Dr. Sugreev Singh
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My husband, aged 40 years, tested positive for COVID-19 ten days ago. He had a high fever of up to 103 degrees till yesterday. He got his CT scan done after three days of the COVID-19 test. The CT scan value was 3/25. His CRP is 7.5 mg/L. He repeated blood tests after three days of CT scan. Now CRP is 15 mg/L, D-dimer is 0.69 mcg/mL FEU, LDH is 320.8 U/L, ferritin is 287.9 ng/mL, and interleukin is 22.3 pg/mL. He has been taking Augmentin 625, Hifenac-P, Dolo, and a few supplements for the last seven days. He took Ivermectin for the first three days and started Ivepred 8 twice a day for the past three days. His SpO2 level stays at 95 to 96 percent. He has no history of diabetes, hypertension, or any other systemic disorders. Kindly suggest if the present line of treatment is acceptable. Is there any need for hospitalization or any additional medication?
Hi,
Welcome to icliniq.com.
Thank you for writing, and I understand your concern. According to the symptoms, current treatment is sufficient, so please do not worry. You do not have to admit your husband because his oxygen saturation is good, and HRCT (high-resolution computed tomography) shows a very mild infection, so nothing to worry. Just continue the treatment, and everything will be fine. Keep monitoring the oxygen saturation. If it goes below 93 percent or the breath rate is more than 25 per minute, mechanical ventilation or oxygen support is required if there is difficulty breathing. If not, isolation and treatment will be sufficient. Continue with this line of treatment. If anything else, please let me know. Thank you.
Patient's Query
Thanks for the reply, doctor,
We took the CT scan on the fourth day of the symptom. Blood tests done around the same time were fine. Within three days, all parameters increased. Is the steroid dose sufficient? Although he has no high fever today. Kindly suggest why the parameters increased so fast.
Hi,
Welcome back to icliniq.com.
The parameters increased due to COVID-19 (coronavirus disease 2019) infection only. With the new strain, almost every patient is facing similar changes in reports. And yes, dosage are sufficient, and Ecosprin (Aspirin) will help you with D-dimer levels as well.
Patient's Query
Thank you, doctor,
His HbA1c level is 6.6 percent in the latest blood test though he does not have diabetes. I also forgot to mention that six days before, the hemoglobin level was 12 g/dL, but a repeat test after three days shows hemoglobin level to be 10 g/dL. Why is it so?
Hi,
Welcome back to icliniq.com.
Sometimes the hemoglobin value varies depending on whether the blood was taken before or after the meal. So do not worry. Sometimes there can be false reports also.
Patient's Query
Hi doctor,
We just checked postprandial sugar level today using a glucometer. It was 327 mg/dL two hours post-meal. Can steroid spike sugar levels. Kindly suggest what to do? Can he take tablet Glyciphage 500 three times a day indicated by a doctor?
Hi,
Welcome back to icliniq.com.
COVID-19 infection does not increase blood sugar levels, but diet does. So can you please tell me what your husband is taking in his diet?
Patient's Query
Hi doctor,
He is taking typical food like dal, vegetable salad, coconut water, fruits like melon, apple, etc. Also, he did not have diabetes before.
Hi,
Welcome back to icliniq.com.
Please check that if tomorrow also remains high, you need to increase the dosage to 1000 mg. Check three times a day. If the morning's result becomes elevated, increase the morning dosage to 1000 mg and keep the rest of the day's dosage to be 500 mg.
Patient's Query
Thanks for the reply, doctor,
The SpO2 level fell to 91 percent around 4.30 AM, and then after proning for some time, the level increased to 95 percent. What to do?
Hi,
Welcome back to icliniq.com.
SpO2 level of 95 percent is average. Keep monitoring four to five times a day. And if it comes below 93 percent and experiences difficulties in breathing, oxygen is required. Thank you.
Patient's Query
Hi doctor,
The fasting blood sugar level was 128 mg/dL today. Before lunch, the random blood sugar level was 138 mg/dL. He took Glyciphage 500 mg last night. Is twice a day dosage acceptable, or thrice a day is needed? Please suggest.
Hi,
Welcome back to icliniq.com.
Now the sugar levels seem to be better, and the medicine is working, so do not worry. Continue with the same line of treatment.
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Internal Medicine
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