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Year : 2021  |  Volume : 10  |  Issue : 1  |  Page : 84-92

Severe COVID-19: A distinct entity

1 Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
2 Department of Anaesthesia, King George Medical University, Lucknow, Uttar Pradesh, India
3 Department of Respiratory Medicine, King George Medical University, Lucknow, Uttar Pradesh, India
4 Department of Radiodiagnosis, King George Medical University, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. Ravindra Kumar Garg
Department of Neurology, King George Medical University, Lucknow - 226 003, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jfmpc.jfmpc_1600_20

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Severe coronavirus disease-2019 (COVID-19) is a distinct entity that rapidly evolves and may abruptly culminate in to a critical illness. As per Chinese experience, approximately, 15% of patients of COVID-19 progress to severe disease and 5% become critically ill. The incidence of severe and critical illness is higher among men, patients older than 65 years of age and in persons with other medical comorbidities. Cytokine storm cause pronounced lung damage and multiorgan failure. Coagulopathy is a key component of severe COVID-19. Critically ill patients are generally predisposed to a high risk of thromboembolism as well. Lymphopenia predisposes to severe disease. None of the antiviral or immunomodulators has proven efficacy in severe COVID-19. Supplemental oxygen need be administered in patients with hypoxemia. Excessive breathing effort, acute respiratory distress syndrome (ARDS), encephalopathy, and multiorgan failure are indications for mechanical ventilation. In a large number of patients, the overall outcome is poor. Health care workers in intensive care units are exposed to the enormous risk of acquiring hospital acquired SARS-COV-2 infection.

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