Department of COVID-diagnostics and rehabilitation at JSC "Medicine" (Clinic of Academician Roytberg)
The WHO protocols describe in detail the procedure for identifying the causative agent of coronavirus infection in patients in countries with an increased risk of infection and states with a moderate epidemiological situation. The diagnosis is made on the basis of laboratory and instrumental studies. Differential diagnosis makes it possible to exclude pathologies with similar symptoms from the patient's history. In Russia, the detection of the SARS-CoV-2 virus was carried out according to a temporary protocol approved by the Ministry of Health in January 2020. Since March, permanent instructions have been applied, taking into account the capabilities of public and private diagnostic centers.
Diagnostic tests in the laboratory involve collecting sputum from the patient beforehand. In its absence, mucus from the upper respiratory tract is examined (against the background of the impossibility of obtaining its samples from the lower sections). A negative test result, accompanied by signs of coronavirus infection, leads to a second test for COVID-19.
The research is carried out on the basis of polymerase chain reaction. The test systems were developed by employees of clinical laboratories in Germany in January this year. A quarter of a million tests have been distributed to countries with COVID-19 outbreaks through WHO and its regional partners. In February and March, test kits began production in many European and Asian countries, North America and the Middle East.
The main task of infectious disease doctors is the development and implementation of serological tests for the rapid detection of antibodies to COVID-19 in the bodies of children or adults. In this case, the research time will be reduced to 5-10 minutes, and its accuracy will exceed 95%. The patient's blood will be used as a biomaterial for analysis
X-ray in a clinical setting
The detection of signs of pneumonia in a person against the background of coronavirus infection becomes the reason for doctors to take a series of X-ray images. In infected patients, an accumulation of infiltrate is found in both lungs (in rare cases, only in one). With persistent symptoms of pneumonia and the absence of foci of infiltration in the images, the child or adult is assigned a computed tomography or magnetic resonance imaging.
Small patients are faced with a mild form of pneumonia against the background of coronavirus. Abnormalities can go unnoticed on x-rays, which can lead to a misdiagnosis. For this reason, children are referred for computed tomography or magnetic resonance imaging without prior radiography.
Pneumonia in coronavirus does not differ from respiratory tract lesions caused by other pathogens. The basis of differential diagnosis is the collection of information about the patient's contacts and his movements within the country or abroad. When pneumonia is detected in a group of people, tests for adenoviral or microplasma infections are performed.
The clinical picture of COVID-19 does not distinguish pathology from other types of respiratory pathologies.
Other infectious pathologies are excluded by a series of laboratory tests. In bacterial pneumonia, a reverse culture of the patient's blood or sputum becomes negative. The presence of influenza in a child or adult is confirmed by a rapid test. But its result does not always indicate the absence of the causative agent of coronavirus infection in the human body.