Query COVID

Question 1

What are the 7 commonest symptoms of COVID?

Answer 1

1. Fever
2. New and continuous cough
3. Shortness of breath
4. Ftigue
5. Loss of appetite
6. Anosmia (loss of smell)
7. Aguesia (loss of taste)

Question 2

What are 9 less common symptoms of COVID?

Answer 2

1. Headache
2. Muscle pain
3. Sore throat
4. Nasal congestion
5. Chest pain
6. Nausea and vomiting
7. Diarrhoea
8. Skin rashes (especially younger people)
9. Delirium and reduced mobility in elderly and immunocompromised

Question 3

What is the recommended approch to management of patients with suspected COVID?

Answer 3

• do not attend GP practice, contact NHS 111 online if symptoms severe enough to warrant interaction with health services
• If mild symptoms, advise to stay at home
• Advise to self-isolate and arrange for swab test by booking online or if not possible call appropriate telephone numbers (119 in England)

Question 4

What are 3 reasons why people should contact NHS 111 online for telephone assessment if they have suspected COVID?

Answer 4

1. Unable to self-care
2. Severe symptoms
3. Immunosuppressed

Question 5

What are 4 criteria to be applied to admit someone with suspected coronavirus to hospital?

Answer 5

1. Hospital pracititioner has decided admission to hospital is required with an expectation that the patient will need to stay at least 1 night and
2. Have either clinical or radiological evidence of pneumonia or
3. Acute respiratory distress syndrome or
4. Influenza-like illness: fever ≥37.8°C and at least one of the following respiratory symptoms, which must be of acute onset:
   
   • persistent cough (with or without sputum),
   • hoarseness,
   • nasal discharge or congestion,
   • shortness of breath,
   • sore throat,
   • wheezing,
   • sneezing

Question 6

What is the isolation advice for people with suspected covid?

Answer 6

• isolate for 10 days after symptoms started
• can stop after 10 days if:
  
  • no symptoms
  • only have cough or changes to sense of smell or taste - can last for weeks after infection

Question 7

What are 4 reasons why you should continue to self-isolate after the 10 day isolation period is up?

Answer 7

1. A high tempearture, or feel hot and shivery
2. A runny nose or sneezing
3. Nausea or vomiting
4. Diarrhoea

Question 8

What is the advice for isolation if you live with someone who has symptoms or tests positive?

Answer 8

• self-isolate for 14 days (takes 14 days for symptoms to appear)
• starts from when first person in home started to have symptoms or day they were tested; if symptoms subsquent to test, isolate further 14 days from when symptoms started

Question 9

What should a person do if they develop symptoms while self-isolating?

Answer 9

book a test and keep self-isolating for remainder of 14 days

if test positive, self-isolate for 10 days from when symptoms started; may mean self-isolate for longer than 14 days

Question 10

What is the advice if you may have been in contact with someone with coronavirus infection?

Answer 10

if told to isolate by Test and Trace app, should isolate for 14 days from day they were last in contact with person who tested positive

Question 11

What are the 2 levels of people who are at higher risk?

Answer 11

1. High risk - clinically extremely vulnerable
2. Moderate risk - clinically vulnerable

Question 12

What are 10 groups who are at high risk from COVID?

Answer 12

1. Had organ transplant
2. Having chemotherapy or antibody treatment for cancer including immunotherapy
3. Having intense course of radiotherapy (radical radiotherapy) for lung cancer
4. Having targeted cancer treatments that can affect the immune system (such as protein kinase inhibitors or PARP inhibitors)
5. Have blood or bone marrow cancer (such as leukaemia, lymphoma or myeloma)
6. Have had bone marrow or stem cell transplant in in past 6 months, or are still taking immunosuppressant medicine
7. Have been told by Dr they have a severe lung condition (e.g. CF, severe asthma, severe COPD)
8. Have a condition that means they have a very high risk of getting infections such as SCID or sickle cell
9. Are taking medicine that makes them much more likely to get infections (such as high doses of steroids or immunosuppressant medicine)
10. Serious heart condition and are pregnant

Question 13

What are 11 things that put you at moderate risk from coronavirus?

Answer 13

1. Are aged 70 years or over.
2. Have a lung condition that’s not severe (such as asthma, COPD, emphysema or bronchitis).
3. Have heart disease (such as heart failure).
4. Have diabetes.
5. Have chronic kidney disease.
6. Have liver disease (such as hepatitis).
7. Have a condition affecting the brain or nerves (such as Parkinson’s disease, motor neurone disease, multiple sclerosis or cerebral palsy).
8. Have a condition that means they have a high risk of getting infections.
9. Are taking medicine that can affect the immune system (such as low doses of steroids).
10. Are very obese (a body mass index [BMI] of 40 or above).
11. Are pregnant

Question 14

What are 4 recommendations for women who are pregnant?

Answer 14

1. Wash their hands regulaly
2. Stay at home as much as possible and follow advice on social distancing
3. Stay away from anyone who has symptoms of coronavirus
4. Go to all of antenatal scans and appointments unless advised not to

Question 15

What are 5 options for how to assess a patient with suspected COVID and how should the decision be made?

Answer 15

1. Telephone consult
2. Video call
3. F2F in surgery
4. Covid hot clinic referral
5. 999

should be shared decision about location of care

Question 16

If someone presents with cough and temperature how should you manage them?

Answer 16

initially suspecting covid - virtual assessment ?video. if need pulse oximetry - hot clinic

Question 17

Why is pulse oximetry important when assessing a patient with suspected COVID?

Answer 17

• for COVID pathway need to know MEWS score
• categorise as severe/moderate/mild
  
  • if severe, consider urgent admission
  • if moderate, consider hospital admission or assessment
  • if mild, consider monitoring

Question 18

What 3 things that can put a patient into the SEVERE COVID category?

Answer 18

1. O2 92% or lower
2. Any of: RR>25, HR>130, new confusion (= NEWS ≥5)
3. ≤ 84% if baseline sats of 88%

Question 19

What are 3 criteria that can put you on the MODERATE COVID level?

Answer 19

1. O2 93-94%
2. RR 21-24, HR 91-131, NEWS 3-4
3. 84-85% if baseline sats of 88%

Question 20

What are 3 criteria that put you in the MILD category of COVID?

Answer 20

1. O2 95% or higher
2. any of RR≤20, HR≤90, NEWS 0-2
3. ≤ 86% if baseline sats of 88%

Question 21

What is the management of COVID based on category? Use the algorithm

Answer 21

Question 22

What are 7 symptoms that mean you should ring 999 in suspected COVID?

Answer 22

1. Coughing up blood
2. Have blue lips or blue face
3. Feel cold and sweaty with pale or blotchy skin
4. Have a rash that does not fade when roll glass over it
5. Collapse or faint
6. Become agitated, confused or very drwosy
7. Have stopped peeing or are peeing much less than usual