Clinical features

Symptomatology

Mild cases: Category A

• cough
• Malaise
• Sore throat without shortness of breath
• Rhinitis
• Diarrhea

Moderate to severe cases:

Categeroy B

Fever and or severe sorethroat/cough/diarrhea

OR

Category A plus two or more of the following:

1. Lung / heart / liver / kidney / neurological disease / Hypertension / haematalogical disorders / uncontrolled Diabetes / Cancer / HIV-AIDS
2. On long term steroids / immunosuppressive drugs
3. Pregnant lady
4. Age – more than 60 years

OR

Category A plus cardiovascular disease

Categeroy C

1. Breathlessness, chest pain, drowsiness, fall in blood pressure, haemoptysis, cyanosis(red flag signs)
2. Children with ILI(influenza like illness) with red flag signs(somnolence, high/persistent fever, inability to feed well, convulsions, dyspnea / respiratory distress etc

Identification of high risk Patients

Comorbidities

• Uncontrolled Diabetes
• Hypertension
• Cardiovascular disease
• Lung Disease
• CKD
• CLD
• On immunosuppressives
• HIV/congenital immunodeficiency disorders
• Age > 60 years

Clinical assessment

• Hypoxia – SpO2 < 93% on room air
• Tachycardia PR >125/min
• Respiratory distress
• RR> 30/min
• Hypotension BP:Systolic < 90mmHg Diastolic < 60mmHg
• Altered sensorium

Laboratory values

• CRP>100mg/L
• CPK>twice upper limit of normal
• Ferritin>300mcg/L
• Trop T elevation
• LDH>245U/L
• D Dimer>1000ng/ml
• Multi organ dysfunction
• ALC <0.8

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