COVID-19: Effects in Comorbidities and Special Populations

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Contents
Preface
	KEY FEATURES:
List of Contributors
SARS-CoV-2 and Co-morbidities
	Yara S. Beyh1, Riya Sachdeva2, K. M.Venkat Narayan1 and Manoj Bhasin2,3,*
	HIGHLIGHTS
	INTRODUCTION
	COVID-19: GENERAL CHARACTERISTICS, SUSCEPTIBILITY, AND ASSOCIATION WITH THE IMMUNE SYSTEM
	COVID-19 AND CO-MORBIDITIES
		Diabetes Mellitus
		Obesity and Metabolic Syndrome
		Chronic Kidney Disease
		Cardiovascular Diseases
		Cancer
		Sickle Cell
		Chronic Obstructive Pulmonary Disease
	CONCLUSION
	MULTIPLE CHOICE QUESTIONS
	LIST OF ABBREVIATIONS
	CONSENT FOR PUBLICATION
	CONFLICT OF INTEREST
	ACKNOWLEDGEMENTS
	REFERENCES
Diabetes Mellitus and COVID-19
	Sanjay Kumar Bhadada1,* and Rimesh Pal1
	HIGHLIGHTS
	INTRODUCTION
	EPIDEMIOLOGY
	PATHOPHYSIOLOGICAL ASSOCIATIONS BETWEEN DIABETES MELLITUS AND COVID-19
		Advancing Age
		Comorbidities
		Obesity
		Dysregulated Immune System
		Angiotensin-Converting Enzyme 2 (ACE2) And Diabetes Mellitus
		Coagulation
	TWO-WAY INTERACTIONS BETWEEN DIABETES MELLITUS AND COVID-19
	DOES GLYCEMIC CONTROL BEFORE, AT, AND AFTER ADMISSION PREDICT OUTCOMES IN COVID-19 PATIENTS WITH DIABETES MELLITUS?
		Glycemic Control Before Hospital Admission
		Plasma Glucose At Hospital Admission
		In-Hospital Glycemic Control
	ANTI-DIABETIC MEDICATIONS IN COVID-19
	CONCLUSION
		MULTIPLE CHOICE QUESTIONS
	LIST OF ABBREVIATIONS
	CONSENT FOR PUBLICATION
	CONFLICT OF INTEREST
	ACKNOWLEDGEMENTS
	REFERENCES
COVID-19 and Diabetic Foot
	Ashu Rastogi1,*
	HIGHLIGHTS
	INTRODUCTION
	FOOT EXAMINATION AND COVID-19
		Foot Inspection
		Neurological Assessment
		Vascular Assessment
	DIABETIC FOOT INFECTIONS AND COVID-19 PANDEMIC
		An Easy Guide to Antibiotic Therapy is as Follows
	DFI, COVID-19 AND WAY FORWARD
	CHARCOT FOOT AND COVID-19
	PREVENTIVE FOOT CARE DURING COVID-19 PANDEMIC
	FOOT CARE IN PATIENTS WITH PRE-EXISTING WOUNDS DURING COVID-19 PANDEMIC
	DRESSING OF FOOT WOUND DURING COVID -19 PANDEMIC
	FOOT CARE FOR DFI DURING COVID-19
	WHO SHOULD BE HOSPITALIZED FOR FOOT COMPLICATIONS?
	UTILIZATION OF TELE-HEALTH SERVICES FOR DIABETIC FOOT DURING COVID-19
	PROMOTE SELF CARE (FOOT) DURING COVID-19
	PRECAUTIONS FOR HEALTH CARE PROVIDERS
	CONCLUSION
	MULTIPLE CHOICE QUESTIONS
	LIST OF ABBREVIATIONS
	CONSENT FOR PUBLICATION
	CONFLICT OF INTEREST
	ACKNOWLEDGEMENTS
	REFERENCES
Gastrointestinal and Hepatobiliary Manifestations of COVID-19
	Rohit Mehtani1 and Sunil Taneja1,*
	HIGHLIGHTS
	INTRODUCTION
	GI TROPISM OF SARS-COV-2
	GI SYMPTOMATOLOGY
		Relation of GI Symptoms with COVID-19 Severity
	POSSIBILITY OF FECO-ORAL TRANSMISSION OF COVID 19?
	GI HISTOPATHOLOGY OF PATIENTS WITH COVID-19
	MANAGEMENT OF GI SYMPTOMS IN COVID-19
	LIVER INJURY WITH COVID-19
	MECHANISMS OF LIVER INJURY
		Role of ACE 2 and Serine protease
		Direct Cytopathic Effects
		Cytokine Storm
		Ischaemic Hepatitis And Drug Toxicity
	HISTOPATHOLOGICAL FINDINGS IN THE LIVER
	COVID-19 IN PATIENTS WITH CHRONIC LIVER DISEASE
	LIVER FAILURE DUE TO COVID-19
	LIVER TRANSPLANTATION AND COVID-19
	GI ENDOSCOPY PRACTICES DURING COVID-19 PANDEMIC
	CONCLUSION
	MULTIPLE CHOICE QUESTIONS
	LIST OF ABBREVIATIONS
	CONSENT FOR PUBLICATION
	CONFLICT OF INTEREST
	ACKNOWLEDGEMENTS
	REFERENCES
COVID-19 and Cardiovascular Manifestations
	Ganesh Kasinadhuni1, Vineela Chikkam2, Parminder Singh1 and Rajesh Vijayvergiya1,*
	HIGHLIGHTS
	INTRODUCTION
		Biology of SARS-CoV-2
		Pathophysiology of SARS-Cov-2 Related Tissue Injury
		ACE2 –A link to Cardiovascular (CV) Injury
		COVID-19 and Cardiovascular Disease (CVD)
		COVID-19 and Cardiovascular (CV) Effects
	ACUTE CARDIOVASCULAR (CV) MANIFESTATIONS
		Acute Cardiac Injury and Myocarditis
		Management
		Cardiac Arrhythmias
		Management
		Acute Coronary Syndromes (ACS)
		Management
		Venous Thromboembolism (VTE)
		Management
		Renin-Angiotensin-Aldosterone System (RAAS) Inhibitors And Cardiovascular Outcomes In COVID-19 Illness
		Antiviral Drugs and their Cardiovascular Effects
		Hydroxychloroquine (HCQ) and Azithromycin
		Lopinavir-ritonavir
		Long-term Cardiovascular Effects - Long COVID
	CONCLUSION
	CONSENT FOR PUBLICATION
	CONFLICT OF INTEREST
	ACKNOWLEDGEMENTS
	REFERENCES
COVID-19 and Hematological Manifestations
	Niranjan Shiwaji Khaire1, Nishant Jindal1 and Pankaj Malhotra1,*
	HIGHLIGHTS
	INTRODUCTION
	COVID-19 AND HEMATOLOGICAL MANIFESTATIONS
		Total Leukocyte Count and Differential Count
			a. Lymphopenia
			b. Neutrophilic Leukocytosis
			c. Thrombocytosis and Thrombocytopenia
			d. Composite Variables: NLR and PLR Ratios
			e. What is the Clinical Utility of Following these Alterations in the CBC?
		Coagulation System
		COVID-19 Coagulopathy
	THROMBOSIS AND THROMBOEMBOLISM
		The Large vessel Thrombosis (Venous thromboembolism and Pulmonary Thromboembolism)
		Large Vessel Thrombosis (Arterial, extracorporeal circuit thrombosis)
		Microvascular Thrombosis and Autopsy data on thrombosis
		Pathophysiology of VTE and Immunothrombosis in COVID-19
		Acute Illness
		Patient-related
		SARS-CoV2 Related
	COVID-19 VS. NON-COVID-19 ILLNESS
	TREATMENT IMPLICATIONS
	CONCLUSION
		MULTIPLE CHOICE QUESTIONS
	LIST OF ABBREVIATIONS
	CONSENT FOR PUBLICATION
	CONFLICT OF INTEREST
	ACKNOWLEDGEMENTS
	REFERENCES
COVID-19 And Chronic Kidney Diseases
	Vikas Makkar1,*, Sudhir Mehta1, Suman Sethi1, Simran Kaur1 and P.M. Sohal1
	INTRODUCTION: AKI/ACUTE ON CKD IN COVID-19
		Prevalence of AKI in COVID-19
		Pathophysiology of Acute Kidney Injury in COVID-19
		Mechanisms
		Systemic Effects
			Fluid Imbalance
		Congestion of Renal Vein
			Rhabdomyolysis
			Superimposed Infections
		Cytokine Storm
		Pathogenesis of AKI in CRS
			Pro-inflammatory Cytokines
			Activation-induced Cell Death
			Activation of Procoagulation Pathways
			Complement System Activation
			Heme-Mediated Pathology
			Systemic Endothelial Injury
		Organ Crosstalk
			Lung–Kidney Axis and Crosstalk
			Mechanism of Lung–Kidney Crosstalk
			Renal Medullary Hypoxia
	ROLE OF ACE2 IN THE PATHOGENESIS OF RENAL INJURY
		Site of ACE2 in Lungs/Kidneys
			Entry of Virus into the Cell
			Priming and Role of TMPRSS2
			Angiotensin II
	DIRECT CYTOPATHIC EFFECT
		Clinical Presentation
			Incidence of AKI
			Timing & Severity of AKI
			Predictors of AKI
			Kidney Abnormalities
			Outcome
			Renal Histopathology
	COVAN
	MANAGEMENT OF AKI
	RECOGNITION, MONITORING, AND DIAGNOSIS OF AKI IN COVID-19 PATIENTS
		Renal Replacement Therapy
		Preferred Treatment Modality for AKI in COVID-19 Pandemic
		Other Extracorporeal Therapies
	CKD IN COVID-19
		Management of Glomerular Diseases During COVID-19 Pandemic
	IMMUNOSUPPRESSIVE TREATMENT IN VARIOUS KIDNEY DISEASES DURING COVID-19 PANDEMIC
		Antiviral Therapy for Covid-19
			Remdesivir
			Hydroxychloroquine
			Lopinavir–Ritonavir and Darunavir–Cobicistat
			High-Dose Steroids
			Tocilizumab and other Anti-Interleukin (IL)-6/IL-6R Monoclonal Antibodies (e.g., Sarilumab)
			Intravenous Immunoglobulins
			Ivermectin
	USE OF ARBS DURING PANDEMIC
		Paradoxical Effect of ACE2 Modulation in COVID-19 Outcome
	COVID- 19 AND DIALYSIS
	COVID 19 AND HEMODIALYSIS
		Dialysis Patients and Dialysis Facilities
		Disinfection and Disposal Practices in the Dialysis Unit
			Bleach Solution
		Alcohol-Based Solutions
	CRRT
		CRRT Dosing
		Modifications to CRRT for COVID- 19 Positive
	OTHER EXTRACORPOREAL THERAPY FOR COVID-19
		ECOS Modifications in Relation to COVID-19
		Extracorporeal Therapies in CRS
		The Rationale of Using CytoSorb Therapy in Critically ill COVID-19 Patients
		CytoSorb Therapy - Experience in Rx of COVID-19
		Recommendations for Anti-Cytokine Storm Therapy
			Recommendations from Italy
			Recommendations from Italy
			Recommendations from Panama
		Practical Recommendations During COVID Pandemic
		PERITONEAL DIALYSIS
			Role of Acute PD in the Management of CoV-AKI
		Advantages
		Patients Already on CAPD
		New Patient Planned for CAPD
			Coronavirus Disease 2019–Specific Concerns for PD
	COVID 19 AND KIDNEY TRANSPLANTATION
		Transplant Activity Report during this Pandemic
		Data Published from India
			Transmission of COVID-19 Infection During Transplantation
			Selection Criteria for Donor/Recipient During COVID-19 Pandemic
		Deceased Donors
			Clinical Criteria (Prasad et al., 2020a).
			Epidemiological Criteria
			Living Related Transplants
			Transplantation Recipients
			Post-Transplant Follows up Measures
			Precautions for Personnel Working in the Program
			Clinical Presentation, Disease Course, or outcomes in the Transplant Recipient
			Evidence and Experiences from Data Published
			Management of Immunosuppression During COVID-19 Pandemic
		MULTIPLE CHOICE QUESTIONS
	LIST OF ABBREVIATIONS
	CONSENT FOR PUBLICATION
	CONFLICT OF INTEREST
	ACKNOWLEDGEMENTS
	REFERENCES
COVID-19 and Pulmonary Diseases
	Kuruswamy Thurai Prasad1,*
	HIGHLIGHTS
	INTRODUCTION
	PATHOPHYSIOLOGY
	TRANSMISSION AND RISK FACTORS
	PULMONARY INVOLVEMENT IN COVID-19
		Clinical Features
		Laboratory Abnormalities
		Radiology
		Clinical Spectrum
		Diagnosis
		Differential Diagnosis
	TREATMENT
	PROGNOSIS
	PREVENTION
	DISEASE-SPECIFIC CONSIDERATIONS
		Asthma
	COPD
		Tuberculosis
		Lung Cancer
		Interstitial Lung Diseases
		Bronchiectasis and Cystic Fibrosis
		Pulmonary Hypertension
		Sleep-Related Breathing Disorders
		Lung Transplantation
	SPECIAL CONSIDERATIONS DURING MANAGEMENT OF PATIENTS WITH PULMONARY DISEASES
		Pulmonary Function Tests
		Bronchoscopy
		Transthoracic Procedures
		Aerosol Therapy
		Airway Suctioning
	CONCLUSION
		MULTIPLE CHOICE QUESTIONS
	LIST OF ABBREVIATIONS
	CONSENT FOR PUBLICATION
	CONFLICT OF INTEREST
	ACKNOWLEDGEMENTS
	REFERENCES
COVID-19 and Pregnancy
	Alka Sehgal1 and Neelam Aggarwal2,*
	OVERVIEW
	IMPACT ON MOTHER AND PREGNANCY
	ANTENATAL CARE
		Effect on Early Pregnancy
		Preterm Labor
		Prenatal Screening in the First or Second Trimester
			Imaging
		Non-Obstetrical Concerns
		Third Trimester
			Pre-Labour Preparation
		Testing Policy
		Segregation of Expectant Women
		Vertical Transmission
		Management of Positive SARS-CoV-2 Test
		Intrapartum Concerns
		Managing Late Referral
		Route of Delivery
		The Third Stage of Labour
	GESTATIONAL DIABETES MELLITUS AND DIABETES WITH COVID- 19
	POST PARTUM CARE IN COVID 19
		Maternal Monitoring
		Venous Thrombo-Embolism Prophylaxis
		Resuscitation and Evaluation of the Neonate
		Neonatal Testing
		Rooming in (Colocation)
		Co-Isolation of Positive or Suspect Mother- Baby Dyad
		Temporary Separation (Separate Rooms)
		Breast Feeding
		Breast Milk Expression With a Manual or Electric Breast Pump
	POSTPARTUM CONTRACEPTION
		Permanent Contraception
		Reversible Contraception
		Postpartum Visit
		Postpartum Depression
		SAFETY OF DRUGS USED FOR COVID-19 IN PREGNANCY AND LABOUR
		Drugs used During Pregnancy Conditions Include
			Corticosteroids
			Magnesium Sulphate
			Antiviral Drug Therapy
		Intrapartum Drugs
		Managing PPH
	PREGNANT HEALTH CARE PROVIDERS
		Overlapping Medical Conditions
	MANAGEMENT OF SEVERE COVID-19 PREGNANT WOMAN
	SUMMARY
	MULTIPLE CHOICE QUESTIONS
	CONSENT FOR PUBLICATION
	CONFLICT OF INTEREST
	ACKNOWLEDGEMENTS
	REFERENCES
Otolaryngological and Ocular Manifestations in COVID-19
	Sandeep Bansal1, Kanika Arora1 and Reema Bansal2,*
	INTRODUCTION
	DIAGNOSIS
	ENT MANIFESTATIONS OF COVID-19
		Anosmia/Ageusia
		Clinical Course of Anosmia in COVID-19
		Pathophysiology of Anosmia in COVID-19
		Treatment of COVID-19 Associated Anosmia/Agues
		Sore Throat
		Headache
		Others
	PAEDIATRIC OTOLARYNGOLOGY AND COVID-19
	SUMMARY
	OCULAR MANIFESTATIONS OF COVID-19
		Background
		Conjunctivitis
		Ocular Symptoms as Rare Presenting Manifestations
		Retinal Involvement
		Retinal Vascular Occlusion
		Treatment
	SUMMARY
	MULTIPLE CHOICE QUESTIONS
	KEY POINTS
	CONSENT FOR PUBLICATION
	CONFLICT OF INTEREST
	ACKNOWLEDGEMENTS
	REFERENCES
COVID-19 in Children and Newborn
	Roshan Daniel1 and Shiv Sajan Saini1,*
	INTRODUCTION
	EPIDEMIOLOGY
	ETIOPATHOGENESIS
	CLINICAL PRESENTATION
		Laboratory Findings
	TREATMENT
		SUPPORTIVE MEDICAL CARE
	COVID SPECIFIC TREATMENT
	MANAGEMENT OF MIS-C
		Managing Newborns Born to COVID Positive Mothers
	OUTCOME
	PREVENTION
	OTHERS
	CONCLUSION
	CONSENT FOR PUBLICATION
	CONFLICT OF INTEREST
	ACKNOWLEDGEMENTS
	REFERENCES
COVID-19 in the Geriatric Population
	Udit Narang1, Ani Abhishek Sharma2, Ritin Mohindra3, Ashish Bhalla3 and Vikas Suri3,*
	INTRODUCTION
	THE DISEASE SPECTRUM
	MODES OF TRANSMISSION
	THE CLINICAL SCENARIO
	DIAGNOSTIC MODALITIES
	MANAGEMENT
	COVID-19 IN GERIATRIC POPULATION
	THE CLINICAL PRESENTATION
		The Geriatric Conundrum
		Stratification of Risk
		Management
		Advance Care Planning (ACP)
		In Quarantine/LTCFs/Hospices
		Caring for the Terminal Patient
	CHALLENGES FOR HOSPICES, RETIREMENT HOMES, AND NURSING HOME
	CONCLUSION AND LEARNING FROM THE CRISIS
	CONSENT FOR PUBLICATION
	CONFLICT OF INTEREST
	ACKNOWLEDGEMENTS
	REFERENCES
Subject Index
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