There are many news that we read these days about the coronavirus, but we really know how to act in case of contracting the virus. Dr. Álvarez, medical director of HC Marbella together with Dr. Sempere, an expert microbiologist and head of the HC laboratory, clarifies these doubts and tells us about the processes that are carried out in the hospital to treat the patient with COVID 19 in the different phases of the disease and the differences between the different tests.
The most common symptoms are cough, fever, and shortness of breath. Other less common symptoms but associated with the virus are tiredness, throat pain, diarrhea, loss of smell and taste. On some occasions cutaneous symptoms have appeared in adolescents and children.
If I get sick with fever, cough … these days and there is the possibility of contact with a positive covid, I must think that it could be a covid.
The first step would be to isolate yourself as a preventive measure, in a single-use room with a window, keeping the door closed, and, if possible, an individual bathroom.
I must assess my condition. If I am acceptably well I can take paracetamol, monitor the temperature and see how it responds to paracetamol. If it is persistent, does not subside or there is respiratory difficulty, we should consult a doctor.
In case of suspicion of disease, it is recommended that you first call the phones that public health officials 900 400 061/955 545 060 in case you do not get an answer, you can call us on +34 952 908 628 and if necessary the doctor will tell you to come to the center to assess their status.
If you go to the hospital, your doctor will examine you and decide if you should be tested for viruses (PCR) or other tests.
In the hospital we have protocols and the necessary safety and hygiene measures to help our patients and that the examination of patients is done safely.
The family depends on the patient’s results. If the family has been in close contact without adequate protection with the Covid patient, they should remain in isolation for 14 days, if during this period no symptoms appear, it would not be necessary.
Unless for other reasons it is necessary to know imminently if they have been infected, and whenever it is prescribed and evaluated by a doctor, a PCR test could be done, which is the most reliable test that detects the presence of the virus in the initial phase. , obtaining the results in our hospital center in less than 24 hours.
At HC Marbella we use the reference technique for the diagnosis of COVID19 which is PCR, which can be complemented with the detection of antibodies with the rapid immunogromatography test.
The PCR detects the presence of the RNA of the virus, in the initial preclinical phase, when it begins to have symptoms and when it is more contagious. Therefore, by detecting the RNA of the virus, it is possible to know if the patient is infected and potentially infectious, from the first days. This test needs a time of approximately 4 hours with technical requirements and specialized people, which means that few private laboratories have it implemented. The fact of having this technique in our laboratory allows us to have results in less than 24 hours.
A rapid antibody test detects the antibodies that the patient has generated in response to the virus. The results are obtained in 15 minutes, but these antibodies are generated late and start to positivize about 5-7 days after the onset of symptoms. The first to appear are IgM antibodies from 7 days, progressively, until they disappear after 20 days, and later IgG-type antibodies from 14 days, although there is no fixed rule or an equal pattern for all patients.
Antibody detection is not used to detect the active presence of the virus (except in initial stages of more than a week and in a short window), but rather to indicate that a patient may have had contact with the virus, but late
Without forgetting that the PCR is the reference technique, and it is the one that must be used to detect symptomatic and potentially infectious cases, however, the combination with serological tests allows to identify in which phase of the disease COVID19 is the patient.
The duration of the disease depends on the severity, it can last from 7 days to 28 days. The admission time according to severity can last from 10 days to 28.
In this chart you can see the average times of each phase of the disease.
Yes. You can be asymptomatic and infect up to 28 days even. This is the big problem of this virus. The WHO requests to keep them in isolation for two weeks after the symptoms disappear. Hence the great importance of wearing surgical masks to avoid infecting others, and the distance of 2 meters when speaking without protection.
In principle it is thought that protection could occur after the disease has passed. If this occurs, we do not know for how long. The presence of antibodies cannot give us false assurance about being safe from reinfection and contagion. We cannot currently rely on a laboratory test to indicate permanent immunity until scientifically proven, further assuming the limitations of the laboratory tests themselves. The immunological defense process is not based solely on antibodies, and innate immunity plays a fundamental role in addition to adaptive, which is not only based on the presence of antibodies but also on the functionality of lymphocytes and the reaction capacity of our immune system.
Dr. Salvador Álvarez, Medical Director of HC Marbella
Dr. Marco Antonio Sempere Alcocer, Microbiology and Parasitology Specialist
April 27, 2020
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