Return to work for COVID with kidney stone disease an occupational medicine case report
Background: Corona virus was first discovered under the name Novel Corona Virus 2019 also referred to as SARS Cov 2 causing Corona Virus 2019 (COVID19) as acute respiratory infections. The cause of the calculogenesis process in kidney stone disease is divided into 2 factors, namely intrinsic factors (such as age, sex, congenital) and extrinsic factors (such as geography, climate, minerals, diet, water content). The Occupational Medicine Specialist Recommendation based on Covid Return to Work from American College of Occupational and Environmental Medicine.
Objective: This article was created to assess the process of returning to work in covid inpatients with respiratory failure, accompanying kidney stones in non shift triage nursing workers. Is there a connection between covid and work and the occurrence of kidney stones and recommendations to return to work in these patients.
Case Presentation: Woman, 54 yo, Chief complaint was Nausea and Vomiting 5 times more, went to the Emergency Room (ER) on September 18th 2020, had decreased saturation and positive swab on September 18th 2020. She was treated in Hospital on September 20th 2020, the lowest saturation was 91 but was not dyspneu and he was given nasal oxygen therapy. There was a previous history of fever on September 15th 2020 but the clinic’s swab was negative, diagnosed with kidney stones. Other complaints include blood pressure rising due to pandemic stress since April and hair loss while being treated in Hospital at September. The person concerned takes care of the patient as Primary Nuurse in the ER with the additional task of technical coordination and the person in charge of medical devices condition. In 1 unit, there are 3 co-workers, namely the nurse in the morning shift. Meanwhile, non shift nurses consist of 6 people (head nurse, nurse officer, ppi nurse, 2 primary nurses, palliative nurse). There are already 13 positive Covid nurses on the 1st floor of the ER and no one has died. Contact with isolation triage patients and no contact with co-workers.
Discussion: Thats 2 diagnose for this patient, with Occupational Covid; and Kidney Stone Disease not related job. The existing consensus is that the main transmission of COVID-19 is through droplets, although it is possible for the virus to be spread through aerosols, especially in health care workers. Covid could affected acute kidney injury, necessary to pay attention to the administration of high doses of vitamin C and certain antibiotic in severe cases of Covid-19 being treated, due to the findings of kidney stone disease due to hyperoxaluria both primary and secondary. The use of non-steroidal anti-inflammatory drugs (NSAIDs) as anti-pain in colic pain was also observed considering from Fang et al that NSAIDs increase ACE2 receptor expression so that it can aggravate the Covid19 disease. Severe increases in cytokines and biomarkers are referred to as Cytokine Storms which are fatal, especially cardiopulmonary and contribute to multiorgan failure. Treated Covid-19 disease can also cause complications in the form of androgenetic alopecia (AGA). The possibility of baldness is due to low oxygen saturation.
Conclusion: Return to work (RTW) recommendation thats Fit with Note, no Ibuprofen NSAID therapy for colic renal, limitation Vit C therapy and certain antibiotic. Occupational Education for Uro-Clinic Control, Drinking water and limiting acidic food and drinks, 3M Protocol (mask-washing hands-keeping distance), Adhere to putting on and removing the red zone Personal Protective Equipment (PPE.) Control with Indoor Air Quality, avoid close contact, PPE according to red zone. Early Diagnosis of other workers via Tracing Swab Contact, Re-swab until negative to return to work. Fit to work is obtained Healthy and returns to work on October 5th 2020. Return to work for COVID-19 patients being treated include Metabolic Stress Echocardiogram (ECG), Full Pulmonary Function testing with impedance booth or washout testing, High-resolution CT scan of the chest especially Covid19 with pneumonia, Functional capacity testing and Neuropsychological testing. AMA Class 0% of respiratory impairment, no current symptom and 10% of upper urinary tract disease, symptom and increase ureum/creatinin (Criteria for Rating Impairments of Station, Gait, and Movement Disorders according to AMA 6th ed). Compensation according to PP no. 82 of 2019.