COVID-19 FAQs – Video Talk

COVID-19 – Some frequently asked questions by patients.

Dr. Anish C A, Consultant Physician and Diabetologist at Keyhole Clinic, Edappally, gives answers to some frequently asked questions by patients on COVID-19

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Watch Video – Malayalam

Which test is best to diagnose COVID-19? RT-PCR or Antigen

Both RT-PCR and Antigen tests are used to diagnose COVID. Both these tests have their own advantages and disadvantages. Antigen test can be done at Rs. 300/-, the rate is comparatively lesser than RT-PCR and the test result can be obtained within 15 to 30 minutes. If the antigen test is positive, it would be considered as COVID. If the test is negative, there is no specific meaning and so the patient would have to undergo RT-PCR test to confirm there is no COVID.

The cost of RT-PCR test is around Rs. 500/-. The result of RT-PCR test takes around 12 to 24 hours to be obtained. If the result is positive, the patient is COVID positive.

If RT-PCR test is negative, can it be confirmed that the patient is COVID negative?

No.  In 30% cases, even if the RT-PCR test is negative, it is likely that the patient is COVID positive.  In such cases where the patient has COVID symptoms, but the RT-PCR test is negative, in one or two days a repeat RT-PCR test is carried out.  In most cases, the repeat test is positive.

But in some cases, even the repeat RT-PCR test is negative.  In such cases, where even the repeat RT-PCR test is negative, but the patient is suspected to have COVID based on the patient’s x-ray and blood test reports, the patient would be advised to undergo a CT scan to confirm whether the patient has COVID-pneumonia.

So if the RT-PCR is negative, but the patient has COVID symptoms, CT Scan would be performed to rule out COVID.

Which antibiotic is prescribed by the doctor for a COVID patient?

Antibiotics doesn’t have much role in COVID.  COVID is a viral infection.  No use in giving antibiotics.  During the initial days of COVID, symptomatic treatment can be provided to the patient.  For example, for fever  – Paracetamol,  proper hydration (have enough water), rest, plenty of fruits.  In addition to this, monitor the oxygen level with a pulse oximeter.   This is enough.

In high-risk cases, that is patients diagnosed with diabetes, hypertension (high blood pressure), cardiac issues, stroke, liver and kidney problems, persons aged 60 above, they are usually given anti-virals.  Medicines usually given are Ivermectin or Favipiravir.

If a COVID patient’s antigen test is negative or after being 17 days in quarantine as suggested by the health worker, will the patient be completely recovered from COVID?

If a COVID patient becomes antigen negative, it means that he is no more contagious.  COVID symptoms have been reported in patients even after 45 days.

There are 3 stages in COVID infection.

• First Stage – Viral phase.  During this phase, symptoms like mild fever, sore throat, cold, cough, diarrhea, loss of taste or smell, etc can occur.  This phase can last for 5 to 7 days.  Almost 80% of patients recover after this phase without further symptoms.   But 20% patients may progress to stage II.
• Second Stage – Pulmonary phase or inflammatory phase.  Once a patient reaches Stage II, they experience persistent fever, cough, shortness of breath, fatigue.  Blood test (CRP) and chest x-ray is conducted to diagnose the symptoms during this stage.  Apart from this, there are other tests like D-dimer, ferritin, which are comparatively costly.   Once a patient reaches this stage, antibiotics have no role, and it would be necessary to treat the patient with steroids, anticoagulants, and if the oxygen level is low, oxygen supplementation is necessary.  If this stage can be diagnosed and treated early, Stage III can be avoided.
• Third Stage – Hyper inflammatory phase.  If a patient reaches this stage, oxygen level will be very low and ventilator support may be needed.  During this stage, there could be worsening of complications and death may also occur.

If a COVID patient’s oxygen level on pulse oximetry testing is less than 94% or if the COVID symptoms like fever, cough, shortness of breath, fatigue do not subside within 7 days or worsens, it means the patient is progressing on to Stage II.   The patient should undergo a chest x-ray and blood test (CRP) immediately.  If diagnosed early on, the further complications can be avoided.

Questions regarding COVID vaccination

How many days should a COVID patient wait to take COVID vaccination?

A COVID patient should take COVID vaccination 3 months after recovery, ie after they are antigen negative. 

After taking the first dose of vaccination, if anyone gets COVID, when should they take the second dose?

The answer is same as above, ie., 3 months after recovering from COVID and they are antigen negative, they can take the second dose of COVID vaccination.

Can a patient who was suffering from some serious disease and was in the ICU take COVID vaccination upon discharge?

A patient who was admitted in a serious condition in the hospital can take COVID vaccination anywhere from 4 weeks to 8 weeks after discharge.

When can a person donate blood after taking COVID vaccine?

A person can donate blood 14 days after taking COVID vaccination.

Can a breastfeeding mother take COVID vaccination?

Yes, a breastfeeding mother can take COVID vaccination.

When can a person who has taken COVID vaccination take anti-rabies vaccine if bitten by an animal?

Anti-rabies vaccine and rabies immunoglobulin can be given immediately to a COVID vaccinated individual who has been bitten by an animal.  Usually, any other vaccinations are given to a COVID vaccinated individual after 14 days, but anti-rabies vaccine is an emergency treatment.

When can a person who has taken anti-rabies vaccine take COVID vaccination?

Two weeks after taking the last dose of the anti-rabies vaccine, the patient can take COVID vaccination.