- Temperature 37.2, saturation 98, weakness is strong, – the famous family psychologist, candidate of sociological sciences Anetta Orlova describes on her page in social networks the typical beginning of covid . On the third day of severe weakness, the girl and her husband had blood tests. “I’m sending tests to the doctor… [he] looks and says: to the hospital, the threat of a cytokine storm,” Anetta recalls. Computed tomography in a covid hospital showed 60% lung damage, the condition deteriorated rapidly, the patient was transferred to intensive care. A little later, my husband was hospitalized.
“Looks like I also faced a midlife crisis. He declared himself brighter after the coronavirus nearly finished my journey, ”a psychologist wrote recently. She and her husband recovered, and Orlova shared with subscribers: “These [blood] tests saved our lives.”
- There are certain standards for the treatment of COVID-19. But coronavirus infection is very insidious, and in each case a different protocol applies. Camoe correct treatment is always individual, based on the parameters of blood – told in the ” Antikovid ” on the radio “Komsomolskaya Pravda” Candidate of Medical Sciences, Head of Preventive Medicine of the European Medical Center, founder of the Foundation for Support of medical staff “Heroes” Kirill oil .
- I think every doctor who treats coronavirus infection has patients whom he provides outpatient medical care. Not everyone needs hospitalization, the expert continues. – The most important thing in outpatient treatment is monitoring the development of the disease and the patient’s condition using blood tests. For my patients, whom I conduct remotely or on an outpatient basis, I recommend taking a certain set of tests, according to which we can understand how the coronavirus infection proceeds and how the body fights it. By analyzing these indicators, the doctor sees whether he will be able to cope with the disease at home and the person will recover, say, in 14 days. Or, most likely, he will have to be hospitalized.
Here is what the list of tests looks like, which determines the dynamics of coronavirus infection, said Dr. Masliev:
- General analysis of blood with a leukocyte formula.
This analysis gives an idea of the levels of various types of cells of the immune system: leukocytes, lymphocytes, eosinophils, neutrophils, etc. Such indicators are important, in particular, for deciding on the appointment of certain drugs. So, antibiotics in therapy in covid patients are used only when there is an attachment of secondary bacterial flora, which is reflected in the blood test by an increase in the level of leukocytes, the doctor explained.
Officially: according to the Methodological Recommendations of the Ministry of Health of Russia for the treatment of COVID-19, antibacterial therapy is prescribed only if there are convincing signs of a bacterial infection, including leukocytosis (that is, an increased level of leukocytes – Ed.)> 12X10 in the 9th degree / l.
- Biochemical blood test.
It is also important for understanding the state of the body and making decisions about the choice of drugs. In addition, a deviation from the norm of indicators in such an analysis may signal that the covid hit one or another target organ, gave complications, and led to an exacerbation of specific chronic diseases. All this is determined by the doctor.
Officially: according to the Method Recommendations of the Ministry of Health, hyperinflammation in COVID-19 can manifest itself, including in damage to liver tissue. At the same time, the level of aminotransferase indices in the blood serum rises (ALT, AST indices in the biochemical blood test).
- Level of C-reactive protein (CRP)
“This protein reflects the level of inflammation: how much our body is affected by such a reaction,” says Kirill Masliev. – If we see a gradual increase in C-reactive protein, then we understand that the defenses cannot cope with the infection, the foci of the spread of the disease are growing.
Officially: according to the Method recommendations of the Ministry of Health:
- C-reactive protein (CRP) is the main laboratory marker of process activity in the lungs. Its increase is interrelated with the volume of damage to the lung tissue and is the basis for the initiation of anti-inflammatory therapy.
- Serum CRP> 10 mg / L is considered one of the signs of a moderate course of coronavirus infection. In this case, taking into account other features of the patient’s condition, the issue of hospitalization should be considered.
- Ferritin level.
Another important indicator for assessing the level of inflammation in the body.
- Ferritin is a protein of the acute phase of inflammation, which gives information about the severity of the course of the disease and the prognosis.
- An increase in the level of ferritin is noted with an unfavorable course of the disease.
- Coagulogram .
The most important analysis that shows the state of the blood coagulation system. “Many people facing coronavirus infection develop damage to the epithelium (inner lining) of blood vessels, and there is a risk of blood clots. Therefore, it is very important for us to monitor the state of the blood coagulation system in order to prescribe appropriate medications, if necessary, ”explains Kirill Masliev.
Officially: in the case of coagulopathy (bleeding disorders) with COVID-19, the number of platelets in the blood serum is moderately reduced, the prothrombin time is slightly lengthened and fibrinogen is significantly increased (all these indicators are indicated in the coagulogram).
- Interleukin 6 (IL-6).
“Interleukins are important indicators of the activity of the immune system,” the doctor explains. – Their excess may indicate a too violent reaction to infection (in fact, it is a marker of a cytokine storm. – Ed.), Which requires the introduction of certain drugs, interleukin blockers.
- Interleukins increase during illness and decrease during recovery.
- Patients requiring hospitalization have significantly higher IL levels.
TO THIS TOPIC
At whose expense analyzes
“The mild course of the disease with the observation of the patient on an outpatient basis does not require additional laboratory tests,” says the guidelines of the Ministry of Health. And only “in case of hospitalization for a moderate, severe and extremely severe course of the infection” are the necessary studies performed, including blood tests. That is, free blood tests are not required for home treatment (unless the regional authorities order this by allocating additional funds).
It is believed that a patient who is not in the hospital, after being diagnosed with COVID-19, remains remotely under the supervision of a local doctor at all times. And with the appearance of outwardly noticeable alarming symptoms of a worsening of the condition (shortness of breath, high fever lasts for a long time, etc.), the question of hospitalization is resolved. However, in practice, especially in the regions, the picture often does not look so ideal. Therefore, if the patient or his loved ones have the opportunity to take care of themselves on their own, it is worth calling a nurse at home for a fee to take a blood test, medical experts advise. Kirill Masliev explains that in order to understand the dynamics of a change in state, you need to re-take the analysis after 2-3 days. If this is difficult, do the analysis at least once, doctors say.
Only a doctor can interpret the results, experts emphasize. An independent attempt to assess “the norm, is it greatly increased”, etc. in this case it is meaningless. If you do not have access to doctors involved in the treatment of covid in order to send tests, you can use telemedicine services (today there are already many mobile applications). Also, specialized communities for finding specialized doctors can be found in social networks.