Until the the diagnosis is confirmed the physician will hesitate in starting treatment for Covid-19 in most of the cases in developed countries. Few days delay during diagnosis and starting treatment may be one of the causes of high mortality in developed countries. Released cytokines ( especially thromboxane ) causing internal blood clotting are the major factors of high mortality. In our area ( a developing country) I have been using NSAID ( ibuprofen , indomethacin etc.) with famotidine in all cases of viral infections (clinically) and in suspected cases of covid-19 infection prednisolone (1mg/kg) for 5 days with an antibiotics added. I have treated more that 120 cases in last few months without any hospitalization and mortality.
Delay in management of COVID-19 patients is associated with high morbidity and mortality particularly is serious cases
Most of the people who are struck with COVID-19 are having mild symptoms and can be looked after at home with home isolation and symptomatic treatment. 15-20% patient need to seek help in the hospitals and 5-10% of such patients have severe disease that needs ICU admission, ventilatory support.
There has not been any treatment that can cure the COVID-19 illness. There ICU admitted patients may be helped by dexamethasone, antibiotics, and other supportive measures, which if not provided lead to death.
Most of the deaths are in ICU, in old people, and those with comorbid conditions or immunocompromised states.
Dear Prof. Rahman!
You spotted a key concern:
1) Matos, L.L., Forster, C.H.Q., Marta, G.N. et al. The hidden curve behind COVID-19 outbreak: the impact of delay in treatment initiation in cancer patients and how to mitigate the additional risk of dying—the head and neck cancer model. Cancer Causes Control (2021). https://doi.org/10.1007/s10552-021-01411-7 Open access: Article The hidden curve behind COVID-19 outbreak: the impact of del...
2) A case-study: COVIDSurg Collaborative, Global Surg Collaborative (2021). Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study, Anaesthesia Early View March 2021, Open access: Article Timing of surgery following SARS-CoV-2 infection: an interna...
3) Fatehi Elzein et. al. (2021). Reinfection, recurrence, or delayed presentation of COVID-19? Case series and review of the literature, Journal of Infection and Public Health, Volume 14, Issue 4, April 2021, Open access: Article Reinfection, recurrence, or delayed presentation of COVID-19...
Delay in treatment might be a result from not recognizing in time this virus, with a patient without symptoms in case of a new mutant for example. I suspect this is the case in Brazil now and that is why they have some many death. Yours sincerely, Bulcsu
Dear Prof. Rahman
The priorities in COVID-19 pandemic is infection containment and the early treatment of infectef person's. Transmission control and early diagnosis require as near as possible real‐time epidemiological information to identify and characterize foci of infection, and inform about transmission dynamics, to enable immediate and effective action to contain and interrupt pandemics.
Rapid tests for symptomatic individuals will enable prompt clinical care and the minimisation of preventable morbidity and mortality.
The SARS‐CoV‐2 infected person's can be infectious prior to symptom development or remain asymptomatic but infectious, a failure to screen asymptomatic groups has important consequences.
tracing of contacts of newly symptomatic individuals is necessarily subject to crucial delays, during which significant further transmission can occur, so both transmission is increased and care of infected individuals delayed, with potentially poorer health outcomes as a result.
COVID‐19 is primarily an infection of the lungs, it can also affect other organs, in particular the cardiovascular system, the magnitude, nature and severity of which we are only beginning to appreciate.
For optimal effectiveness in reducing disease severity, these will need to be promptly instituted, which in turn requires early diagnosis and monitoring.
https://www.theatlantic.com/health/archive/2020/08/long-haulers-covid-19-recognition-support-groups-symptoms/615382/
https://unsdg.un.org/sites/default/files/2020-05/UN-Policy-Brief-COVID-19-and-mental-health.pdf
https://www.who.int/emergencies/diseases/managing‐epidemics‐interactive.pdf
