Definition of Disease Severity of COVID19 is detailed below:
COVID-19 disease severity definitions according to the World Health Organization (WHO COVID-19 clinical management: living guidance).
Mild disease |
| Patients with symptoms meeting the case definition for COVID-19 without evidence of viral pneumonia or hypoxia.
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Moderate disease | Pneumonia | Adolescents or adults with clinical signs of pneumonia (fever, cough, dyspnoea, fast breathing) but no signs of severe pneumonia, including SpO2 90% or more on room air. |
Severe disease | Severe pneumonia | Adolescents or adults with clinical signs of pneumonia (fever, cough, dyspnoea, fast breathing) plus 1 of the following: respiratory rate more than 30 breaths per minute; severe respiratory distress; or SpO2 less than 90% on room air.
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Critical disease | Acute respiratory distress syndrome (ARDS) | Onset: within 1 week of a known clinical insult (that is, pneumonia) or new or worsening respiratory symptoms.
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Critical disease | Sepsis | Adults with acute life-threatening organ dysfunction caused by a dysregulated host response to suspected or proven infection. Signs of organ dysfunction include: altered mental status, difficult or fast breathing, low oxygen saturation, reduced urine output, fast heart rate, weak pulse, cold extremities or low blood pressure, skin mottling, laboratory evidence of coagulopathy, thrombocytopaenia, acidosis, high lactate and hyperbilirubinaemia. |
Critical disease | Septic shock | Adults with persistent hypotension despite volume resuscitation, requiring vasopressors to maintain MAP 65 mmHg or more and serum lactate level of more than 2 mmol/litre. |
[1] If altitude is higher than 1000 m, then the correction factor should be calculated as follows: PaO2/FiO2 x barometric pressure/760. [2] When PaO2 is not available, SpO2/FiO2 315 or less suggests ARDS (including in non-ventilated patients). [3]Oxygenation index (OI) is an invasive measurement of the severity of hypoxaemic respiratory failure and may be used to predict outcomes in children. It is calculated as follows: percentage of fraction of inhaled oxygen multiplied by the mean airway pressure (in mmHg), divided by the partial pressure of arterial oxygen (in mmHG). Oxygen saturation index (OSI) is a non-invasive measurement and has been shown to be a reliable surrogate marker of OI in children and adults with respiratory failure. OSI replaces PaO2 with oxygen saturation as measured by pulse oximetry (SpO2) in the OI equation. [4] SIRS criteria: abnormal temperature (more than 38.5°C or less than 36°C); tachycardia for age or bradycardia for age if less than 1 year; tachypnoea for age or need for mechanical ventilation; abnormal white blood cell count for age or more than 10% bands.
For full details then see:
NICE guideline [NG191].COVID-19 rapid guideline: managing COVID-19
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