COVID-19 TREATMENT GUIDELINEIN TANZANIA, MARCH 2021
Posted by ULY CLINIC
24 Machi 2021 18:49:57
The guidance is based on proper case management aspects intended for clinicians involved in the care of patients with suspected or confirmed COVID-19. It is not meant to replace clinical judgment or specialist consultation but rather to strengthen frontline clinical management and the public health response.
NOTE. THIS GUIDELINE IS THE POPERTY OF MINISTRY OF HEALTH, COMMUNITY DEVELOPMENT, GENDER, ELDERLY AND CHILDREN
7. INVESTIGATIONS
Important categories of Investigation to be done are;
• Imaging investigations
• Tests for differentials
• Routine Investigations
• Monitoring of Routine/mandatory investigations
• Markers to determine prognosis
• Control investigations
i. Imaging investigations
• Early investigation for any facility - Chest X-ray
• Advanced imaging for referral and specialized hospitals - CT- Scan and Ultrasound Chest) Control test should be done seven days (7) from the baseline investigation for patient’s monitoring. Otherwise clinical judgement should be applied in decision making for earlier or later control investigations.
ii. Tests for differentials
a) PT-TB, Influenza,
b) Malaria,
c) Dengue Fever,
d) Typhoid Fever,
e) Cardiac diseases,
f) Renal Diseases,
iii. Routine Investigations
• D- Dimer
• CBC
• Electrolytes
iv. Other routineinvestigations
• Blood culture - For COVID-19 patients with severe or critical disease (Sepsis markers – raised WBCs especially raised neutrophil level), but do not delay other interventions including initiation of antibiotics therapy when indicated.
• If patient patients with diarrhea, stools culture should be done
• Confirmatory test for COVID-19 (RT – PCR).
• Blood gas analysis when applicable,
• ECG.
v. Monitoring of Routine/mandatory investigations
On admission:
Routine/mandatory investigations
a) CBC
b) CXR
c) MRDT
d) RFT
e) LFT
f) RBG
g) Urinalysis
h) Urine dip-stick (for patients with Hyperglycaemia)
i) HbA1c (when indicated – hyperglycaemic patients on admission without history of DM).
j) HIV serology (If positive, VR <200) PCP management is deemed necessary)
k) Bleeding indices (severe and critical)
l) ECG (Severe or critical disease)
vi. Markers to determine prognosis
The following markers have shown to determine the prognosis of the patients, where available they can be done.
a) CRP,
b) Troponins,
c) Neutrophil-Lymphocyte ratio,
d) D-dimer,
e) Mg.
f) Ferritin,
g) ABG
h) A PCT is essential to rule out coexisting bacterial pneumonia.
i) High resolution CT – Scan (Chest)
j) Lactate dehydrogenase
vii. Control investigations
a) Laboratory glucose is recommended to confirm the blood glucose levels (to be done daily).
b) Routine investigations (to be done at least twice in a week and whenever required)
c) CRP, Ferritin, D-Dimer and PCT (to be done every two (2) days and whenever necessary).
d) CXR should be done based on clinical judgement whenever indicated.
e) CT – scan during follow up of patients when needed
f) ECHO to monitor sequelae e.g. pulmonary hypertension
Updated,
24 Machi 2021 20:17:17
References
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