ABSTRACT
Background: Long term respiratory complications seems to be a major concern in patients treated for COVID 19 infection. Objectives: To study the association between CT severity and lung age in patients treated for COVID 19 infection and to thereby study the impact of COVID 19 infection on pulmonary functions of patients. Methodology: This cross sectional hospital based study was conducted on 147 patients in the Department of Pulmonary Medicine, Goa Medical College for 6 months. Patients confirmed to be COVID 19 positive by either molecular test or antigen test were subjected to 128 slice CT machine for assessing CT severity score at admission. Based on clinical and radiological parameters patients were called for follow up at 6 weeks for assessment of lung Age , FEV1 and FEV6 using a Vitalograph lung age monitor device Results: Patients with severe CT severity score (CTSS) had a higher mean lung age (102.4) at follow up than patients with mild and moderate CTSS ,who had lung age of 48.3 and 87 respectively. Thus as CT severity progresses there will be an accelerated decline in lung function. Conclusion: The Vitalograph lung Age monitor is a hand held device which is easily available OPD level/ bed side to assess the limitations of pulmonary functions/ extent of damage in suspected cases of post covid fibrosis .This method of assessment will avoid the unnecessary radiation exposure in our patients (in the form of follow up CT thorax) and ultimately help in better rehabilitation of patients.
ABSTRACT
Background: A mysterious cluster outbreak of pneumonia in Wuhan, China in December 2019 was traced to Severe Acute Respiratory Syndrome Coronavirus 2 and declared a Pandemic by WHO on 11th March 2020. The pandemic has spread rapidly causing widespread devastation globally. Purpose: This review provides a brief understanding of pathophysiology, clinical features, diagnosis and management of COVID-19 and highlights the current knowledge as well as best practices for orthopaedic surgeons. These are likely to change as knowledge and evidence is gained. Results: Orthopaedic surgeons, like other front-line workers, carry the risk of getting infected during their practice, which as such is already substantially affected. Implementation of infection prevention and control as well as other safety measures for health care workers assumes great importance. All patients/visitors and staff visiting the hospital should be screened. Conservative treatment should be the first line of treatment except for those requiring urgent/emergent care. During lockdown all elective surgeries are to be withheld. All attempts should be made to reduce hospital visits and telemedicine is to be encouraged. Inpatient management of COVID-19 patients requires approval from concerned authorities. All patients being admitted to the hospital in and around containment zones should be tested for COVID-19. There are special considerations for anaesthesia with preference for regional anaesthesia. A separate Operation room with specific workflow should be dedicated for COVID-19 positive cases. Conclusions: Despite the magnitude of challenge, the pandemic offers significant lessons for the orthopaedic surgeon who should seek the opportunity within the adversity and use this time wisely to achieve his/her Ikigai.