D Dimer is the only lab criteria for severity: No, Absolute lymphocytic count < 800, D Dimer > 100, CPK > 2x ULN, CRP > 100, LDH > 245, Trop I rising, Ferritin > 300

There are no standard lab guidelines: Daily tests: CBC with differential lymphocytes, CMP, CPK

Risk stratification Q2-3 DAY PRN (as needed): D Dimer, Ferritin, ESR, CRP

Once: HBV, HCV, HIV, Influenza A/B, RSV, Resp Biofire profile, Tracheal aspirate if intubated

All pneumonia patients need admission

No.

Admission is needed when:

Temperature > 38°C

Respiratory rate > 20

Heart rate > 100 with new confusion

Oxygen saturation < 94%

There are no clear cut red flags for COVID-19

No.

Red flags include:

Severe shortness of breath at rest

Difficulty in breathing

Pain or pressure in the chest

Cold, clammy, pale and mottled skinNew confusion

Becoming difficult to rouse

Blue lips or face

Little or no urine output

Coughing up blood

Neck stiffness

Non blanching rash

Headache rules out COVID-19

It is present in 14% cases.

Fever with chills means flu

Chills are present in 12% cases

Cough with sputum rules out COVID-19

No, sputum may be present in 34% cases

Nasal congestion is common in COVID-19

No, it is present in only 5% of cases

Hydroxychloroquine can cause QT prolongation

No, it’s the combination with azithromycin.

[Input Dr Monica Vasudeva]

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA