There are a few major complications of COVID-19 when managing patients in an in-patent setting, and they can all present similarly with respiratory deterioration, so it’s important to distinguish between them.
- Progression of the viral pneumonia, typically presenting with progressive oxygenation failure, bilateral changes to the chest x-ray (usually lymphocyte count low and decreasing with increasing CRP).
- Secondary bacterial infection, which is difficult to distinguish between progression of the viral pneumonia. Typically, patients may have a productive cough with purulent sputum, more dense, focal changes on the chest x-ray, neutrophilia with elevated CRP and elevated pro-calcitonin >0.5 µg/l (if available).
- Venous thromboembolic disease, typically presenting with progressive oxygenation failure but no real changes on the chest x-ray.