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

Question

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 was treated at home. I sent you the blood test he did yesterday.

Could you please advise?
Which treatment should he take?

Please help.

Thank you.

Answer 1

Hi,

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), which is significantly higher than the normal level. His anti-COVID-19 IgM is -4.3 (index<1), which is positive, and anti-COVID-19 IgG is 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 antibodies against COVID-19 infections have 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.

Answer 2

Hi,

Welcome back to icliniq.com.

A raised fibrinogen level does not indicate a 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 cases like COVID-19 infections.

As your brother was previously COVID-19 positive, 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.

I hope this helps.

Thank you.