COVID-19: Mention clinical severity as a diagnosis

The Case

A 78 year M was admitted with history of fall at home under orthopedic surgeon. He was a KCO HTN, Hypothyroidism and CKD. There were no symptoms suggestive of COVID-19.

RT PCR was test was done as a routine during pre anesthetic checkup which came out as positive. Case was transferred under respiratory physician and operation was postponed until he is COVID-19 negative and ready to be operated.

During hospital stay his oxygenation levels started falling. He was given medical care as per the best standard of care.

He required Oxygen by mask, then Hi mask, then BiPAP/ NIV and invasive mechanical ventilation.

He expired on 24th day of admission with cause of death as COVID-19 (Critical).
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COVID-19 is a variable disease.

COVID-19 stands for

-=-
COVI -Coronavirus

D -Disease

-19 -of 2019
-=-

This was the acronym used for the disease which is caused by SARS-Cov-2 virus.

As on date it has been found that this is a very variable disease and has been classified into the following five categories:

1.    Asymptomatic- No symptoms
 
2.    Mild – No need of oxygen

3.    Moderate- SPO2 level more than 94% on air 

4.    Severe- SPO2 less than 94% on air needing oxygen 

5.    Critical - Need of respiratory support NIV/ Ventilator etc.


While making case summaries or death certificates etc. the diagnosis should be specifically mentioned as below:

COVID-19 (Category)

Such as

COVID-19 (Critical)

There is no need to further add adjectives to COVID-19 such as COVID-19 disease.


Coronavirus disease is basically the same diagnosis. But this does not specify the same disease as being referred as COVID-19.


Diagnosis can be listed as below:

COVID-19 (Critical)
DM- type 2
Hypertension

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Dr. Prashant Kumar
-==-    
    

https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum/

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