Covid-19 infection
Investigations:
Pulse oximeters: CE, CE UKNI or UKCA mark and meet the technical standard BS EN ISO 80601-2-61:2019
Haemoglobinopathies, high glycosylated glucose, carbon monoxide (e.g. smoking) (heavy smoking may overestimate SpO2 by up to 8%)In patients with sats of 92-96% on pulse oximeter almost 12% of black patients actually had sats <88% compared to 3.6% of white patients.
Highest-risk subgroup: entitled for free lateral flow test via the gov.uk website or by calling 119 (shop bought (including pharmacies) tests cannot be registered via gov.uk or 119 so are ineligible for access to treatments
Treatment:
First line
- Nirmatrelvir + ritonavir (Paxlovid) - an oral antiviral given BD for 5 days, or
- Sotrovimab (Xevudy) - an IV nMAB (neutralising monoclonal antibody) given as a single dose
Second line
- Remdesivir - an IV antiviral given OD for 3 days, double dose D1
Third line
- Molnupiravir (Lagevrio) - an oral antiviral drug given BD for 5 days
Risks increase:
In the 1-30 / 30-60 / 60-90 days from covid infection risk ratios were increased by:
32x / 4x / 2.5x for PE
6x / 2.6x / 1.4x for DVT
2.5x / 1.4x / 1.1x for bleeding
Absolute risks:
0.17% PE
0.004% DVT
0.1% bleeding
Resource(s):
NHS: Assessment, monitoring and management of symptomatic COVID-19 patients in the community
Info for patients/carer(s):
NHS: How to look after yourself at home if you have coronavirus (COVID-19) or symptoms of COVID-19