Detection of secondary bacterial or fungal infections

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Identification of indicators of inflammatory response

It is recommended to take tests for C-reactive protein, procalcitonin, ferritin, D-dimer, total content and subpopulations of lymphocytes, interleukins IL-4, IL-6, IL-10, TNF-α, INF-y and other indicators of inflammation and immune status, which can help assess the clinical course of the disease, alert to severe and critical conditions, and also serve as a basis for the formation of treatment strategies.

Most patients with COVID-19 have normal procalcitonin levels and significantly elevated C-reactive protein levels. A rapid and significant increase in C-reactive protein levels indicates the possibility of secondary infection. In severe cases, D-dimer levels increase significantly, which is a potential risk factor for poor prognosis. Patients with low overall lymphocyte counts at the onset of the disease usually have a poor prognosis. In severe patients, the number of peripheral blood lymphocytes steadily decreases. The expression level of IL-6 and IL-10 is significantly increased in severe patients. Monitoring IL-6 and IL-10 levels helps to assess the risk of developing a severe condition.



Patients who are severely or critically ill are at risk of developing secondary bacterial or fungal infections. Samples should be expertly collected from the site of infection for bacterial or fungal culture. If secondary pulmonary infection is suspected, deep lung sputum, tracheal aspirates, bronchoalveolar lavage, and brush specimens should be israel number data collected for culture. Blood cultures should be taken promptly in patients with high fever. Blood cultures from peripheral intravenous lines should be taken in patients with suspected sepsis who have had an indwelling catheter placed. It is recommended that they have blood G and GM at least twice weekly in addition to fungal culture.

6 Safety in the laboratory

Biosafety measures should be determined based on the different levels of risk associated with the experimental process. Personal protection should meet BSL-3 laboratory protection requirements for respiratory specimen collection, nucleic acid detection, and virus culture operations. Personal protection in accordance with BSL-2 laboratory protection requirements is mandatory for biochemical, immunological, and other routine laboratory analyses. Specimens should be transported in special containers and boxes that meet biosafety requirements. All laboratory waste should be strictly sterilized in an autoclave.

III. Tomography results of patients with COVID-19

Thoracic imaging is extremely important in diagnosing COVID-19, monitoring therapeutic response, and assessing patient readiness for discharge. High-resolution CT is strongly recommended. Portable chest radiography is suitable for immobilized critically ill patients. CT for the initial evaluation of COVID-19 patients is usually performed on the day of admission, and can be repeated after 2-3 days if ideal therapeutic response is not achieved. If symptoms are unchanged or have become less severe after treatment, chest CT can be repeated after 5-7 days. Daily routine portable chest radiography is recommended for critically ill patients.