New coronavirus disease (COVID-19): symptoms, laboratory blood indicators in the critically ill and dead patients
Keywords:new coronavirus infection, symptoms, laboratory parameters
The article states that the new coronavirus disease (COVID-19) is characterized by a range of clinical manifestations, the development of various complications, inconsistency of clinical, laboratory and instrumental data of the patient’s state, which the authors have observed so far according to the results of our previous studies. A review of the literature is presented on the symptoms, laboratory blood tests of critically ill patients who recovered and those who died of a new COVID-19. Among the hospitalized seriously ill patients, there were mostly men, a significant number had comorbidities. According to the literature, hospitalized critically ill patients with confirmed new COVID-19 in most cases had cough, fever, chills, shortness of breath, lymphopenia. Other symptoms include sputum, headache, dizziness, rhinorrhea, anosmia, dysgeusia, sore throat, abdominal pain, anorexia and vomiting, diarrhea, nausea, and muscle pain. The study concluded that doctors, especially after 3 days of illness, when assessing the state of the patient, should pay attention to the following data or their severity, a combination of several symptoms that may suggest the need for hospitalization, particularly in the intensive care unit: the age of the patient; the presence of concomitant pathology (cardiovascular, cerebral, chronic respiratory diseases, diabetes, obesity), especially in the stage of decompensation; the presence and extent of impaired consciousness (Glasgow Coma Scale); cyanosis, pallor of the skin, mucous membranes; acrocyanosis or central cyanosis; duration of fever (> 38 °C) more than 3 days, especially > 39 °C; manifestations of dyspnea (chest tightness, shortness of breath or tachypnea, shortness of breath during exercises), respiratory rate > 24 beats per minute or < 10; heart rate ≥ 125 beats per minute (measured when the patient is sitting); systolic blood pressure < 100 mmHg; SOFA score > 2; CURB-65 score > 2; the presence of signs of emergencies (acute respiratory distress syndrome, acute renal failure, bleedings and others); SpO2 < 93 %; leukocytosis > 10 • 109/l, lymphopenia, thrombocytopenia, serum C-reactive protein > 10 mg/l; an increase in prothrombin time (> 16), in the levels of D-dimer (> 1.5 ng/ml), ferritin (> 300), lactate dehydrogenase (above 360 U/l), procalcitonin (≥ 0.5 ng/ml), lactate (> 2 mmol/L), NT-proBNP (≥ 400 pg/ml), high-sensitivity cardiac troponin (> 5 pg/ml), changes on the electrocardiogram; lung damage more than 25 % according to computed tomography.
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