Interview with a doctor from Ufa, Elena Davletova –

Recently, a lot of bloggers have appeared on social networks who are ready to talk about the coronavirus, it would seem, everything. But sometimes their advice raises even more questions. correspondent spoke with Elena Davletova, deputy chief physician for the medical department of the Ufa polyclinic No. 38 and found out why smears for COVID-19 can be negative even when symptoms appear and when anticoagulants can only harm.

– A patient comes to a therapist or a doctor comes to a call: how does he distinguish whether it is flu, ARVI, or is there a suspicion of COVID-19?

– When the doctor sees the patient, he pays attention to a pair of reference points in the differential diagnosis. These are temperature, day of illness, symptoms (runny nose, cough, body pain), it is important to take into account the epidemiological history. Next, we examine the patient objectively: we conduct auscultation (listening to sounds in the internal organs – ed.), Percussion (tapping some parts of the body) and measure blood saturation. But you must always be prepared for the fact that any patient with ARVI can be covid. Therefore, according to the orders of the Ministry of Health, smears are taken from all patients with ARVI.

– How many patients do you see a day, including when you go out on calls? Do you give a referral to a computed tomography scan or a smear test for coronavirus?

– Today we have about 200 calls. We take swabs for coronavirus infection from all patients with signs of ARVI and fever, symptoms of intoxication – these include headaches, weakness, weakness, muscle pain, nausea and others. A CT scan is performed strictly according to indications.

– Situation: a person got sick, he is afraid that it is a covid, but he does not know for sure yet. Should you drink blood thinners for prevention?

– It is imperative to call a doctor and resolve issues with a specialist. See related diseases, if possible, get tested. In practice, there was a case when a young patient himself, without appointment, began to drink blood thinners, but a strong cough contributed to the trauma of the bronchi and bronchioles, a cough with streaks of blood appeared, which had to be stopped in the hospital. Anticoagulants are needed, but strictly according to indications and under the supervision of a doctor.

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– Aspirin has been shown to reduce the risk of death and complications in COVID-19 patients. Is the drug recommended as a prophylaxis for people at risk?

– Yes, we recommend if there is no alternative. One aspirin tablet contains 500 milligrams, and the proven antiplatelet dosage is 100 milligrams, it is so difficult to separate the pill. Therefore, it is better to use tablets with a dosage of 100 milligrams (acecardol, ass-cardio, cardiomagnum, thrombosis and others).

– According to foreign studies, a deficiency of vitamin D or zinc increases the risk of a severe course of coronavirus. What complexes of vitamins and minerals do you recommend for patients to drink for the prevention or treatment of covid and seasonal diseases?

– Any multivitamins with group B, zinc, ascorbic acid, preparations with a sufficient content of vitamin D. No preferences.

– Are there any dietary recommendations during covid disease? What to eat and what not?

– Now a lot of materials are published on nutrition. They write that pomegranates, black chokeberry and others help alleviate the disease. Perhaps this is true, but not from the point of view of evidence-based medicine. You can eat anything, but you should limit sugar, spicy, salty so that chronic diseases do not worsen. It is better to drink plenty of fluids. It helps to reduce intoxication. With an illness, appetite abruptly disappears, but it is imperative to take food.

– It is believed that sports improve health. However, many young people who go in for sports are now getting sick. Why is this happening?

– Due to the high contagiousness of the virus. That is, it is more infectious than the flu. But healthy bodies, according to statistics, carry the disease easier and faster.

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– In one of the hospitals, doctors recommended to patients with covid to drink hot water – supposedly it helps to heal faster. Are there really such recommendations? If so, how does it work?

– There is no data in the official recommendations regarding the temperature of the water, but you need to drink at least two liters a day. The volume may vary depending on body weight and concomitant diseases. As mentioned above, the liquid helps to reduce the intoxication of the body.

– People with cardiovascular diseases, diabetes, and lung diseases are the hardest to carry the coronavirus. Are there individual recommendations for them on how not to get infected with the coronavirus?

– Specifically, there are no patients for these groups of patients, they are common to everyone and have already been learned by everyone: to wash hands, wear masks and change them regularly, avoid crowded places and public transport, use an antiseptic, and observe self-isolation whenever possible.

– Why are obese people at risk?

– People with obesity are at risk, as they already have problems with the heart and blood vessels. Obesity is very rarely one by itself. Most likely, there is a decrease in glucose tolerance – this is a form of latent diabetes, characterized by the absence of clinical signs. This is a high risk condition for the development of clinically significant diabetes mellitus in the future. All these problems exacerbate the course of the disease. In addition, people with impaired glucose tolerance tend to have more severe comorbidities.

– How long do the symptoms of coronavirus last and how long is a person infectious?

– According to all official data, up to 14 days. But in practice, 5-7 days after the onset of symptoms and before they appear too. The patient is not contagious after receiving a negative smear. But it happens that the second smear, which is taken on 10-12 days of illness, comes positive, such people are considered infectious, and their quarantine is extended even before they receive a negative smear, but in the absence of symptoms. Even if the smear is negative and symptoms persist, treatment continues until satisfactory.

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– According to recent studies, cognitive disorders (for example, decreased memory, mental performance, difficulty expressing one’s own thoughts or understanding someone else’s speech, deterioration in concentration) increase the risk of a severe course of coronavirus. Is there such a connection in Bashkiria?

– There are no such statistics, but I dare to assume that yes. Such a relationship may be due to a violation of the regimen prescribed by the doctor and non-compliance with treatment.

– How long does it take for patients with covid to regain their sense of smell?

– Individually, but usually after five to eight days.

– How often are there mistakes in tests? A patient may have all symptoms of COVID-19, but tests (smear and antibody) are negative – why?

– The most frequent question among my friends. This is not a test error, they are relatively accurate. The error could be in the collection, transportation, concentration of the virus in the sample. If the patient ate, brushed his teeth, or gargled an antiseptic before the collection, the virus will most likely not be present. Plus, patients visit late – on the third or fifth day, when they may no longer isolate the virus, therefore, SARS-CoV-2 PCR will no longer be detected in smears. But if the patient is interested in finding out with a negative smear and similar symptoms, whether he has had covid, it is best to be tested for immunoglobulins, but not earlier than 12-14 days from the onset of the disease. That is how many days it takes for antibodies of both classes to develop.

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