Concluded Case

Non - RT- PCR positive COVID-19 disease- a new entity

A 58 years old male with history of fever and cough 3 days,duration. RT - PCR for COVID-19 disease done 1 week was negative. Other investigations revealed multi, organ involvement. Including- Fever profile , USG and cardiac evaluation HRCT was suggestive of COVID-19 disease A new clinical entity seems to be emerging Nln - RT - PCR positive- COVID-19 disease

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The Aim of this post is that if a patient of COVID-19 disease is NEGATIVE by RT - PCR - then clinician really faces a diagnostic dilemma. As in this case CBC was done - only lymphopenia was supportive of COVID-19 disease USG was done which showed congested hepatic veins, hepato - splenomegaly and bilateral pleural effusion with Ascitis Echocardiography was done to evaluated USG findings suspicious of CCF - It was normal except for moderate TR Lipid profile was done - showed increased TG levels- 337 Finally COVID-19 was suspected by HRCT chest - which showed Patchy areas of air space consolidation involving bilateral basal segments predominantly anterior, lateral and posterior segments and enlarged mediastinal lymph nodes Now I feel - in this case COVID CARE PANEL which many labs are promoting should be done and in all suspected RT - PCR negative patients .This Panel includes Inflammation level assessed by - CRP and ESR which are raised Tissue damage assessed by - Increased LDH Pulmonary thrombosis ( microvascular)- by D- DIMER levels which are increased Vitality- by Sodium, Potassium chloride and calcium KFT including GFR FERRITIN- levels are increased Interleukin IL- 6 CBC , LFT, Sugar ( Random) OPINIONS FROM EXPERTS WELCOMED

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The Aim of this post is that if a patient of COVID-19 disease is NEGATIVE by RT - PCR - then clinician really faces a diagnostic dilemma. As in this case CBC was done - only lymphopenia was supportive of COVID-19 disease USG was done which showed congested hepatic veins, hepato - splenomegaly and bilateral pleural effusion with Ascitis Echocardiography was done to evaluated USG findings suspicious of CCF - It was normal except for moderate TR Lipid profile was done - showed increased TG levels- 337 Finally COVID-19 was suspected by HRCT chest - which showed Patchy areas of air space consolidation involving bilateral basal segments predominantly anterior, lateral and posterior segments and enlarged mediastinal lymph nodes Now I feel - in this case COVID CARE PANEL which many labs are promoting should be done and in all suspected RT - PCR negative patients .This Panel includes Inflammation level assessed by - CRP and ESR which are raised Tissue damage assessed by - Increased LDH Pulmonary thrombosis ( microvascular)- by D- DIMER levels which are increased Vitality- by Sodium, Potassium chloride and calcium KFT including GFR FERRITIN- levels are increased Interleukin IL- 6 CBC , LFT, Sugar ( Random) OPINIONS FROM EXPERTS WELCOMED

Absolutely This is new trend of covid19 infection Rt pcr are negative But hrct and xray chest are suggestive with inflammatory markers are indicating Here in this case we find deranged LFTS with jaundice as well So many faces are seen to understand and to treat

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All of us are puzzled about the diagnosis of fever now. I have a case of fever , with leucothrombocytopenia, positive NS1 and Dengue IgM and rise in inflammatory parameters and DDIMER. RT PCR for Covid was negative. Felt confident that it is only Dengue. Such blood picture is common in COVID ,but it has been documented in Dengue very well. Then a second RTPCR came as positive. CT chest was normal. Though Covid and Dengue are known to occur together, when such a situation happens in practice ,it is confusing. There are a lot of hidden facets to the present viral infections.

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The virus is totally a mystery and has made the whole medical fraternity at large, initially it started with some specific signs and symptoms with a norm if diagnostic modality. As days on it made the medical practitioners totally confused during handling a fever case. Many more confusion and puzzle yet to come.

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It's a weird disease seriously. I had a case of effusive COVID, where in a young postpartum lady presented with fever n DOE. She had Pericardial effusion, bilateral pleural effusion n ascites. She had past history of RA also. We kept on getting fluid analysis, Echo, Autoimmune profile, USG abdomen, almost everything came normal. But due to current scenario we got her RT PCR n turned positive. Difficult to diagnosis in very beginning when symptoms n presentations are so weird.

Absolutely true. RT PCP WAS FOUND NEGATIVE IN COVID 19 POSITIVE CASE. EXACT MODE OF TRANSMISSION,SIGN AND SYMPTOMS ARE NOT CONSISTENT IN EVERY CASE. HRCT and x Ray are suggestive of COVID. In few cases other body systems are indicative and found positive. After elapsed of more than one years we are not exactly know the virus spread ,sign and symptoms etc and we are not excepting our defeat and saying live with corona or we will defeat corona because whole world has knees down to this red dragon.

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ताली शादी चूर्ण 2 ग्राम शीतो फलादि चूर्ण 2 ग्राम गोहदन्ती भस्म 4 रत्ती शहद में मिलाकर सुबह-शाम सेवन कराएं। ताजा गिलोय का काढ़ा बनाकर पीने को दें।

AGREE.. ... .. SIR..

I am agree with@Dr. Shivraj Agarwal Sir.

Thank you doctor
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