COVID-19: Current Perspectives

COVID-19 has caused disruption, damage and death at an unprecedented scale. Knowledge about this disease is constantly evolving. The mode of transmission is believed to be primarily through droplet spread during face to face contact. In addition to the classical symptoms of fever, fatigue and breathlessness, loss of sense of smell and taste, skin manifestations and anorexia/ nausea/ diarrhea are emerging as new symptoms. The virus is now known to cause complications of almost all organ systems including blood vessels, heart, lung, kidney, brain and liver. The pediatric multi system inflammatory syndrome (PIMS) is a well-defined entity. Diagnosis is still by RT PCR in respiratory secretions. Obesity, genetic susceptibility have emerged as additional risk factors for severe disease. Evidence supports use of oxygen, anticoagulation, steroids and remdesivir in treatment of severe COVID-19. Steroids should not be given to non-hypoxic patients. Hydroxychloroquine, lopinavir ritonavir and azithromycin are no longer recommended for treatment. The jury is still out for tocilizumab and convalescent plasma. Patients can now be de-isolated 10-20 days after onset of symptoms for mild and severe disease respectively and demonstration of negative swabs is no longer essential. Vaccine development is underway.