How to evaluate the course and predict the severity of COVID-19
Iryna Sidorova, medical director of the medical laboratory DILA
In COVID-19, the human barrier and defence mechanism functioning passes through the test of strength. The disease course depends largely on the state of organs and systems at the moment of invasion by an infectious agent, their ability to take a “viral” blow. A healthy organism quickly mobilises its resources, and, in the majority of such cases, the course of COVID-19 infection is mild, like any ARVI.
A high-risk group of developing a severe COVID-19 infection includes patients over 60 years of age, or with obesity, chronic comorbidities, and smokers. It is they who require timely and integrated monitoring of the body’s response to the disease.
The peculiarity of COVID-19 is that it is not limited to the involvement of one organ, but affects virtually all body systems. This is precisely why it is impossible to do only with a full blood count in the condition monitoring.
What is the first thing we should pay the most attention to in the laboratory diagnosis of the disease
- Intensity and nature of the inflammatory reactions. The levels of C-reactive protein, interleukin-6, and ferritin help the clinician understand the urgency and scope of the first curative measures.
- Changes in the coagulation system and risk of thrombosis. The haemocoagulative parameters and the D-dimer level allow evaluating this process. The D-dimer test can indicate increased thrombus formation, which is often the cause of fatal outcomes. The increased blood clot formation in small vessels leads to oxygen deficiency (hypoxia), injury of the lungs, myocardium, kidneys, liver, gastrointestinal tract, and nervous system.
- Organ dysfunction. This is evidenced by standard biochemical indicators. Creatinine and urea show the kidney function; bilirubin and transaminases (ALT, AST) reflect the liver function; troponin expresses the myocardial function; LDH indicates an increase in tissue hypoxia (and this is an immediate threat to life).
- Full blood count. It introduces additional clarity during the patient’s condition assessment and decision for treatment strategy.
- Monitoring of indicators in dynamics. Negative changes in the body functioning can develop very quickly. That is why laboratory parameters require mandatory repeated testing for timely improving treatment strategies. For example, an increase in the neutrophils and procalcitonin level suggests the addition of a bacterial infection and the need to prescribe antimicrobial drugs.
COVID-19 is an insidious disease. Its onset is often mild with a common runny nose, loss of smell, coughing, indigestion, and no fever. And already in the second week, it can rapidly change for the worse with high fever, intoxication, weakness, and difficulty breathing. In these cases, a comprehensive physical examination is of utmost importance.
Laboratory diagnostics is intended to quickly assess risks and find indicators deviations from the norm. A doctor, receiving data from a comprehensive risk factor analyses for developing severe COVID-19 from Medical Laboratory DILA, promptly determines the strategy of treating the patients or refers them for urgent hospitalization.
What to do after receiving the lab test results?
Only your healthcare provider is the best person to properly assess the severity of COVID-19 infection by analysing all the data (anamnesis, physical examination, and lab test results). Self-medication can lead to a worsening of the condition and unintended consequences.