By rray, 3 June, 2024 PMHx Check pre COVID cognitive status issues current cognitive sx severity and impact on daily activities QOL ROS 1 COVID severity hospitalization3 e g post ICU syndrome
By rray, 3 June, 2024 Assess for contributing meds e g antihistamines anticholinergics antidepressants anxiolytics hypnotics muscle relaxants antipsychotics etc 1
By rray, 3 June, 2024 Sx timeline Cognitive issues common w acute COVID sx 1 Evaluate if cognitive sx severe or affect QOL 4wk from onset Assess current vs pre COVID functional status 3
By rray, 3 June, 2024 Brain fog definition 2 Common self reported cognitive dysfunction in adults includes attention working memory processing speed executive function phonemic and category fluency and memory encoding recall Memory recognition is relatively spared Hospitalized
By rray, 3 June, 2024 Mental cognitive fatigue definition 1 progressive darr in cognitive resources over time while performing tasks that require sustained attention and executive function independent of deficits related to motivation or inadequate sleep
By rray, 3 June, 2024 Post COVID cognitive fatigue1 and cognitive dysfunction e g brain fog affecting processing speed exec function etc 2 etiology unknown likely multifactorial may overlap w mood disorders physical fatigue Sx may include post exertional malaise worsening of s
By rray, 3 June, 2024 Chest pain 1 If ischemia ruled out and pain is pleuritic or underlying inflammation present e g costochondritis Consider 1 to 2 wk NSAID trial w low dose colchicine added prn If sx worsen w NSAID consider esophagitis esophageal spasm If suspected endothel
By rray, 3 June, 2024 Suspected pericardial involvement w o myocarditis Can likely manage as out pt if chest pain is only sx LV systolic function preserved no ventricular arrhythmias If pericardial involvement NSAIDs colchicine or prednisone Monitor closely Consider repeat car
By rray, 3 June, 2024 Severe myocarditis Manage in hospital w advanced cardiac expertise If severe concurrent lung injury hemodynamic compromise MIS A or severe myocardial infiltrates fulminant myocarditis on bx steroids balanced against infection risk If reduced LVEF Treat HF
By rray, 3 June, 2024 Mild moderate myocarditis Manage in hospital w advanced cardiac expertise If concurrent lung injury steroids If pericardial involvement NSAIDs colchicine or prednisone If reduced LVEF Treat HF Avoid vigorous physical activity x3 6mo repeat cardiac testing