SIGS Week 3: COVID-19 Jeopardy Template

All about COVID-19!

Pathophys and Pathogen

Lab/Diagnostics

Masks and Management

Wild or Throwback?

100

What is the mode of transmission for SARS-CoV-2?

aerosols and fomites (objects or materials which are likely to carry infection, such as clothes, utensils, and furniture)

100

Compare natural history of disease between unvaccinated and vaccinated patients

Vaccinated people have reduced severity, complications, and mortality compared to unvaccinated
Unvaccinated people have higher rates of clinical deterioration, increased hospitalization, and a higher mortality rate

100

Justify the use of NAAT test for COVID-19

It's highly sensitive

(more sensitive than viral antigen tests)

100

Describe the need for SARS-CoV-2 vaccine after exposure

Can prevent future illness or less severity of illness as having COVID-19 once doesn't result in long-term immunity
Especially beneficial for patients who experienced severe complications or hospitalizations

100

What are strategies to prevent COVID-19?

Vaccination
Physical distancing
Wearing masks
Hand hygiene
Covering mouth or nose when coughing or sneezing
Avoid contact with infected individuals
Avoid touching face
Cleaning and disinfection
Monitor symptoms

200

Where did the SARS-CoV-2 virus originate from?

Started in bats and jumped to humans
Originated in Wuhan, China-->other regions in China--> throughout world

200

Name a virulence factor for COVID-19

Evade type 1 and type 3 interferon (allows virus to infect and spread to surrounding cells more rapidly with fewer initial flu-like symptoms)

200

What are expected findings from a nasal swab lab test? Why do we do a nasal swab?

Peak shedding (release of viral particles from an infected person to others) of infectious virus occurs 1-2 days before onset of symptoms until 5-7 days post onset
Highest concentration of virus in nasal secretions followed by sputum in patients who develop pneumonia

200

Name 2 OMT treatments used to support patients with COVID-19?

rib raising, abdominal diaphragm doming, thoracic lymphatic pump with activation, pedal lymphatic pump

200

How does hemagglutinin (HA) function as a virulence factor for Influenza A and B?

binds sialic acid and promotes viral entry (remember: time to make a new Home)
Major determinant of cell tropism

300

List the characteristics of SAR-CoV2

-stable

-viral envelope

-spike glycoprotein (s)

300

What are complications of COVID-19?

Can progress to acute respiratory distress syndrome (ARDS), septic shock, metabolic acidosis, bleeding, and coagulation dysfunction that are difficult to cure

300

What results would we expect for a patient who has COVID-19?

C-reactive protein, D-dimer, liver function, inflammatory markers

all elevated

300

Justify the use of antibiotics for COVID-19

Used if there's evidence of bacterial superinfection. Empiric therapy can be started if there's clinical suspicion (e.g. new fever after defervescence with new consolidation on chest imaging)

300

What is one bacteria that causes otitis media?

S. pneuomoniae

Haemophilius influenzae

Moraxella catarrhalis

400

Identify 5 risk factors for COVID-19

Age (65 years+: highest rates of morbidity and mortality
Cancer
Chronic kidney disease
COPD
immunocompromised state from solid organ transplant
Obesity
Hypertension
Serious lung or heart conditions
Sickle cell disease
Type 2 diabetes mellitus
Ongoing inflammatory processes indicated by elevated neutrophil to lymphocyte ratios
Younger and healthy individuals are also susceptible to serious disease
Race: Black, Hispanic, and Southern Asian due to SDH
Socially vulnerable groups (e.g. incarcerated people)

400

Describe the pathophysiology of cough, fever, and dyspnea, and myalgia!

Feel free to discuss others as well

see slide!

400

What are possible differential diagnoses for SARS-CoV-2?

Respiratory conditions:

Pneumonia
Influenza
RSV

Non-respiratory:

Acute heart failure
Pulmonary embolism
Exacerbation of COPD

400

Justify the use of CPAP management in COVID-19

Minimized risk of viral transmission to healthcare workers
Provided oxygenation to COVID-19 patients

400

What are the variants of COVID-19?

omicron, delta, beta, and alpha

500

Identify clinical features for mild or severe/critical COVID-19

Asymptomatic

Mild: low fever, fatigue, dry cough, myalgia, headache, loss of taste and smell, soar throat, diarrhea

Severe or Critical:

pneumonia, fever, cough, dyspnea (shortness of breath) , bilateral infiltrates on chest imaging, hypoxemia

500

Describe the pathogenesis of SARS-CoV-2

Exposure to virus via aerosol or fomite
Spike glycoprotein (S) cleaved by cell surface protease to produce binding and fusion subunit
SARS-CoV binds ACE-2 through receptor-binding domain on spike protein on to target tissues, mimics ACE-2, gains access to cells, and replicates
Infection initiated in upper respiratory tract and then lung-->loss of sense and taste (correlated with initial infection in nose)
Evades initiation of type 1 and 3 interferons
Infect on and cytolysis of lung epithelium-->damage of molecular signals that activate acute phase response from macrophages-->immune response with greater inflammation and hyperinflammatory-cytokine store systemic response
Diminished T cell and B cell responses

500

Simply, how is NAAT performed?

The NAAT procedure works by first amplifying the virus’s genetic material, if any is present in a person’s specimen. Amplifying those nucleic acids enables NAATs to detect very small amounts of SARS-CoV-2 RNA in a specimen, making these tests highly sensitive for diagnosing COVID-19 (CDC).

500

Each team will chart one vaccine! If your team answers correctly, you get points!

Pfizer-BioNTech COVID-19 Vaccine

Moderna COVID-19 Vaccine

Novavax COVID-19 Vaccine

Discuss amongst the group!

500

What drug can be used to treat Lyme disease? What is its MOA?

Doxycycline

Prevents bacterial protein synthesis by binding to the 30S ribosomal subunit