Care of Clients with Life- Threatening

Conditions, Acutely ill/ Multi- Organs

Problems, High Acuity and
Emergency Situations

‘’A CASE SCENARIO ON COVID- 19’’

Presented By: Balbontin, Abie Jean B. BSN 4- D

 WHAT ARE THE NECESSARY
LABORATORY TEST
PROCEDURES TO DETERMINE
THE PRESENCE OF COVID ?
Because the signs and symptoms of coronavirus disease
2019 (COVID-19) may overlap with those of other
respiratory pathogens, it is important to perform
laboratory testing to specifically identify symptomatic
individuals infected with severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2). Moreover, it
is estimated that up to 40% of people with SARS-CoV-2
infection may be asymptomatic (subclinical infection) or
presymptomatic, and still potentially capable
of transmitting the virus to others.Therefore, in certain
cases, individuals without obvious signs or symptoms of
SARS-CoV-2 infection also require testing.
•Three basic types of tests to determine if an
individual has been infected with SARS-CoV-
2: viral nucleic acid (RNA) detection, viral
antigen detection, and detection of antibodies
to the virus.
•Viral tests (nucleic acid or antigen detection
tests) are used to assess acute infection,
whereas antibody tests provide evidence of
prior infection with SARS-CoV.
 RT- PCR TEST
• The polymerase chain reaction (PCR) test for
COVID-19 is a molecular test that analyzes
your upper respiratory specimen, looking for
genetic material (ribonucleic acid or RNA) of
SARS-CoV-2, the virus that causes COVID-19.

•  Scientists use the PCR technology to amplify

small amounts of RNA from specimens into
deoxyribonucleic acid (DNA), which is
replicated until SARS-CoV-2 is detectable if
present. The PCR test has been the gold
standard test for diagnosing COVID-19 since
authorized for use in February 2020. It’s the
fastest , accurate and reliable method.
 Three key steps to the COVID-19 PCR test:
STEP 1
• Sample collection: A healthcare provider uses a swab to
collect respiratory material found in your nose. A swab is a
soft tip on a long, flexible stick that goes into your nose.
There are different types of nose swabs, including nasal
swabs that collect a sample immediately inside your
nostrils and nasopharyngeal swabs that go further into the
nasal cavity for collection. Either type of swab is sufficient
for collecting material for the COVID-19 PCR test. After
collection, the swab is sealed in a tube and then sent to a
laboratory.
 STEP 2
• Extraction: When a laboratory scientist receives
the sample, they isolate (extract) genetic material
from the rest of the material in the sample.
STEP 3
• PCR: Uses special chemicals and enzymes and a
PCR machine called a thermal cycler. Each heating
and cooling cycle increases (amplifies) the amount
of the targeted genetic material in the test tube.
 RAPID ANTIGEN TEST
• This detects bits of proteins on the
surface of the virus called antigens.
• Antigen tests typically take only 15 to 30
minutes.
• Rapid antigen tests are most accurate
when used within a few days of the start
of your symptoms, which is when the
largest amount of virus is present in your
body.
• Low sensitivity- produces false negative
results.
 Rapid Antigen Test Procedure
1. Mucus sample is swab from the nose or
throat.
2. Sample is mixed with lysis buffer.
3. The sample is placed on a strip, card or
slide that contains reagents.
4. Viral antigens are detected based on
the amount of fluorescence.
5. Wait 30 minutes.
6. Check the results. 1 line means no
virus detected (NEGATIVE), 2 lines
mean virus detected (POSITIVE)
7. If the result is positive, you must
confirm the infection with a RT-PCR Test.
• If the sample contains SARS-CoV-2
Antigens, a colored line will appear in test
line region. If the sample does not contain
SARS-CoV-2 antigens, no colored line will
appear in the test line region, indicating a
negative result. As positive control, a
colored line should always appear in the
control line region, indicating that the
proper volume of specimen has been added
and membrane wicking has occurred.
 Antibody Test

• Measures the presence and

in some cases, the level of
antibodies to the SARS- CoV-
2 virus in the blood of a
patient who have already had
Covid and are successfully
recovering from the disease
or are vaccinated.
 ANTIBODY TEST PROCEDURE
1. Wash your hands thoroughly.
2. Wipe alcohol on the finger youre taking the blood sample
from.
3. Pinch the tip of the finger with the tool, wait for blood to
pool up.
4. Use the tool to suck blood drops from the finger and drop
2-3 drops onto the portable test kit. Then drop 2-3 drops of
the test solution into mix with the blood.
5. Wait 15-30 minutes.
6. Check the results. 1 line means antibody is undetected, 2
lines means antibody either IgM or IgG, or both is detected.
 dimer is the most sensitive
change in coagulation
parameters in COVID-19 and
indicate a greater risk for the
development of thrombosis. In
the pt. case elevated result is
associated with her aging and
being positive for SARS- COV
virus.
Hemoglobin 11. 9 g/dL 13.0 – 18.0 Decrease Low hemoglobin level leads to
anemia, and in the patient
case it seems to be associated
with an enhanced risk of
severe COVID-19 infection.
Which causes to have a
symptoms of fever and trouble
breathing.

Hematocrit 0. 36 0. 37- 0. 48 Decrease This results indicates an

isufficient amount of healthy
red blood cells which causes
anemia. In the pt. case it was
associated with the virus,
which cause the pt. to have
symptoms like fever and
shorthness of breath.
LABORATORY RESULT NORMAL VALUE INCREASE / SIGNIFICANCE
EXAM DECREASE

RBC 3.79 4.5 -6.2 Decrease This results indicates a shortage

of iron in the body of the pt. due
to the infection brought by SARS-
COV.

Neutrophil 0.99 0.55- 0.65 Increase This pt. result increases due to
the infection brought by the
virus which causes her to have a
fever.

Lymphocyte 0.17 0.25- 0.35 Decrease A decrease lympocytes makes

hard for the body to fight against
the infection. In the pt. case it is
due to the virus brought by covid
which causes her to have
common cold like- symptoms.
LABORATOR RESULT NORMAL INCREASE / SIGNIFICANCE
Y EXAM VALUE DECREASE

CRP- C- 96.0 mg/L Less than 6 Increase Higher levels of CRP

reactive indicates  in the early
Protein stage of COVID-19 , due
to inflammatory reaction
and related tissue
destruction of lung lesions
and disease  severity of
Mrs. Covs.

APTT Test 43.8 30.7 – 39.1 Increase The abnormal patterns in

the APTT second-
derivative curves appear
with highest frequency at
around 2 weeks after the
onset of COVID-19 and
were not associated with
the severity of COVID-19.
These results suggest the
possible presence of a
specific abnormal
coagulopathy in COVID-
19.
LABORATO RESUL NORMAL INCREASE SIGNIFICANCE
RY EXAM T VALUE /
DECREAS
E
Eosinophil 0.00 0.02 – 0.04 Decrease Eosinopenia, if progressively
worsening, indicates that
COVID-19 patients may
progress to critical disease
and have a significantly
higher chance of mortality.
Additionally, eosinopenia
correlates with biomarkers of
coagulation disorder  and
those of tissue damage in
kidney, liver, and other
tissues.

LDH 591 u/L 106 - 211 Increase Elevated LDH signifies tissue

hypoperfusion indicates the
extent of the disease, hence,
may affect prognosis
in COVID-19.

SGPT 44.26 Less than 31 Increase High level of SGPT in the

u/L blood can be an indication of
damage related to liver.
It suggest that liver injury
in COVID-19 patients may
result from direct effect by
the virus and immune-
mediated inflammation.  
LABORATORY RESULT NORMAL VALUE INCREASE/ DECREASE SIGNIFICANCE
EXAM

FBS 11.20 mmol/L 3.9- 6.4 Increase Bodies stressed by

severe COVID-19 could produce
abnormally high blood sugar
levels, even in people without
diagnosed diabetes. The
findings suggest the need for
early blood glucose screenings
in people with SARS-CoV-2
infections.
SGOT 53.23 Less than 31 Increase When the liver is damaged or ill,
SGOT can leak from the liver
into the bloodstream. When
this happens, levels in the blood
will be higher than normal. If
a person has heart or kidney
problems, levels of SGOT may
be particularly high. Elevation of
some liver markers were higher
in patients with severe COVID-
19 infection.
 E

Urinalysis Increase 4. 5- 8.0 Increase Urinalysis is a simple

RBC and test, which can be
pus cells, used to predict
epithelial development of acute
cells and kidney infection and
cast cells mortality may be
and used for risk
presence of stratification of Covid-
bacteria. 19 patients.

Sputum Exam No fungal Sputum testing

elements, provides higher rate
few gram of Covid-19
negative detection.
bacilli and
gram
positive
cocci.
LABORATORY EXAM RESULT NORMAL VALUE INCREASE / SIGNIFICANCE
DECREASE

WBC Normal

Monocytes 4.5 – 11.0 Normal

Basophil 0.0 – 300 mL Normal

Platelet count 150,000- Normal

400,000cells

BUN 8- 25 mg/dL Normal

ABG 7.35- 7.45 Normal

LABORATOR RESULT NORMAL INCREASE/ RATIONALE
Y VALUE DECREASE
Prothrombin 11- 13 sec. Normal
Time
K₊ 3.5- 5.0 mEq/L Normal
Procalcitonin 0.15 mg/mL Normal
Uric acid Normal
Cholesterol Less than 200 Normal
mg/dL
Na ₊ 135- 145 Normal
mEq/L

Prothrombin 11- 13 sec. Normal

Time

Albumin 3.4 – 5 g/Dl Normal

Creatinine 0.6 – 1.3 Normal

mg/dL