International Journal of Clinical Case Reports and Reviews Copy rights@ Habip Gedik et.al. Auctores Publishing – Volume 4(5)-0086 www.auctoresonline.org ISSN: 2690-4861 Page 1 of 3 Clinical complications and challenges during the follow-up of inpatients with COVID-19 Habip Gedik Department of Infectious Diseases and Clinical Microbiology, Ministry of Health Bakırköy Sadi Konuk Training and Research Hos pital, Istanbul, Turkey. Corresponding Author: Habip Gedik, Department of Infectious Diseases and Clinical Microbiology, Ministry of Health Bakırköy Sadi Konuk Training and Research Hospital, Istanbul, Turkey. Received date: October 27, 2020; Accepted date: November 28, 2020; Published date: December 07, 2020 Citation: H Gedik. (2020) Clinical complications and challenges during the follow-up of inpatients with COVID-19. International Journal of Clinical Case Reports and Reviews. 4(5); DOI: 10.31579/2690-4861/086 Copyright: © 2020 Habip Gedik, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract: Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), affecting people. Turkey was reported to the public by COVID-19 first cases of the Ministry of Health on March 10, 2020; and 520,167 cases and 14316 deaths were reported on December 03, 2020, respectively. The survival of these patients is usually determined over a 7-day intensive care follow-up. The survivors begin to recover clinically after the 15th day. So the riskiest period in terms of mortality is between 7-14 days. The antiviral called Favipiravir was administered only to intensive care patients in the first period and then allowed to patients in the clinic with oxygen saturation below 90% to achieve an improvement in the early period of patients with impaired oxygen saturation. But, it did not benefit patients with support with mechanical ventilation in ICU and their mortality rates. The cause of death is generally a respiratory failure due to the functional loss of lungs. Antiviral treatment is certainly needed to administer in the early period of disease to prevent a severe inflammatory response. Key words: COVID-19; diagnosis; follow-up; complications COVID-19 (COVID-19), long coronavirus disease 2019; an infectious respiratory disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), affecting people [1]. The disease, first discovered in Wuhan, China's Hubei province in 2019, has spread worldwide. Since its discovery caused a 2019-20 coronavirus pandemic. As of 9 May 2020, more than 3 759 967 cases have been reported across 187 countries and territories, resulting in more than 259 474 deaths. More than 1.31 million people have recovered. [1, 2] Turkey was reported to the public by COVID-19.The Ministry of Health reported the first case with covid-19 on March 10, 2020, and 520,167 cases and 14316 deaths were reported on December 03, 2020 respectively. [3] Super silent spreaders are active in the vial transmission. Because, super silent spreaders, whose immune response is insufficient or unreturned, allow the virus to reproduce silently and that is a major factor in the spread of the disease. [4, 5] According to our observation, the virus binds to the upper respiratory epithelium and reproduces itself. [6, 7] After that it makes its first viremia, infecting almost all organs such as lung, brain, intestine, muscles, vascular structure, after viremia, and revealing related clinical pictures. [8-11] In other words, we do not think that the virus reaches the lung and creates an infection. If this were the case, there would not be so many patients, due to the spread of the virus and the number of infected people. Since the amount of virus that would reach the lung was prevented by physiological barriers. Clinical and radiological findings were more helpful in diagnosing patients, since the result of the PCR test was concluded 1-2 days after application. Although the PCR test was negative, we found that patients with clinical and thoracic tomography findings were predominant. CT is more sensitive in diagnosis than the PCR test (Another issue is the situation of people who have no clinical findings, but who have PCR positivity. First, the false positivity of the PCR test, unfortunately, did not allow questioning due to the severity of the pandemic during this period. It will be useful to evaluate samples, such as oropharynx, nasopharynx, sputum, etc. and to support the results with antigen screening tests to reveal false positivity of these individuals. [12, 13] We suppose that these people have the real PCR positivity, so is this action in the transmission? As we have the case of Tuberculosis disease, sputum PCR samples remain positive for some time in patients receiving tuberculosis treatment, although sputum culture and smear tests are negative. We know that the PCR positivity here is not infectious. In this case, can the PCR Covid-19 viral load value be taken into account? Because, how effective is it in transmitting low PCR positivity? Is it infectious? The Republic of Turkey, Ministry of Health has published a COVID-19 treatment guideline to avoid treatment chaos in the management of patients with COVID-19. [14] According to the guideline, hydroxychloroquine + azithromycin + oseltamivir (due to the Influenza season) was initiated to patients with clinical and/or radiological findings Open Access Mini Review International Journal of Clinical Case Reports and Reviews Habip Gedik* AUCTORES Globalize your Research