Kasiulevičius advised how to behave after experiencing the first symptoms of COVID-19 and who needs to stay at home


The professor writes on the social network Facebook: “As Lithuania is currently in the zone of intensive dissemination of Covid-19 infection and the measures currently applied do not have sufficient effect, a strategy to protect risk groups is necessary”.

Based on BMJ data, V. Kasiulevičius noted that the majority of patients with C0VID-19 have mild to moderate disease.

“In this group, the most common duration of the disease is 5 days (2 to 10 days). Treatment is symptomatic (fluids, rest, acetaminophen, ibuprofen for fever and pain) ”, wrote the professor.

V. Kasiulevičius explained that a severe course of the disease develops in a much smaller group of patients. In this group, the breaking point is 7 days, when tired of increasing shortness of breath, the pulse oximeter shows a decrease in oxygen saturation in the blood – the SpO2 index drops less than 92 percent. Go to the hospital, where you will receive extra oxygen or other measures.

“We must remember that it usually infects at least 15 minutes. when communicating with another person without a mask at a distance of less than 2 meters. Recent US data shows that the risk of infection remains high when communicating with a sick person several times with a single contact time of several minutes, but a total communication time of more than 15 minutes. The disease usually starts 5-6 days after infection. A person with COVID-19 infects others 1-2 days before the onset of symptoms and can infect up to 9 days after the disease (!!!).

Although PCR samples detect SARS-CoV-2 RNA for an average of 17 days or even longer (max. 83 days), virus cultures are no longer grown after 9 days of disease. Therefore, 10 days of isolation in case of illness to not infect other people is enough “, assured V. Kasiulevičius.

Kasiulevičius advised how to behave after experiencing the first symptoms of COVID-19 and who needs to stay at home

© Vidmantas Balkūnas

How to reduce the number of seriously ill people?

According to the professor, it is known that old age, male gender and a higher body mass index correlate with a more severe course of the disease, but several chronic diseases are also associated with a higher risk. It is essential that people with these diseases communicate clearly how they need to behave in order to protect themselves.

V. Kasiulevičius highlighted several groups of people who currently receive special care:

Stay at Home Group

The following groups must be protected from any contact with Covid-19 (high risk):

Patients after solid organ transplantation (liver, kidney, pancreas) (recipients) receiving treatment that causes long-term suppression of the immune system

* Cancer:

* Chemotherapy is currently available

* Radiotherapy for lung cancer

* Blood / bone marrow cancer at any stage of treatment

* Immunotherapy or antibody treatment

* Applies to cancer treatments that affect the immune system

* Bone marrow or stem cell transplant in the last 6 months or immunosuppressive therapy

* Immunosuppressive conditions that significantly increase the risk of infection

* Severe respiratory disease:

* Severe asthma (≥3 steroid cycles in 12 months)

* Severe COPD (≥3 steroid cycles in 12 months)

* Cystic fibrosis, interstitial lung disease, sarcoidosis, bronchiectasis or pulmonary hypertension

* Rare diseases or congenital metabolic diseases:

* Severe combined immunodeficiency

* Homozygous sickle cell disease (sickle cell anemia)

* Pregnancy is when you have severe congenital or acquired heart disease

Kasiulevičius advised how to behave after experiencing the first symptoms of COVID-19 and who needs to stay at home

© Vidmantas Balkūnas

Strict social distance group

People with these conditions should avoid Covid-19 infection, keep their distance and wear masks as they are at medium risk:

* Mild chronic respiratory disease:

* Asthma

* COPD (emphysema and chronic bronchitis)

* Alveolites allerginis

* Chronic kidney disease:

* Stage 3 or 4

* End-stage kidney disease requiring dialysis

* End-stage kidney disease when a transplant is scheduled

* Heart disease:

* Congestive heart failure

* Heart valve disease

* Chronic liver disease:

* Chronic infectious hepatitis (hepatitis B or C)

* Alcohol-related liver disease

* Primary bile cirrhosis

* Primary sclerosing cholangitis

* Hemochromatozė

* Chronic neurological conditions:

* Epilepsy

* Parkinson’s disease

* Motor neuron disease

* Cerebral palsy

* Dementia (Alzheimer’s disease, vascular or frontotemporal)

* Down’s syndrome

* Diabetes:

* Type 1

* Type 2

* Conditions or treatments that may increase the risk of infection (eg steroid treatment):

* Rheumatoid arthritis

* Systemic lupus erythematosus

* Ankylosing spondylitis or other inflammatory arthropathy (for example, psoriatic arthritis)

* Connective tissue disease (eg, Ehlers-Danlos syndrome, scleroderma, Sjogren’s syndrome)

* Polymyositis or dermatomyositis

* Vasculitis (for example, giant cell arteritis, nodular polyarteritis, Bechet’s syndrome)

Other health conditions associated with increased risk, but not attributed to a specific group. However, it is also recommended to avoid contact with COVID-19 under these conditions. The list of these diseases includes:

* Cardiovascular diseases:

* Atrial fibrillation

* Recurrent diseases: myocardial infarction, stroke, angina pectoris, transient ischemic attack

* Peripheral vascular disease

* Hypertension is detected and treated

* Hyperthyroidė

* Chronic pancreatitis

* Non-alcoholic liver disease

* Malabsorption:

* Celiac disease

* Steatorėja

* Peptic ulcer (stomach or duodenum)

* Osteoporosis and hip, spine, shoulder or wrist fractures

* Serious mental illness:

* Bipolar affective disorder

* Psychosis

* Schizophrenia or schizoaffective disorder

* Sudden depression

* LIVE infection

* Hypersplenism

* Sphingolipidosis (pvz., Thai-Sachso League)

* History of thromboembolism

* Tuberculosis

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