The Covid-19 virus is behaving differently in different people. Up to now, we have seen 7 different manifestations of the coronavirus.
1. It is a viral illness, so it is a self-limiting disease; antiviral drugs are effective
2. It has bacterial activity, procalcitonin is high in some persons; antibiotics like doxycycline, azithromycin may work.
3. It has some HIV like properties, as there is lymphopenia (viruses usually cause lymphocytosis), a decrease in CD4 cell count; anti-HIV drugs may be effective.
4. It causes immuno-inflammation: rise in acute phase reactants (ESR, CRP, ferritin, and platelet count). Hydroxychloroquine may work.
5. It causes thrombo-inflammation: Increase in d-dimer and fibrinogen; anticoagulation may be important.
6. Silent hypoxia (walking dead phenomenon): Hypoxia (oxygen 60-70%) without loss of consciousness. put on 02...Think of methemoglobin.
7. Cytokine storm - Tocilizumab