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In recent times, many bloggers have appeared on social media ready to talk about the coronavirus, it would seem, of everything. But sometimes their advice raises even more questions. UfacityNews.ru correspondent spoke with Elena Davletova, Deputy Chief Medical Officer of the Medical Department of Polyclinic No. 38 of Ufa and I have discovered why COVID-19 smears can be negative even when symptoms appear and when anticoagulants can only harm.
– A patient comes to a therapist or a doctor comes to a call: how does he tell if it is flu, SARS or there is a suspicion of COVID-19?
– When the doctor sees the patient, he pays attention to a couple of landmarks in the differential diagnosis. These are the temperature, the day of the illness, the symptoms (runny nose, cough, body pain), it is important to take into account the epidemiological history. Next, we examine the patient objectively: we conduct auscultation (listening to sounds in the internal organs – ed), percussion (touching certain parts of the body) and measure blood saturation. But you must always be prepared for the fact that any patient with ARVI can be covid. Therefore, according to the orders of the Ministry of Health, smears are taken from all patients with ARVI.
– How many patients do you see a day, even when you go out for calls? Are you referring to a computed tomography or coronavirus smear?
– We have about 200 calls today. We take coronavirus swabs from all patients with signs of ARVI and fever, symptoms of intoxication – these include headache, weakness, weakness, muscle pain, nausea, and others. A CT scan is performed strictly according to indications.
– Situation: a person has fallen ill, is afraid that it is a covid, but does not know for sure yet. Should you drink blood thinners for prevention?
– It is imperative to call a doctor and solve problems with a specialist. See related diseases, if possible take the test. In practice, there was a case when a young patient himself, without a prescription, began to drink blood thinners, but a strong cough contributed to the trauma of the bronchi and bronchioles, a cough with blood streaks appeared , which had to be discontinued in the hospital. Anticoagulants are necessary, but strictly according to the indications and under the supervision of a doctor.
– Aspirin has been shown to reduce the risk of death and complications in patients with COVID-19. Is the drug recommended as a prophylaxis for people at risk?
– Yes, we recommend if there is no alternative. There are 500 milligrams of aspirin in one tablet and the proven antiplatelet dosage is 100 milligrams, the tablet is so hard to separate. Therefore, it is better to use tablets with a dosage of 100 milligrams (acecardol, ass-cardio, cardiomagnum, thrombosis and others).
– According to foreign studies, a vitamin D or zinc deficiency increases the risk of a severe coronavirus course. What vitamin and mineral complexes do you recommend for patients to drink for the prevention or treatment of covid and seasonal diseases?
– Any multivitamins with group B, zinc, ascorbic acid, prepared with a sufficient content of vitamin D. No preference.
– Are there any dietary recommendations during covid disease? What to eat and what not to?
– Now many materials on nutrition are published. They write that pomegranates, black chokeberry, and others help relieve the disease. Perhaps this is true, but not from the point of view of evidence-based medicine. You can eat anything, but you should limit sugar, spicy, salty, so as not to exacerbate chronic diseases. It is best to drink plenty of fluids. Helps reduce intoxication. With a disease, the appetite suddenly disappears, but it is necessary to take food.
– Sport is believed to improve health. However, many young people who play sports are now getting sick. Why is this happening?
– Due to the high contagiousness of the virus. That is, it is more contagious than the flu. But healthy bodies, according to statistics, carry the disease easier and faster.
– In one of the hospitals, doctors recommended covid patients to drink warm water – supposedly it helps to heal faster. Are there really such recommendations? If so, how does it work?
– There is no data in the official recommendations regarding the water temperature, but it is necessary to drink at least two liters per day. Volume may vary depending on body weight and concomitant diseases. As mentioned above, the liquid helps reduce the intoxication of the body.
– People with cardiovascular disease, diabetes and lung disease are the hardest to carry the coronavirus. Are there any individual recommendations for them on how not to get infected with the coronavirus?
– Specifically, there are no patients for these patient groups, they are common to all and have already been learned by all: wash your hands, wear masks and change them regularly, avoid crowded places and public transport, use an antiseptic and observe the self-isolation whenever possible.
– Why are obese people at risk?
– People with obesity are at risk, as they already have heart and blood vessel problems. Obesity is very seldom on its own. Most likely, there is a decrease in glucose tolerance – this is a latent form of diabetes, characterized by the absence of clinical signs. This is a high risk condition for the development of clinically significant diabetes mellitus in the future. All these problems exacerbate the course of the disease. Additionally, people with impaired glucose tolerance usually have more severe comorbidities.
– How long do coronavirus symptoms last and how long is a person infectious?
– According to all official data, up to 14 days. But basically, 5-7 days after symptoms appear and before they appear too. The patient is not contagious after receiving a negative smear. But it happens that the second smear, which is taken in 10-12 days of illness, becomes positive, such people are considered infectious, and their quarantine is extended even before they receive a negative smear, but in the absence of symptoms. Even if the smear is negative and symptoms persist, treatment continues until satisfactory.
– According to recent studies, cognitive impairments (e.g. decreased memory, mental performance, difficulty expressing one’s thoughts or understanding someone else’s speech, deterioration in concentration) increase the risk of a severe coronavirus course. Is there such a connection in Bashkiria?
– There are no such statistics, but I dare to assume that yes. Such a relationship may be due to a violation of the regimen prescribed by the doctor and non-compliance with treatment.
– How long does it take for patients with covid to regain their sense of smell?
– Individually, but usually after five to eight days.
– How often are there errors in the tests? A patient can have all the symptoms of COVID-19, but the tests (smear and antibody) are negative, why?
– The most frequently asked question among my friends. This is not a test error, they are relatively accurate. The error could be in the collection, transport, concentration of the virus in the sample. If the patient ate, brushed their teeth or gargled an antiseptic before harvesting, the virus will most likely not be present. In addition, patients arrive late: on the third or fifth day, when they may no longer isolate the virus, therefore, the SARS-CoV-2 PCR will no longer be detected in smears. But if the patient is interested in finding out with a negative smear and similar symptoms, if he has had covid, it is better to be tested for immunoglobulins, but not earlier than 12-14 days after the onset of the disease. This is the number of days it takes for antibodies of both classes to develop.
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