In category 1 , the patient does not show any symptoms . In category 2 , patients will have symptoms such as fever and sore throat , but do not have any lung involvement . In category 3 and 4 , the infection involves the lungs ,
SEPSIS ALERT
BY BY DR AZLIN ITHNIN
AND ASSOC PROF DR TAN TOH LEONG with or without oxygen dependency . In category 5 , the patient is critically ill with multi-organ involvement .
The majority of patients present with mild disease in category 1 to 3 . In patients who deteriorate , the disease often progresses to a more severe condition needing oxygen supplementation and ICU care .
This deterioration can be due to progression into sepsis , where we may get a hyper- and hypo-inflammatory stage associated with rapidly worsening pneumonia and organs failure . Other factors that can cause a patient to deteriorate may include the viral effect of the disease itself , patients with diabetes and high blood pressure , and complications such as thromboembolism ( where you develop blood clots within the blood vessels ) or nosocomial pneumonia ( when you develop lung infection from the hospital environment ).
Monitoring the illness
In order for early detect the progression of Covid-19 into sepsis , the illness is monitored using a special scoring system known as the Sequential Organ Failure Assessment or SOFA score .
SOFA score was scored based on six different organs functions . They are respiratory , cardiovascular , liver , blood hemostasis , urinary and neurological systems with each score from 0 to 4 with an increasing score reflecting worsening organ function .
Those who develop sepsis will need ICU close monitoring to prevent it developing into Covid-19 septic shock . The issue of a prolonged stay in the ICU for each Covid-19 septic shock patient causes a reduced chance for the next critically ill patient to be admitted in the ICU as well .
Thus , let us all play our part in fighting this viral pandemic by staying at home whenever possible , wear masks when we need to go out , wash our hands or sanitise them frequently and use technology advancement in our social and work activities .
May this pandemic resolve fast and may we be more prepared when the next pandemic knocks on our doors again in the future . — The Health
Dr Azlin Ithnin is Senior Lecturer and Chemical Pathologist Consultant , UKM Medical Center , Universiti Kebangsaan Malaysia ( UKM ) and Vice President of Malaysian Sepsis Alliance while Assoc Prof Dr Tan Toh Leong is Senior Lecturer and Emergency Medical Consultant , UKM Medical Center , UKM and President and Founder of Malaysian Sepsis Alliance .
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