What We Know So Far... Part 3

What To Expect When You Are Covid Positive

So, despite wearing a mask, washing your hands, and keeping your distance...you got COVID-19 anyway. The question often comes up “what's going to happen to me?”, “What do I do?”, “How will I know if I have a problem?”. Because this is a new disease, we are still learning what can happen when someone contracts the virus.

Most of us have heard about people who did not have any symptoms. While there are some patients who truly do not have any symptoms, most of the “asymptomatic” people actually have very mild symptoms (headache for a day, nasal congestion, etc.). For those people, you just need to self-quarantine for 10 days (starting from the day you tested, or from the first day of symptoms if you have any). Everyone else who is positive has a range of illnesses. There are three common symptom clusters:

  1. Flu-like without fever (headache, muscle aches, cough, sore throat and chest tightness/pain, and loss of sense of smell)
  2. Flu-like with fever (Fever, Headache, cough, sore throat, hoarseness, loss of appetite and loss of sense of smell)
  3. GI illness - (Headache, loss of appetite, diarrhea, sore throat, loss of sense of smell and chest pain - but usually no cough)

Most people go through one of the symptom complexes over the course of the first week. After the first week about half of those who are ill recover. For the other 50% of the people who get ill, they go through a series of added difficulties. First is an overwhelming sense of fatigue. While the other symptoms continue or resolve over the next week, the fatigue can last for weeks after the rest of the symptoms resolve. If the person does not get better during the second week, then it often progresses to the next symptom of confusion. Patients seem to lose a sense of time, or where they are, or what is going on with them. If this happens, it is time to go to the ER as over half of the patients who reach this stage end up in the hospital. Once someone is admitted to the hospital due to COVID-19, where they can get supportive care, remdesivir (antiviral) and dexamethasone (antiinflammatory steroid) they will usually get better over the next 4-5 days. These are the only two drugs that have been shown to be effective against COVID-19. If, on the other hand, they are sick enough to be admitted to the ICU, the average hospital stay is 15 days.

As you can see, there are a wide range of symptoms with COVID-19. Most cases are very mild, but a significant number of people get quite ill and can be sick for 2-3 weeks, often requiring a hospital stay or ICU care. As we are reminded on the news every day, people die from this disease all too often. So take care of yourself. Wear a Mask. Wash your hands. If you get ill, get plenty of rest and drink fluids (water). If you get short of breath, or confused, or are unable to eat or drink then seek medical help. We will get through this - together.

- Craig Kopecky, M.D.

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