Err is human: the covid-19 example about hydroxychloroquine

 April 2020
Dr. L. B. General practice in France

.

Covid19 treatment protocol in Algeria (thank Dr. Yasmin RAHALI).

ladies and gentlemen, here is a summary on the JEP of a COVID 19 case

• Clinical signs: research should be made:

1- Fever

2- Asthenia and myalgia (crowd)

3- Cough (dry or productive)

4- Dyspnoea: Effect or rest

Five-headaches

6- Diarrhoea, abdominal pain, nausea and vomiting

7- throat irritation

8- Anosmia (loss of smell)

9- Anorexia (bad smell in the mouth that gives disgust for food)

10- Hemoptysis

• Biology

1- Blood formula (NFS) to search for lymphopenia +++

2- Glycaemia, kidney balance

3- Hepatic assessment: AST, ALT, BT: increased

4- LDH (high), CRP high

5- Ferritin (high), VS and D-Dimeters (high), Procalcitonin (high)

6- ECG before plaquenil is introduced

• positive PCR or positive rapid test (if negative re-routing in 6 days)

• Radiology:

- Base pneumonia on Telethorax

- Basal and peripheral depoli glass

Lesions spread:

. Minimum less than 10 %

. Moderate: 10-25 per cent

. Severe: 50-70 per cent

Critics: exceeding 75 %

• Treatment:

1- Check plaquenil dose (xaria Cp 200 mg) 1 Cp 3 times a day for 10 days

2- Azithromycin 250 mg: 2 Cp/day on 1 Day and 1 Cp/day for 4 days

3- Claforan 1 g/ 8 h if the patient is hospitalized

4- Lovenox 0.4 / day

5- Vitamine C 1g: 1 cp twice daily

6- Zinc Cp: 1 cp twice a day

7- Treatment of comorbidities

NB: For CEC exacerbations of BPCO or asthma: avoid using the aerosol and privileges the inhalation chamber to avoid spreading the virus,( corticosteroids are not contraindicated?????? )

• Hygiendietetic councils:

1 - Sleep well at least 7 hours a night

2- Vitamine D: stay in the sun for 15 minutes

3- Maintain its microbiote: fermented foods: yogurt

4- Less stress if possible

5- Reduce sugar: a large amount of sugar slows down GB activity and imbalance microbiote

6- Eat certain foods:

Proteins that provide repair of cells

- Orange, lemon

- Cabbage, Brocoli, Peppers, Spinach

- Garlic +++

- Ognon

- Ginger

- Antioxidant

• Secondary effects of Hydroxychloroquin:

Cardiac:

- Lighting QT interval, peak torsades

- Branch block, syncopes.

2- Neurological:

- Psychotic episodes and neuropsychiatric

- Psychological (attention to corticosteroids that may induce these seizures)

3- Hepatitis: risk of fulminating hepatitis

4- Ocular:

- Retine and macula damage

- Visual field impacted

5- Digestive:

- Vomiting and anorexia.

cordially Dr. KADI.A

3