Given the chest x-rays (CXR) results showing pneumonia, her elevated white blood cells (WBC) count, combined with elevated ferritin, D-dimer, and c-reactive protein (CRP), suggests that she has a systemic inflammatory response. Additionally, Beverley’s lymphocytes are elevated, which indicates a viral cause. Her physical symptoms confirm that she has low oxygenation despite oxygen use, fever, and such symptoms as lack of appetite, diarrhea, myalgia, cough, and runny nose. Despite her negative COVID-19 test last week, her symptoms point to a COVID-19 diagnosis.
Pneumonia could be the correct pathology for Beverly’s weakness because the patient exhibits coughing, fever, chest pain, difficulty breathing, headache, tiredness, and appetite loss. Moreover, the CXR results and elevated WBC count show a high likelihood of pneumonia. The correct diagnosis could be influenza because the patient shows signs of coughing, fever, diarrhea, and headache (Azer, 2020). In addition, Beverley is feeling tired almost always and has an aching body. The accurate pathology for Beverly’s weakness would be COVID-19 since the virus is a mild illness that shows cough and fever as the primary symptoms, which she has. Furthermore, the patient appears to be having symptoms of tiredness, headache, runny nose, diarrhea, body aches, and difficulty breathing. In 2020, I witnessed COVID-19 patients die upon reaching the hospital due to shortness of breath.
A cytokine storm refers to an aggressive immune response that is accompanied by interleukins, chemokines, interferons release, and other mediators (Fajgenbaum & June, 2020). The immune response is often hyperactive, which leads to a highly inflammatory reaction to the COVID-19 infection (Hu, Huang, & Yin, 2021).
An elevated CRP in the blood is an indicator of inflammation, tissue damage, and infections (Landry, Docherty, Ouellette, & Cartier, 2017). Additionally, elevated CRP levels can mean that there is inflammation in the heart’s arteries indicating a higher likelihood of heart attack (Huang et al., 2020).
Elevated ferritin levels show that a patient’s body has a condition that makes their body accumulate excessive iron (Huang, Pranata, Lim, Oehadian, & Alisjahbana, 2020). I have seen several instances where general patients with high ferritin levels showed many clinical conditions and poor outcomes.
People watch the D-dimer level to determine whether they have a blood clotting disorder such as the deep vein disorder (DVT) that impacts the lower legs (Yu et al., 2020). When the D-dimer test is positive, a patient’s body can have high fibrin products degradation (Yao et al., 2020).
After entering the body, COVID-19 viruses bind themselves to host receptors and use membrane fusion or endocytosis to enter host cells. Post-membrane fusion, the COVID-19 viruses enter the pulmonary epithelial cells and release viral contents into the cells (Velavan & Meyer, 2020). COVID-19 replicates and forms a negative RNA strand in the host cells (Azer, 2020). The first phase of the attack happens in the upper respiratory tract through conducting airways (Hu et al., 2021). Due to the upper airways’ involvement, the patient starts mild symptoms such as fever, tiredness, malaise, shortness of breath, and dry cough.
As a future advanced practice registered nurse, comprehending infectious diseases’ pathology is crucial for me. Likewise, understanding the effects of essential medical terms is critical. The information gained on the pathology and pathophysiology of influenza, COVID-19, and bacterial pneumonia will be crucial for assessing and evaluating patients with similar symptoms. For instance, a positive D-dimer test would indicate a patient has a high level of fibrin degradation, which would be easy for me to identify. Advanced practice registered nurses should understand pathology to effectively diagnose, create treatment plans, as well as assess patient outcomes.
References
Azer, S. A. (2020). COVID-19: pathophysiology, diagnosis, complications and investigational therapeutics. New Microbes and New Infections, 37, 100738. Web.
Fajgenbaum, D. C., & June, C. H. (2020). Cytokine storm. New England Journal of Medicine, 383(23), 2255-2273. Web.
Hu, B., Huang, S., & Yin, L. (2021). The cytokine storm and COVID‐19. Journal of Medical Virology, 93(1), 250-256. Web.
Huang, I., Pranata, R., Lim, M. A., Oehadian, A., & Alisjahbana, B. (2020). C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: A meta-analysis. Therapeutic Advances in Respiratory Disease, 14. Web.
Landry, A., Docherty, P., Ouellette, S., & Cartier, L. J. (2017). Causes and outcomes of markedly elevated C-reactive protein levels. Canadian Family Physician, 63(6), e316-e323. Web.
Velavan, T. P., & Meyer, C. G. (2020). The COVID‐19 epidemic. Tropical Medicine & International Health, 25(3), 278. Web.
Yao, Y., Cao, J., Wang, Q., Shi, Q., Liu, K., Luo, Z.,… & Hu, B. (2020). D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: A case-control study. Journal of Intensive Care, 8(1), 1-11. Web.
Yu, H. H., Qin, C., Chen, M., Wang, W., & Tian, D. S. (2020). The D-dimer level is associated with the severity of COVID-19. Thrombosis Research, 195, 219-225. Web.