Introduction
The advent of COVID-19 has posed challenges for healthcare professionals to diagnose and provide medical care to patients quickly. The most common clinical manifestation of the new coronavirus infection is bilateral pneumonia, acute respiratory distress syndrome (ARDS) was recorded in 3-4% of patients (COVID-19 – China, 2020). The recommendations presented in the essay are primarily based on materials on the diagnosis, prevention, and treatment of COVID-19 published by experts from the WHO, the Chinese, American, and European Centers for Disease Control.
What is COVID-19, and Why It Is an Emergency
Coronaviruses are a large family of RNA viruses that can infect both animals (their natural hosts) and humans. Currently, four seasonal coronaviruses (HCoV-229E, -OC43, -NL63, and -HKU1) circulate among the population, which are present in the ARI structure all year round. Coronaviruses usually cause mild to moderate upper respiratory infections (Infection prevention and control, 2019). There are also two highly pathogenic coronaviruses – the Middle East respiratory syndrome virus (MERS) and the novel coronavirus infection COVID-19.
From December 2019 to March 2020, SARS-CoV-2 was most widespread in the PRC, in which confirmed cases of the disease were registered in all administrative entities. The most significant number of cases was detected in the southeastern part of the PRC, with the epicenter in Hubei province. The World Health Organization (WHO) declared an international public health emergency in January 2020 over the spread of the coronavirus, which is causing a new type of pneumonia in humans (COVID-19 – China, 2020). On March 11, 2020, WHO announced the beginning of the COVID-19 pandemic due to the rapid spread of a new infection everywhere outside the PRC.
Covid Diagnosis: Medical Examination
In the presence of factors indicating a case suspicious of COVID-19, patients, regardless of the type of medical care provided, undergo a complex clinical examination to determine the severity of the condition, including taking anamnesis, physical examination, examination of diagnostic material using NAAT, pulse oximetry. Based on the complex clinical analysis results, the question of the type of medical care and the amount of additional examination is being resolved. The diagnosis is established based on clinical study, data from epidemiological history, and laboratory results.
When collecting an epidemiological history, the presence of foreign travel is established 14 days before the first symptoms and the presence of close contacts in the last 14 days with persons suspected of being infected with SARS-CoV-2 or persons whose diagnosis of COVID-19 has been confirmed by a laboratory.
A medical examination with the establishment of the severity of the patient’s condition must necessarily include (Infection prevention and control, 2019):
- Assessment of the visible mucous membranes of the upper respiratory tract.
- Auscultation and percussion of the lungs.
- Palpation of lymph nodes.
- Examination of the abdominal organs with the determination of the size of the liver and spleen.
- Thermometry.
- Assessment of the level of consciousness.
- Measurement of heart rate, blood pressure, respiratory rate.
- Pulse oximetry with SpO2 measurement to detect a respiratory failure and assess the severity of hypoxemia.
Organization of Medical Care
The heads of medical organizations providing emergency medical care must ensure:
- Availability of a stock of necessary consumables for sampling for laboratory tests for the presence of COVID-19, disinfectants, and PPE.
- Informing healthcare workers on the prevention, diagnosis, and treatment of COVID-19.
- Fulfillment of the Instruction on compliance with infectious safety measures for specialized mobile ambulance teams per methodological recommendations.
- Transfer of biological material (nasal and oropharyngeal swab) of patients (if it is necessary to take biological material at the emergency stage the need for special quarantine measures) in case of suspected COVID-19 in the laboratory of medical organizations that have an epidemiological report for work with III and IV groups of pathogenicity (Critical preparedness, 2020).
- Indication by medical workers in the form of referral for laboratory examination of the diagnosis of “pneumonia” when referring biological material of patients with community-acquired pneumonia for the diagnosis of COVID-19.
It is very important not to forget about the constant informing of the population about the risks of COVID-19, individual prevention measures, and the need for timely seeking medical help.
Territorial bodies register patients with COVID-19 and entry into reporting forms only upon received emergency notifications. When entering information about a patient, it is necessary to indicate the date of onset of clinical symptoms, diagnosis, date of diagnosis, the presence of concomitant diseases: chronic diseases of the bronchopulmonary system, the cardiovascular system, the endocrine system or other diseases; pregnancy; vaccination information (influenza and pneumococcal infection (if any); triage of patients is an essential administrative measure and is used to quickly identify and treat patients with ARI, including suspected MERS-CoV infection (Infection prevention and control, 2019). Patients with established ARI should be accommodated in an area separate from other patients, and additional precautions related to PBI should be quickly taken. Clinical and epidemiological aspects of cases should be assessed as soon as possible and complemented by laboratory assessment.
Conclusion
Currently, there is still an active study of the clinical and epidemiological characteristics of a new infectious disease and the development of new means of its prevention and treatment. In humans, coronaviruses can cause various diseases, from mild forms of acute respiratory infection (VRI) to severe acute respiratory syndrome (SARS). Since December 2019, the new coronavirus infection COVID-19 has become widespread. Standardized diagnostic measures are fundamental to ensuring safe health care, reducing the risk of further infection, and protecting health workers. They should be applied in all health care settings for all patients.
References
COVID-19 – China. (2020). World Health Organization. Web.
Critical preparedness, readiness and response actions for COVID-19. (2020). World Health Organization. Web.
Infection prevention and control during health care for probable or confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. (2019). World Health Organization. Web.