COVID-19 frequently asked inpatient questions: Difference between revisions

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====What anti-viral medications are available to treat COVID-19?====
====What anti-viral medications are available to treat COVID-19?====
There are no drugs or other therapeutics presently approved by the U.S. Food and Drug Administration (FDA) to prevent or treat COVID-19. Current clinical management includes infection prevention and control measures and supportive care, including supplemental oxygen and mechanical ventilatory support when indicated.
There are no drugs or other therapeutics presently approved by the U.S. Food and Drug Administration (FDA) to prevent or treat COVID-19. Current clinical management includes infection prevention and control measures and supportive care, including supplemental oxygen and mechanical ventilatory support when indicated. There are many ongoing clinical trials in the US and around the world for the treatment of COVID-19.


====Should I stop my ACE Inhibitors and ARBs while on admission for COVID-19?====
====Should I stop my ACE Inhibitors and ARBs while on admission for COVID-19?====

Revision as of 17:32, 11 June 2020

Frequently Asked Inpatient Questions Microchapter

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COVID-19 Main Page

Treatment Based Questions

Complications Based Questions

Co-Morbidity Based Questions

Hospital Discharge Related Questions

Re-Infection Related Questions

Pregnancy Related Questions

Pediatrics Related Questions

Visitors Related Questions

General In-Patient Questions

Management of Dead Bodies from COVID-19

General Health Care Practitioner (HCP) Questions

To go back to the COVID-19 project, click here.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Gurmandeep Singh Sandhu,M.B.B.S.[2] Aisha Adigun, B.Sc., M.D.[3]Harmeet Kharoud M.D.[4]Rinky Agnes Botleroo, M.B.B.S.Nuha Al-Howthi, MD[5]Ifrah Fatima, M.B.B.S[6]}

Treatment Based Questions

I read about the retraction of the two articles that halted the use of hydroxychloroquine in COVID-19 patients, can I currently receive this medication if infected?

Does every patient with a positive COVID-19 test need to be admitted to the hospital?

Not all patients with COVID-19 require hospital admission. Patients whose clinical presentation warrants in-patient clinical management for supportive medical care should be admitted to the hospital under appropriate isolation precautions.

Some patients with initial mild clinical presentation may worsen in the second week of illness. The decision to monitor these patients in the inpatient or outpatient setting should be made on a case-by-case basis. This decision will depend not only on the clinical presentation, but also on the patient’s ability to engage in self-monitoring, the feasibility of safe isolation at home, and the risk of transmission in the patient’s home environment.

What are the chances of recovery in a hospital admitted COVID-19 patient?

Are empirical antibiotics recommended for patients suspected of having COVID-19?

Several patients with COVID-19 have been reported to present with concurrent community-acquired bacterial pneumonia. Decisions to administer antibiotics to COVID-19 patients should be based on the likelihood of bacterial infection (community-acquired or hospital-acquired), illness severity, and antimicrobial stewardship issues.

What anti-viral medications are available to treat COVID-19?

There are no drugs or other therapeutics presently approved by the U.S. Food and Drug Administration (FDA) to prevent or treat COVID-19. Current clinical management includes infection prevention and control measures and supportive care, including supplemental oxygen and mechanical ventilatory support when indicated. There are many ongoing clinical trials in the US and around the world for the treatment of COVID-19.

Should I stop my ACE Inhibitors and ARBs while on admission for COVID-19?

Complications Based Questions

What population is most at risk for severe disease from COVID-19?

What risk factors result in severe complications from COVID-19?

Will I be placed on a ventilator?

What systems other than the Respiratory system can be involved?

Does prolonged ventilation in hospitalized patients worsen the outcome of COVID-19?

Co-Morbidity Based Questions

Patients with Hypertension

Should I stop my ACE Inhibitors and ARBs while on admission for COVID-19?

Patients with Asthma

If I experience an Asthma exacerbation, should that exacerbation be treated any differently to reduce the risk of COVID-19?

Are any changes recommended to my treatment plan if a paitent with asthma has COVID 19?

Patients currently Undergoing Hemodialysis

Can I continue receiving Hemodialysis in a hospital where other COVID-19 patients are treated?

Cancer Patients

Can/Should Cancer surgery be delayed? What about radiation therapy?

Should treatment that suppresses my immune system be stopped or delayed?

Are the support groups or activites still available in the hospital?

Should I be taking an antiviral medication such as Tami flu for protection?

Hospital Discharge Related Questions

I no longer have symptoms but my tests still came back positive for COVID-19, can I be discharged?

If after discharge I show new symptoms of COVID-19, should I be isolated and tested again?

If after discharge, a close contact test positive, should I self-isolate again?

After I have been discharged, should I continue to wear a face mask?

After discharge, how soon can I get back to my job?

After discharge can I use public places and transportation?

What can I expect after I leave the hospital?

Re-Infection Related Questions

Do I become immune after I have recovered from COVID-19?

Is re-infection worse than the initial infection?

Will a re-infected person show the same symptoms as the initial infection?

Are clinically recovered persons infectious to others if they test persistently or recurrently positive for SARS-COV-2 RNA?

Pregnancy Related Questions

If I deliver in the hospital will that increase my chances or my baby's chances of contracting COVID-19?

Should intrapartum fever be considered as a possible sign of COVID-19 infection?

Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Fever is the most commonly reported sign; most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness (cough, difficulty breathing). Data regarding COVID-19 in pregnancy are limited; according to current information, presenting signs and symptoms are expected to be similar to those for non-pregnant patients, including the presence of fever. Other considerations that may guide testing are epidemiologic factors such as the occurrence of local community transmission of COVID-19 infections. As part of evaluation, clinicians are strongly encouraged to test for other causes of respiratory illness and peripartum fever.

I am currently pregnant and hospitalized due to COVID-19, is my unborn child infected?

What is the guidance available for labor and delivery Health Care Personnel with potential exposure in a healthcare setting to patients with COVID-19 infection?

Are Pregnant healthcare personnel at increased risk for adverse outcomes if they care for patients with COVID-19 infection?

Can I proceed with a scheduled cesarean delivery if hospitalized with COVID-19?

Are glucocorticoids contraindicated in pregnant patients with COVID-19?

Are pregnant women more susceptible to infection or at increased risk for severe illness, morbidity, or mortality with COVID-19?

I have heard that some hospitals are testing all women for COVID-19 who arrive at the hospital for labor—even women without any symptoms. Will I be tested?

If I contract COVID-19, will I still be able to breastfeed?

In the limited studies available, COVID-19 has not been found in breast milk. However, your baby could get the virus from contact with you or other caregivers. The CDC recommends breastfeeding or feeding expressed breast milk to your baby while taking precautions to avoid spreading the virus to your baby. Breast milk protects babies from getting sick and is the best source of nutrition for most babies. Breastfeeding helps strengthen your baby’s immune system because breast milk contains antibodies and other important components.

If you are sick or experiencing symptoms, you should take all possible precautions to protect your baby, including washing your hands before and wearing a facemask when you touch your baby. You may breastfeed directly at the breast or express breast milk for a healthy caregiver to feed to your baby.

How many people can be present in the room during my birth?

The CDC has advised hospitals to limit the number of people allowed in hospitals, including visitors and non-essential staff to reduce exposure of patients and health care workers, to COVID-19. During labor, hospitals have generally made exceptions to allow a support person as long as they are not experiencing symptoms associated with COVID-19.

Talk to your facility or health care provider about the policies where you are going to deliver your baby and if the facility is allowing any exceptions on a case-by-case basis. Decide in advance who your primary support person would be and identify a secondary person who can be available if your primary support person is experiencing symptoms of COVID-19. You can also make plans with your provider about connecting with additional support people through platforms such as FaceTime, Google Hangouts, or Zoom.

If I have COVID-19 at the time of my birth, will my baby be able to stay with me?

CDC recognizes that the ideal setting for the care of a healthy, full-term newborn during the birth hospitalization is within the mother’s room. Temporary separation of the newborn from a mother with suspected or confirmed COVID-19 should be considered to reduce the risk of spreading the virus to the newborn. The risks and benefits of temporary separation of the mother from her newborn should be discussed with the mother by her healthcare team. Decisions about temporary separation should be made with respect to the mother’s wishes. If the mother chooses a temporary separation to reduce risk of spreading the virus and would like to breastfeed, she should express breast milk and have a healthy caregiver who is not at high-risk for severe illness from COVID-19 bottle feed the newborn the expressed breast milk if possible.

If the mother with suspected or confirmed COVID-19 does not choose temporary separation in the hospital, she should take precautions to avoid spreading the virus to the newborn, including washing her hands and wearing a cloth face covering when within 6 feet of her newborn. The newborn should be kept ≥6 feet away from the mother, as much as possible, including the use of physical barriers (e.g., placing the newborn in an incubator).

Can COVID-19 be transmitted via breastmilk?

The limited studies on breastfeeding women with COVID-19 have not found the virus in breast milk. The main concern is the parent or caregiver infecting the baby through respiratory droplets. Precautions should be taken to keep your baby healthy, including washing hands before touching and feeding your baby and wearing a face mask if you are experiencing symptoms or confirmed positive with COVID-19.

If I am separated from my baby after birth due to COVID-19, can I breastfeed?

  • If you have COVID-19 and choose to breastfeed:
    • Wear a cloth face covering while breastfeeding and wash your hands with soap and water for at least 20 seconds before each feeding.
  • If you have COVID-19 and choose to express breast milk:
    • Use a dedicated breast pump (not shared).
    • Wear a cloth face covering during expression and wash your hands with soap and water for at least 20 seconds before touching any pump or bottle parts and before expressing breast milk.
    • Follow recommendations for proper pump cleaning after each use, cleaning all parts that come into contact with breast milk.
    • If possible, expressed breast milk should be fed to the infant by a healthy caregiver who does not have COVID-19, is not at high-risk for severe illness from COVID-19, and is living in the same home.

What Mothers who are discharged from the hospital but have not met criteria to discontinue isolation should do?

they may choose to continue to separate from the newborn at home to reduce the risk of spreading the virus, if a healthy caregiver is available. If a healthy caregiver is not available, a mother with COVID-19 can still care for her infant if she is well enough while using precautions (for example, hand washing, wearing a cloth face covering).

What precautions should I take to breastfeed my baby directly at the breast?

As always, before touching your baby you should wash your hands. If you have tested positive or suspect you have COVID-19, wear a face mask and wash your hands before each feeding.

What precautions should I take to feed my baby expressed breast milk?

If you are sick or choose to express breast milk to feed your baby, you can do so with hand expression or a breast pump (manual or electric). Be sure to use proper hand washing before touching any pump or bottle parts and before expressing breast milk. Follow recommendations for proper pump cleaning after each use and thoroughly clean all parts that come into contact with breast milk. Clean the pump after each pumping session according to the pump manufacturer’s instructions. If possible, or if you are too sick to feed your baby, have another healthy person feed your expressed milk to your baby. Be sure everyone feeding your baby follows proper hand hygiene and wears a face mask if experiencing symptoms. To establish and keep your milk supply, it is important to express your milk from the breast as often as your baby eats every day, typically 8-12 times a day for newborns or every 1.5 to 3 hours.

should i put Face shields for newborns and infants?

Plastic face shields for newborns and infants are NOT recommended. There are no data supporting the use of infant face shields for protection against COVID-19 or other respiratory illnesses. An infant face shield could increase the risk of sudden infant death syndrome (SIDS) or accidental suffocation and strangulation. Infants, including newborns, move frequently, which could increase the possibility of their nose and mouth becoming blocked by the plastic face shield or foam components. The baby’s movement could also cause the face shield to become displaced, resulting in strangulation from the strap.

Pediatrics Related Questions

My child has congenital heart disease, is he at increased risk of COVID-19?

Are children with underlying conditions at increased risk of hospitalization?

I am currently hospitalized due to COVID-19, can I breastfeed my infant child?

What is KAWASAKI disease? What is the association with COVID-19?

What is a multisystem inflammatory syndrome? What is the association with COVID-19?

Should routinely recommended Hepatitis A and B vaccines continue to be administered to the children?

Should vaccinations for HBV exposed infants be continued during the COVID 19 pandemic?

Visitors Related Questions

Can I have visitors while I’m in the hospital?

Is there anything I can to do to help others who have COVID-19?

I would like to accompany my family member or friend for their procedure or appointments I am concerned they will need my support to cope or understand the information being shared with them by the healthcare team

General In-Patient Questions

Does being hospitalized with other COVID-19 patients worsen my outcome?

What are the diet recommendations if I get hospitalized?

What can I expect while I’m in the hospital?

When can I leave the hospital?

Can you catch COVID-19 from a blood transfusion?

There is no evidence that coronaviruses are transmissible by blood transfusion. Furthermore, pre-donation screening procedures are designed to prevent donations from people with symptoms of respiratory illnesses.

Do wastewater & sewage workers need additional protection when handling untreated waste from hospitals with COVID-19 patients?

Management of Dead Bodies from COVID-19?

Do any special procedures exist for the management of bodies of persons who died from COVID-19?

Health Care Practitioner (HCP) questions

I have underlying health conditions, are there work restrictions in place for me?

Is post-exposure prophylaxis currently available, and when can it be used?

Can routine vaccinations still be administered to patients?

Should I use face mask/respirator while taking care of pregnant patients with known/suspected COVID-19 infection?

I am a Health Care Practitioner living with someone who is at a higher risk of severe illness from COVID-19 infection. What precautions should I take?

I am pregnant and a health care worker. Can I work with patients who are potentially infected with COVID-19?

Information on COVID-19 in pregnancy is limited. Pregnant women are not currently considered at increased risk for severe illness from COVID-19. However, pregnant women have had a higher risk of severe illness when infected with viruses from the same family as COVID-19 and other viral respiratory infections, such as influenza.

Are there work restrictions recommended for HCP with underlying health conditions who may care for COVID-19 patients?

  • Adherence to recommended infection prevention and control practices is an important part of protecting HCP and patients in healthcare settings. All HCP who care for confirmed or suspected COVID-19 patients should adhere to standard and transmission based precautions.
  • To the extent feasible, healthcare facilities could consider prioritizing HCP who are not at higher risk of developing severe illness from COVID-19 or who are not pregnant to care for confirmed or suspected COVID-19 patients.
  • If staffing shortages make this challenging, facilities could consider restricting HCP at higher risk for severe illness from COVID-19 or who are pregnant from being present for higher risk procedures (e.g., aerosol-generating procedures) on COVID-19 patients.
  • HCP who are concerned about their individual risk for severe illness from COVID-19 due to underlying medical conditions while caring for COVID-19 patients can discuss their concerns with their supervisor or occupational health services.
  • People 65 years and older and people of all ages with serious underlying health conditions — like serious heart conditions, chronic lung disease, and diabetes — seem to be at higher risk of developing severe illness from COVID-19.

Whom should healthcare providers notify if they suspect a patient has COVID-19?

Healthcare providers should immediately notify infection control personnel at their facility if they suspect COVID-19 in a patient. If a patient tests positive, providers should report that positive result to their local/state health department.

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