On this special coronavirus episode of The Nurse Keith Show nursing podcast, Keith discusses various aspects of the COVID-19 pandemic, including new symptomatology; excellent evidence-based medical podcasts; the stages of grief; and other salient issues and reflections.
One excellent evidence-based podcast mentioned in the course of this episode is The Clinical Problem Solvers, and the specific episode referenced was episode 74, a case-based COVID-19 conversation with Drs. Brian Block, Neeta Thakur, and Peter Chin-Hong.
Some clinical information to digest:
- All cold and flu-like symptoms need to be triaged for COVID-19
- Special respiratory screening clinics are highly recommended for separating patients in terms of risk
- There are specific GI symptoms in 10-25% of COVID+ patients
- Loss of sense of smell and taste is a new potential clinical presentation in COVID-19, and the accumulation of evidence-based data is currently in process
- A COVID-era axiom: “Don’t forget about everything else” when making a differential diagnosis, (e.g.: community-acquired pneumonia (viral or bacterial); fungal or mycobacterial infections; and other causes)
- With immunocompromised patients, you also must consider adventitious secondary infections that patients with HIV can experience, like crypto or PCP
- The presence of influenza makes COVID less likely but can‘t be ruled out. If a flu patient doesn’t respond to treatment in due course, consider COVID-19
- In patients with COVID-19, there is up to 20% co-infection with other respiratory viruses
Two more recommended podcasts are:
- The Curbsiders, specifically episodes 200 and 201
- Dr. Ted O’Connell’s Commonsense Conversations on the Coronavirus Pandemic (Ted was recently featured on episode COVID-19-3 of The Nurse Keith Show
- Fecal Evidence of COVID-19 Raises Transmission Concerns
- Why Some Heart Patients May be Especially Vulnerable to COVID-19
Of note: there are now signs of cardiac involvement in COVID-19 patients
Researchers know generally that infections can take a toll on people who have other health problems. But SARS-CoV-2, the virus that causes COVID-19, may pose particular danger to the heart because of how the virus gets into ACE2 cells, researchers speculate.
To invade a cell, SARS-CoV-2 latches onto a protein called angiotensin-converting enzyme 2, or ACE2 (SN: 3/3/20). This protein is found on cells in the lungs, allowing the virus to invade these cells and cause respiratory symptoms. But ACE2 also is on heart muscle cells and cells that line the blood vessels.
- Mixed messages from the President
- The stages of grief being experienced by most everyone on the planet as we fight this pandemic
- Calls for help from nurses around the country; what does it mean when, in the US in the 21st century, citizens are sewing masks for nurses who don’t have enough masks for themselves, if any?
- What will we do as the nursing workforce takes a hit in terms of illness and absenteeism, not to mention burnout?
- The concept of care-mongering vs fear-mongering
- The need for the rise in telehealth and telemedicine jobs
- A moment of gratitude for those on the front lines, not to mention those in support roles and not engaged in direct patient care. Small Acts of kindness and heroism are taking place every day.
- We have a choice between the stages of grief; where would we like to spend most of our time?
DISCLAIMER: In these episodes regarding COVID-19, I reference the most up-to-date information I can, as well as adding personal opinions and reflections from me and my guests. Please note that the situation is changing by the moment, and any information shared in the course of any episode may not apply once new data or evidence emerges. Please also note that nothing shared in the course of any Nurse Keith Coaching COVID-19 podcast is intended for diagnosis or treatment; please consult your healthcare provider, your local Department of Health, the CDC, the WHO, or other reputable evidence-based sources.
If you hear or read something I have shared that appears to be erroneous, if you can, please send an email me directly at email@example.com. Thank you for understanding, stay safe, and keep informed.