COVID-19 Management in India: Medical Aspects, Current Concepts, and Evolving Directions

Abstract

This review deals with the emerging coronavirus disease 2019 (COVID-19) epidemic summarizing current and evolving medical management in India, and also indicating future directions in the light of possible resurgence of this disease as pandemic as well as prospective biological threats resulting from acts of bioterrorism. Clinical accounts both in published or prepublication reports from the frontline epicenters were used, incorporating the evolving flux in guidelines and current controversies, expressed not only in Print media but also video-webinars and conferences constantly in progress. Rather than presenting hard conclusions from the few randomized controlled trials, less formal clinical impressions have been incorporated in the review as it is felt that at this stage of the COVID-19 battle, such data are relevant! Periodic rewriting on this subject is in our opinion, therefore, eminently desirable (Box format used to allow this). Apart from the respiratory crisis aggravated by cytokine storms, reference is made to the cardiovascular, neurological, renal, gastrointestinal, and cutaneous features, these generalized manifestations being related to the widespread distribution of angiotensin-converting enzyme-2 receptors in the body as well as to the acute inflammatory hypercoagulopathy and disseminated intravascular coagulation typified by hyperacute levels of acute phase reactants as well as the effects of hypoxia-overt or silent!

Keywords

• covid-19
• cytokine storm
• hypoxia
• cardiovascular
• respiratory
• hypercoagulopathy