Dr. Muhammad Zubayer Alam
Pulmonology (Asthma Doctors)
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,
Today is my thirteenth day of COVID-19. From yesterday I do not have a fever. I even got tested today and awaiting the results. My oxygen saturation is above 96 percent. I just got my blood report which shows elevated CRP, ferritin, and IL-6 levels, which worries me. I have attached reports of the blood test, which I did two days back. I just repeated a blood test from a different laboratories today. My CRP is 39 mg/L, IL-6 is 19 pg/mL, ferritin is 351 ng/mL, D-dimer is 0.23 mcg/mL, and LDH is 391 U/L. Is CRP going up due to some other inflammation? I am still taking Dexamethasone, and I am worried if I stop, will the inflammation in my lungs increase?
Hi,
Welcome to icliniq.com.
According to your reports (attachments removed to protect the patient's identity), your D-dimer level is normal, so you do not have to worry because patients with raised D-dimer levels are more prone to develop bleeding disorders like DIC (disseminated intravascular coagulation), deep vein thrombosis, etc. These are life-threatening conditions. So, a normal D-dimer level is the most crucial factor for the prognosis of a disease. As a part of the ongoing disease process, chemical mediators and acute-phase proteins like ferritin, LDH (lactate dehydrogenase), CRP (c-reactive protein), IL-6 (interleukin 6), etc., will be raised for a certain period, atleast for fifteen to twenty more days after the disease subsides. Your fever has declined and is already over thirteen days of COVID-19 (coronavirus disease 2019), which were the crucial period for prognosis. No need to worry now. COVID-19 infection cannot spread and worsen the respiratory function after successful treatment of fourteen days. So, quitting Dexamethasone will not affect anything. It will take some more time for your levels to become normal. Take care and knock me in case of any query. Thank you.
Patient's Query
Thanks for the reply, doctor,
Now that fourteen days have passed, do you think I should relax? I feel better physically, but these laboratory reports give me anxiety and stress. Can anything worsen after fourteen days of COVID-19 infection?
Hi,
Welcome back to icliniq.com.
Thanks for joining again. As you feel better now, which is the most important thing you should relax now. After becoming positive for COVID-19 infection, fourteen days have passed, which is crucial for prognosis. Nothing will worsen after this. Apart from your blood tests, you could have repeated the RT-PCR (reverse transcription-polymerase chain reaction) test on the fourteenth or fifteenth day to know whether you are COVID-19 positive or not. You do not have to repeat other blood tests here because these markers' elevation only suggests that you were previously infected by some type of infection like COVID-19. You have almost recovered from COVID-19. So you can calm and relax. Take care and in case of any other query ask me.
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Pulmonology (Asthma Doctors)
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