Mainly note for myself.
I've heard that the immune system produces different types of antibodies when a person is infected with the COVID-19 coronavirus. How do they differ? Why is this important?
The COVID-19 coronavirus contains ribonucleic acid (RNA) surrounded by a protective layer, which has spike proteins on the outer surface that can latch on to certain human cells. Once inside the cells, the viral RNA starts to replicate and also turns on the production of proteins, both of which allow the virus to infect more cells and spread throughout the body, especially to the lungs.
While the immune system could potentially respond to different parts of the virus, it's the spike proteins that get the most attention. There are two main categories of antibodies:
Binding antibodies. These antibodies can bind to either the spike protein or a different protein known as the nucleocapsid protein. Binding antibodies can be detected with blood tests starting about one week after the initial infection. Binding antibodies help fight the infection, but they might not offer protection against getting reinfected in the future.
Neutralizing antibodies. help prevent re-infection.
In November 2020, the FDA authorized emergency use of a test for COVID-19 neutralizing antibodies.
Can a person who has been infected with coronavirus get infected again?
Natural immunity to COVID-19 is the protection that results from having been sick. But we don't know how long natural immunity lasts, or how strong it is. So can we count on natural immunity to protect us from reinfection? If so, for how long? Unfortunately, we don't know the answer to either of those questions.
There have been some confirmed cases of reinfection with COVID-19. This is rare.
The CDC states that people who have gotten sick with COVID-19 may still benefit from getting vaccinated.
It's also worth noting that someone who has been re-infected — even someone with no symptoms — has the potential to spread the virus to others. That means that everyone, even those who have recovered from coronavirus infection, and those who have been vaccinated, should continue to follow CDC guidance on mask wearing and other prevention measures.
Major complication?
Heart- Tăng troponin (+/- NMCT; tuy nhiên cũng có những nguyên nhân khác NMCT và COVID gây tăng troponin-vd như viêm cơ tim, tổn thương giảm oxy mô…- nếu nghĩ tới thì tầm soát); Loạn nhịp tim (đa số không triệu chứng), suy tim.
Đông cầm máu- COVID-19 là một tình trạng tăng đông, tăng nguy cơ VTE (gồm DVT và PE), đột quỵ nhồi máu, MI, thiếu máu nuôi chi. Biến chứng xuất huyết nếu có thường liên quan đến đến kháng đông và chấn thương.
Da liễu- Phát ban dạng sởi (ửng đỏ, nhiều ban, dạng dát hoặc sẩn, giữa ban là khoảng da lành), hồng ban đa dạng (liên quan hội chứng viêm đa hệ thống), ngứa, sang thương mạch hoại tử, tổn thương ngón chân dạng cước (Covid toes), livedo-like lesion,...
What is "long-COVID"?
"Long-COVID," also referred to as post-COVID conditions, post-COVID syndrome, or post-acute sequelae of SARS-CoV-2 infection (PASC), generally refers to symptoms that develop during or after acute COVID-19 illness, continue for ≥4 weeks, and are not explained by an alternative diagnosis. It is not yet known whether "long-COVID" represents a new syndrome unique to COVID-19 or overlaps with recovery from similar illnesses.
Persistent physical symptoms following acute COVID-19 are common and typically include fatigue, dyspnea, chest pain, and cough. Headache, joint pain, insomnia, anxiety, cognitive dysfunction, myalgias, and diarrhea have also been reported. The time to symptom resolution depends primarily on premorbid risk factors, the severity of the acute illness, and the spectrum of initial symptoms. However, prolonged symptoms are common even in patients with less severe disease who were never hospitalized.
Các dấu hiệu CLS thường gặp ở BN COVID?
Giảm Lympho máu.
Tăng AST, ALT, LDH, marker viêm (như ferritin, CRP, tốc độ lắng máu), Procalcitonin, Troponin.
Bất thường XN đông máu: PT và aPTT kéo dài, D-dimer tăng, fibrinogen tăng
What are the indications for testing asymptomatic individuals?
Indications for testing asymptomatic individuals include close contact with an individual with COVID-19, screening in congregate settings (eg, long-term care facilities, correctional and detention facilities, homeless shelters), and screening hospitalized patients in high-prevalence regions. Screening may also be indicated prior to time-sensitive surgical procedures or aerosol-generating procedures and prior to receiving immunosuppression.
Thời điểm nào test COVID là thích hợp nhất?
Không chắc chắn. Nếu đã nghi ngờ / xác định có phơi nhiễm và kq test âm, thì thử lại sau 5-7 ngày. Ngoài ra cũng để xác định thời gian xuất viện.
BN COVID tại nhà cần dặn dò những gì?
Đ/trị hỗ trợ, uống đủ nước
Có thể liên lạc với 01 bác sĩ / nvyt
Theo dõi các tr/c có trở nặng không- đặc biệt là khó thở tiến triển.
Cách li với những người khác, kể cả vật nuôi
Gia đình rửa tay thường xuyên
Khử khuẩn thường xuyên các bề mặt hay đụng chạm.
What is the significance of a persistently positive RT-PCR for weeks after illness?
Patients diagnosed with COVID-19 can have detectable SARS-CoV-2 RNA in upper respiratory tract specimens for weeks after the onset of symptoms. However, prolonged viral RNA detection does not necessarily indicate prolonged infectiousness. According to the CDC, isolation of infectious virus more than 10 days after illness onset is rare in patients whose symptoms have resolved.
There is no standardized approach to management of patients with persistently positive reverse transcription polymerase chain reaction (RT-PCR) 10 days or more after resolution of symptoms. However, such patients are generally felt to have low infectiousness, particularly after mild to moderate disease and in the absence of immunocompromise. This is why symptom- and time-based approaches for discontinuation of precautions are recommended for most patients
Chích vaccine rồi có nên đeo mask và giữ khoảng cách không?
In the United States, CDC suggests that fully vaccinated individuals wear masks in indoor public settings in areas where community transmission is substantial (ie, ≥50 cases/100,000 people over the prior seven days or >8 percent positive nucleic acid amplification test [NAAT] rate). In areas of lower community transmission, masks in indoor spaces are optional for fully vaccinated individuals unless otherwise mandated by government, employer, or business regulations; such individuals who are or have household members at risk for severe COVID-19 should be encouraged to wear masks indoors. Masks are also recommended on all forms of public transportation, regardless of vaccination status. Additionally, fully vaccinated individuals do not have to quarantine following exposure to SARS-CoV-2 but should undergo testing and wear a mask in public spaces for 14 days or until receiving a negative test.
Bị COVID có xông pha hiến máu được không?
Having a history of COVID-19 is not an exclusion to donation as long as the illness resolved at least 14 days prior to donation.
Vaccination for COVID-19 is also not a contraindication to blood donation. Individuals who have received an mRNA vaccine or other non-infectious vaccine (nonreplicating, inactivated) can donate immediately; those who have received a live-attenuated viral vaccine (and those who are unsure which vaccine they received) should refrain from donating blood for a short waiting period (eg, 14 days) after receiving the vaccine.
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