COVID Pneumonia: Anatomical, Physiological and Pathophysiological Concepts and Management Approaches

This report discusses the case of a patient with COVID Pneumonia, including the anatomy, physiology, and pathophysiology of the condition. It also evaluates the science underpinning pharmacotherapy and non-pharmacotherapy management approaches, such as ECMO therapy and ventilator support.

Covid 19

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Brief outline of the complex health condition of the patient.......................................................3
Anatomical and Physiological concepts related to complex health condition.............................4
Pathophysiological concepts of the complex concept related to speciality patient.....................5
Science underpinning pharmacotherapy management of the person’s condition........................6
Evaluation of science underpinning non-pharmacotherapy management of the patient’s
condition.......................................................................................................................................7
Critically analysing and application of the high quality evidence underpinning approaches of
care ..............................................................................................................................................8
CONCLUSION................................................................................................................................9
REFERENCES...............................................................................................................................10

INTRODUCTION
During the time of pandemic the spread of the Covid-19 disease has created the serious
problems for the people all over the globe. This is because the disease has reduced the effective
capacity of the lungs and created the various types of the problems to the people that was related
to the respiratory system. The major threat that has been created due to COVID is aligned with
the COVID- 19 Pneumonia. The pneumonia that has been caused due to COVID leads to impact
the lungs in patient and this leads to create shortness of breath Wilcox, (2020). There were the
various types of conditions that has resulted into the deaths of the people and the number of
deaths was very high as the respiratory system requires the continues flow of oxygen and
COVID Pneumonia directly impacts the breathing system in patient. Thus, the present case is
based on COVID pneumonitis.
This report will explain about the various aspects of the Pneumonia due to the covid-19
and the situation that it can create for the patient. Along with this, the report will discuss COVID
pneumonitis anatomy and physiology. Furthermore, the report will help in understanding the
various types of pharmacotherapy and non-pharmacotherapy management that can be used for
helping the conditions of the patient. Lastly, the report will discuss the approaches that can be
adopted for COVID pneumonitis that includes lungs transplant, social distancing, protective
gears and vaccination. The major care approaches that assure effective cares services to COVID
pneumonitis will be highlighted in the report.
MAIN BODY
Brief outline of the complex health condition of the patient
The available information of patient is stating that, patient has fever from last 9 days and
from last two days patient is often facing shortness of breath. Yellow cough along with the blood
stained sputum has been produced by the patient. When the patient has been arrived in ED, Spo2
of the patient was 72%. Heart rate of the patient was 120, BP was 134/85 and the temperature
was 37.3. The partial pressure of oxygen has been found between 80-100. However, the Initial
ABG(Arterial blood gas) is 100% in the patient. The ratio of the arterial oxygen partial pressure
to fractional inspired oxygen is 50%. Partial pressure of carbon dioxide is 30. WCC is 13.4 and
CRP is 42. 1G ceftriaxone and azithromycin has been given to the patient in ED. The patient has
been found COVID positive. There is difficulty in recruiting the hameodynamics in patient. All

of available information from the case is stating that patient has COVID Pneumonia. The major
symptoms of COVID Pneumonia has been considered as that infection that cause impact over
the lungs of the patient. The lungs of the patient has been filled with the fluid that is causing
difficulty in breathing. This is necessary to understand that when the covid-19 virus enters the
human body it starts to impact the lungs of the human and causes damage to the respiratory
system which results into the ineffective breathing and the reduced oxygen storing capacity of
the lungs Endeman & et.al. (2020).
The covid-19 virus when enters the human body and starts making damage to the lungs
and the respiratory system creates problem for the person which results into the ineffective
breathing and continuous coughing. The virus can lead to a serious and complex health condition
of the lungs damage that can reduce the efficiency of the infected person and make them suffer
and it creates a situation that can be problematic for the person and make it tough for them in
breathing. Thus, same has happened in the case of patient and this leads to create the infection
(Pneumonia) in patient.
Anatomical and Physiological concepts related to complex health condition
Gurjar & et.al (2022) Elucidates that the major complication that has been arrived due to
COVID pneumonia is associated with the hypoxaemic respiratory failure that requires the
mechanical ventilation. The COVID creates the mild fever, headache and cough in individuals.
This occurs due to an infection (Pneumonia) that has been caused in the upper respiratory tract.
As stated by Saha & et.al. (2021). The physiological concept behind the pneumonia due to
COVID is associated with impacting the lungs. Virus has directly impacted the lungs and
damaged the alveoli. The major function of alveoli is to transferring the oxygen to the blood
vessels. The capillaries of the blood vessels contains oxygen and carries it to the Red blood cells.
Finally, RBC delivers oxygen to the internal organs in body. Thus, the virus impacts the wall and
lining of the alveolus and capillaries by damaging them.
Often, wall becomes thick and transfer of oxygen becomes more difficult. As a result, this
causes difficulty in breathing for patient as the range of oxygen in body reduces. Thus, the lack
of oxygen in body results in creating deficit in order to perform another mandatory functions in
body. As a result, there is lack of oxygen that major functioning in body. The air sacs become
damaged and creates liquid that further hinders oxygen exchange. Often, this fluid leads to create
situation of Pneumonia. Therefore, it creates difficulty in breathing for patient. When it becomes

hard to breath the patient feels large number of issues it often creates the loss for patient. Major
cases of the COVID Leads to pneumonia. Once the patient faces difficulty in breathing it
automatically leads to pneumonia. This leads to disturb the transfer of oxygen in patient and
often creates the problem in breathing.
As per the views of Rossi & et.al. (2022) the major symptoms of COVID pneumonia
includes, fever, shortness in breathing, coughing with blood. The major symptom is aligned with
difficulty in breathing. Same has been observed in the patient. The patient has high fever and
shortness in breathing. Often, the patient has produced yellow cough with the blood. This is
indicating infection in the upper respiratory track of patient and that is pneumonia. As the
COVID pneumonia mainly impacts the upper respiratory tract and creates issues in breathing.
Pathophysiological concepts of the complex concept related to speciality patient
Pathophysiology of COVID PNEUMONIA
Pathophysiology refers to the disordered psychological procedure that is associated with
diseases or the injury. Thus, the pathophysiology of COVID Pneumonia has been marked by the
inflammation -mediated disturbance in the alveolar capillary permeability, reduced the alveolar
clearance, reduced the compliance, increases the pulmonary vascular resistance. Thus, this
results in the abnormalities in exchange of gases. It happens in patient due to the shunting and
the ventilation mismatch. Mechanical ventilation in the regional disease heterogeneity may
propagate the ventilator associated injury (Joly, Siguret & Veyradier, (2020). Lung injury due to
COVID resembles in the other caused of pneumonia. The initial clinical features includes the
Hypoxemia and the loss of dyspnea perception.
The primary alternation that has been occurred in the patient creates the shift from the
oederna and the atlelectasis for organizing pneumonia. Along with this, the major impact has
been created over the lungs of the patient. The abnormalities in gas exchange creates the issues in
breathing. Thus, COVID pneumonia has been determined as the form of non-cardiogenic that is
concerned with the inflammatory conditions that has been marked by diffuse alveolar damage. A
wide spectrum of perfusion including dead space is responsible for the gas exchange (Duzgun &
et.al. (2020). Thus, the over-all pathophysiology along with the clinical course of the COVID is
directly related to the lung injury that is highly similar with the other forms of the virally-
mediated.

Science underpinning pharmacotherapy management of the person’s condition
Pharmacotherapy management has been determined as the treatment of the disorder or
any diseases with the help of medication. During the treatment the medication has been used in
order to assure effective care services to the patient so, the patient can easily recover from the
diagnosis. The assured medication helps in reducing the symptoms and impacts of the existing
disorder in the patient. Thus, in similar manner the pharmacotherapy management of the COVID
Pneumonia includes providing medication to the patient. (Barlow & et.al. (2020).
The drugs that has been proven most promising in the case of COVID pneumonitis are
Chloroquine and Hydroxychloroquine. These drugs have the long-standing history in the
prevention of Pneumonia and the treatment of the chronic inflammatory diseases that includes
the systemic lupus erythematosus and rheumatoid arthritis. These agents have the
immunomodulatory effects through attenuation of the cytokine production and the inhibition of
the autophagy and the lysosomal activity in the host cells. Ritonavir and Other Antiretrovirals
has been also proven as effective drug in the treatment of COVID pneumonia. However, there
are side effects of this drug that is associated with the nausea and liver injury (Raghunathan &
Dhaliwal, (2020).
The patient gas provided the pharmacological agents which are intravenous anti-biotic,
Remdesivir and Dexamethasone. The major benefit of Remdesivir is associated within showing
faster improvement in the symptoms of the COVID. Also, this leads to reduce the chance of
death for the patient who is facing COVID- pneumonia. The patient must take this drug when
there is requirement of oxygen. The major side effect of this drug are entitled with the liver
damage in the patient (Izumo & et.al. (2021). Often, there is potential risk of kidney damage in
patient. The another drug that has been given to the patient is Dexamethasone. This drug has
been considered as life saving medication for COVID- pneumonitis. Dexamethasone dose of 6
mg to the patient on daily basis improves the condition of the patient. The major side effects of
this drug in entitled to allergic reaction in patient. High dose of this drug can create the impact
over heart of the patient. The another side effects are associated with the eye problems and
infections.

Evaluation of science underpinning non-pharmacotherapy management of the patient’s
condition
Non-pharmacotherapy management refers to the providing treatment to the patient
without giving any kind of medication it involves therapies that does not involve any kind of
drug. Non-pharmacotherapy is equally important as pharmacotherapy is. Medication that has
been given to patient often crates side effects and impacts the conditions of patient. Therefore,
complete dependency over medication cannot be prefer therefore, non-pharmacotherapy is
important as it does not contain any kind of side effects and often useful for the patient. Thus,
non-pharmacotherapy for pneumonia due to COVID involves ECMO therapy and ventilator
support. The real breathing issue due to COVID comes from damaging all areas of lungs. Due to
this the body of the patient does not working in well condition. As stated by Ghasemiyeh &
Mohammadi-Samani, (2020) When the body fails to pass the rate of oxygen in such situation
ECMO therapy becomes helpful. The RVAD has been placed inside the patient with the help of
the tube that directly goes in the neck of the patient down to the right artium and the right
ventricle in the heart and under the pulmonary artery. This helps in taking blood out and sent it to
the ECMO machine. In the machine the blood has been filtered and the carbon dioxide has been
removed. Afterwards the blood has been entered into the pulmonary artery. 100% of the oxygen
has been put into the pulmonary artery that solves the breathing issues in patient and often helps
in performing body functions in effective manner. Thus, this therapy helps in clearing the
pathways that act as hurdle in breathing pattern of the patient. The blood has been filtered and
sent again in the pulmonary arteries and patient become able to breath.
Ventilation support has been considered as another non-pharmacotherapy management in
COVID pneumonitis. With the help of this effective exchange of gas has been done in patient
without harming the parts of the lungs. COVID pneumonia impacted the lungs of the patient and
creates respiratory failure and that creates numerous issues in breathing. Therefore, it is
important to assure focus over increasing the exchange of gases in patient. This needs to be done
in such manner that does not impact the lungs of the patient and ventilation support assures no
harm to the lungs. The major goal of the ventilation is to acute the hypoxemic respiratory failure
and it supports the exchange of gases. As per the views of GÜNER, Hasanoğlu & Aktaş, (2020)
Ventilator has been determined as the machine that provides support to the patient in order to
breath. It helps in pumping the oxygen into the lungs of the patient so patient can easily breath. It

often helps in breathing out carbon dioxide which is a harmful gas and that needs to get rid of
from the body. Thus, ventilator support helps in assuring oxygen in the body so patient can easily
breath along with this it helps in taking carbon-dioxide out from the body that impacts lungs in
negative manner. Thus, this is one of the non-pharmacotherapy management that has been used
for providing treatment for the patient.
Critically analysing and application of the high quality evidence underpinning approaches of
care
Preventative care:
The preventative care for patient is practising standard hygiene within washing hands
properly as the patient has been vaccinated three times. Therefore, self-monitoring of the upper
respiratory tract needs to be done. Personal items such as, towels, clothes and utensils needs to be
keep away from the other people. Social distancing must be maintained and immediate
interaction with the visitors needs to be neglected. Often, at home also social distancing needs to
be maintain within keeping the distance of 2 meters with the family members. All these measures
helps in managing prevention (Zhao & et.al. (2020). Thus, the patient has infected from COVID
pneumonia. Therefore, Isolation needs to be done patient needs to be quarantine so the threat of
infection cannot be transferred to other people.
Curative care
Lung transplant has been proven life-saving treatment for the patient who are facing
COVID pneumonia. However, the patient is not receiving lung transplant. The complex health
condition of patient is associated with the respiratory failure. Recovery of the native lung results
in long term effective outcome (Kurihara & Bharat, (2021). However, infection can create
technical barrier in lung transplantation in the patient. Therefore, it has not been approached for
the patient. Super-infecting pathogens are associated with the viral pneumonia in the native of
lung may occur in allograft. Often, there is uncertainty whether the lung of the patient can repair
itself after associating with pneumonia. Thus, effective lung repair is often better than lung
transplantation.
palliative care
Comfort measures and oxygen therapy needs to be given to patient. Palliative oxygen
therapy that needs to be given to patient increases the rate of oxygen in patient that helps in
solving the problems of breathing. This therapy works at the time of resuscitation of patient in

order to achieve the SpO2 of 94% or more than the 90% when the patient is stable. This therapy
filters the blood of the patient and often removes carbon-dioxide gas from the body and
maintains gas exchange in upper respiratory tract that helps in dealing with the shortness of
breathing (Gorenstein & et.al.. (2020). Thus, respiratory failure due to COVID is the major issue
that is related with the breathing problem in the patient. Therefore, palliative care approach is
best in terms of assuring treatment to the patient as it helps in solving the breathing issue of
patient that impacts the respiratory system in the patient.
CONCLUSION
Thus, it can be concluded that the various aspects of the covid-19 can make an impact on
the health of the person which can result into the ineffective treatment of the patient. The covid-
19 virus can cause the various types of problems such as the ineffective breathing and the
reduced oxygen storage capacity of the lungs. The disease can lead to the various types of
complex conditions such as the respiratory failure and develop infection (Pneumonia) which can
create the problem of reduced efficiency in breathing and can cause into the death of the patient.
The respiratory failure can affect the overall body of the patient and make the person suffer as
there is not enough capacity of oxygen storing.
The various levels of analysis such as the anatomy and the physiology can be done so that
there can be the effectiveness in the analyses and understanding of the complex situation. There
are various pathyophisiological concepts of the respiratory failure that can be evaluated so that
there can be better and effective understanding of the complex condition. There can be the
various types of the pharmacotherapy management such as the vaccines and the common
intensive care covid drugs can be used so that the problem that is caused due to the respiratory
failure can be reduced. The various non pharmacology managements such as the ECMO
therapies and the ventilator support can be given to the patient that is dealing with the problem of
respiratory failure due to the covid-19 virus.

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