Q. My brother has mild symptoms of COVID-19 infection. What treatment should he take?

Answered by
Dr. Zubayeralam
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 22, 2020 and last reviewed on: Jan 22, 2021

Hello doctor,

I am writing about my brother. He is 41 years old and was positive for COVID-19 four weeks ago. He had mild symptoms and treated at home. I send you the blood test he did yesterday. Could you please advise? Which treatment should he take?



Welcome to icliniq.com.

I can understand your concern. According to your statement, your brother was COVID-19 positive. I have gone through your brother's investigation reports (attachment removed to protect patient identity) and found that serum ferritin is 578 ng/mL (30-400) that is significantly higher than the normal level. His anti-COVID-19 IgM -4.3 (index<1), that is positive and Anti COVID-19 IgG - 6.84 (index<1.4), which is also positive.

Serum ferritin is the acute phase protein that can increase during infection, inflammation, burn, stress, and other conditions. Your brother's raised serum ferritin indicates that he may suffer from a severe COVID-19 infection or poor recovery from the infection.

Antibody against COVID-19 usually develops within one to three weeks in a COVID-19 affected person. Your brother's IgM and IgG are both positive, which indicates that antibody against COVID-19 infections has been produced in his body. His formed immunity will give him protection against infections for a few months. Some parameters are also slightly raised in his blood pictures, which are not significant at all. Do not worry. Antibody or body immunity has already been developed in our brother's body, and he is protected from COVID-19 infection for a few months. No treatment is needed for him.

I hope this helps.

Thank you doctor,

I saw the fibrinogen is high. Do you think it is normal after COVID? Should he take some Aspirin or anticoagulant?



Welcome back to icliniq.com.

Only raised fibrinogen does not indicate future coagulation state or clot formation for which anticoagulants like low molecular weight heparin may be needed. Here D-dimer is the main predictor for future clot formation. Raised D-dimer and low platelet count with raised fibrinogen indicate higher thrombotic risk. Fibrinogen is an acute-phase protein that can rise in the presence of infection, inflammation, ongoing trauma, pregnancy, etc. As an acute-phase protein, raised fibrinogen antagonizes leukocyte recruitment during an infection or inflammation and can contribute to inflammation resolution and serve as a protective barrier. Indeed increased fibrinogen has never been shown to play a direct, causative role in causing thrombus in these cases like COVID-19 infections.

As your brother was previously COVID-19 positive, so his fibrinogen was increased to fight against the infection. His raised fibrinogen level will decline gradually over time. Hopefully, no treatment will be needed as D-dimer, aPTT, PT, and platelet count are within normal limits.

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