Blood smear for COVID-19 patient

An 88-year old female, with a history of hypertension, depression, and dementia, with this report for positive SARS-CoV-2 PCR test, which is done as part of the screening of this institution residents. The patient denied any symptoms. On exam, she was little pale, without acute distress, afebrile, cardiocirculatory and respiratory stable. Lung auscultation revealed inspiratory crackles on lung bases bilaterally, and a slight murmur above the mitral area. The rest of the exam was unremarkable. Chest X-ray showed bilateral hilo-basal slight opacification which can resemble the beginning of pneumonia. On laboratory analyses that surprised me, the patient has extreme leukocytosis with neutrophilia (108 × 10⁹ with 88% of neutrophils). What is your opinion on this case? What would be your diagnostic and therapeutic plan?

ARDS with pneumonitis in tersery stage in covid 19 positive case with sepsis Look for serum iron level , D -Dimer , Troponin i, cret LFT, RBS Treatment : admit patient in isolation Start HCQ 400 bd for 1 day and then 200 mg bd Tab moxikind cv 625 bd Iv lopanavir abd retornavir Tab vitamin c od
Neutrophilic /myeloid leukemoid reaction Secondary to pneumonitis Due to Covid 19 Investigations D dimer assay Procalcitonin LFt KFt CK MB Troponin PT PTTK Treatment plan by Physicians/Intensivist
Lymphocytopenia and increased neutrophil count are corroborative COVID points. Careful patient watch on the patient suggested.
Agreed with Dr.Neelkanth P Sir
Thank you madam

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