5 ms·

On the front lines, here’s what the seven stages of severe Covid-19 look like

51 points by rmason 5y ago

criticaltinker 5y ago
> Stage 1. You’ve had debilitating symptoms for a few days, but now it is so hard to breathe that you come to the emergency room. Your oxygen saturation level tells us you need help, a supplemental flow of 1 to 4 liters of oxygen per minute. We admit you and start you on antivirals, steroids, anticoagulants or monoclonal antibodies. Your chances of survival and healthy recovery greatly increase if you begin treatment early in the symptomatic phase with antivirals, corticosteroids, and antithrombotics. Mistake number 1 is having severe symptoms and waiting for days before seeking treatment. Most people are seemingly unaware of this advice, but many front line doctors have been using these techniques to significantly reduce hospitalization and death since the beginning of the pandemic. [1] Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19) https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?article=1139&context=infectiousdiseases_articles https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?a... [2] Timing of Antiviral Treatment Initiation is Critical to Reduce SARS-CoV-2 Viral Load https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/psp4.12543 https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/psp4.1... [3] Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection https://rcm.imrpress.com/EN/article/downloadArticleFile.do?attachType=PDF&id=5074 https://rcm.imrpress.com/EN/article/downloadArticleFile.do?a... [4] Early multidrug treatment of SARS-CoV-2 infection (COVID-19) and reduced mortality among nursing home (or outpatient/ambulatory) residents https://www.sciencedirect.com/science/article/abs/pii/S0306987721001419 https://www.sciencedirect.com/science/article/abs/pii/S03069...
- jdhn 5y ago
  I don't know why you're getting downvoted. I remember reading a story about a woman who thought she had worsening allergies before getting a covid test, and then going to the hospital. With the way this spreads, if you have any breathing symptoms, it's worth getting a covid test, and then trying to start treatment if it comes back positive instead of just waiting for it to get worse.
  - criticaltinker 5y ago
    Yes it’s extremely important that people are aware of the benefits of beginning treatment early. Waiting for a positive test isn’t even strictly necessary. Apparently some people here find that to be disagreeable? I would love to hear their perspective and reasoning.
  - 1shooner 5y ago
    >trying to start treatment This is contrary to the directions given by the healthcare system, which generally tells covid-positive patients to wait until they have trouble breathing to seek medical care. So they may be getting downvoted because they're essentially recommending cutting in line ahead of people that need more immediate care from strained ED / ICU infrastructure.
    - criticaltinker 5y ago
      You don’t need to go to the ED / ICU, just about any clinic will write you a prescription. In fact early ambulatory treatment is one of the best ways to avoid straining healthcare infrastructure. No cutting in line necessary.
      - 1shooner 5y ago
        That's great to hear, it's just not what GPs are telling their patients.
- nradov 5y ago
  The first symptom of many diseases is denial.
- blub 5y ago
  But how can one tell that they need treatment, just by o2 level? I’ve heard of cases where they felt terrible and then it cleared up and they were fine.
  - nradov 5y ago
    A decreased SpO2 doesn't necessarily indicate that you need treatment. It means you should get a diagnostic test and then consult with your physician on what if any treatment is needed.
deleted 5y ago
[deleted]
jleyank 5y ago
Buy or borrow a fingertip blood oxygen level to see where you are at. Covid has been different (see below) in that people feel ok while their blood O2 levels are on the way down - they're breathing normally, CO2 does not build up in the blood and so no internal "feelings" appear. Thus, by the time you notice that you can't do much at all, you've been sick for a few days and are behind the curve on treatment. Pay f*ckin' attention when you think you have a cold or the flu right now... https://www.science.org/doi/abs/10.1126/science.368.6490.455 https://www.science.org/doi/abs/10.1126/science.368.6490.455
- nradov 5y ago
  Some modern smart watches from vendors like Garmin and Apple also have blood oxygen sensors. They're generally less accurate than dedicated fingertip sensors, but good enough to catch significant decreases. Both types can sometimes read way off depending on skin tone.
- CobaltFire 5y ago
  I've been using my Garmin for this and though the absolute numbers may be slightly off, it's useful to have a running track for reference to what it says you are.
- landemva 5y ago
  Treatment... what is the standard of care? I had it and have a letter from my Dr. that says so and that I have recovered. Dr. said the standard of care is to send people home until they choke, then rush to the hospital for a breathing tube. The standard of care could be to lose weight now, before you get it.
  - nradov 5y ago
    Here is the treatment protocol. https://www.covid19treatmentguidelines.nih.gov/about-the-guidelines/whats-new/ https://www.covid19treatmentguidelines.nih.gov/about-the-gui...
vokep 5y ago
Many of these stories would be prevented if ivermectin was more readily available. Yet the first thing that comes up when googling it is the FDA making baseless claims of it being dangerous. Of course it can be dangerous when people have to turn to questionable sources instead of being able to get it from their doctor with instructions for use.
- nradov 5y ago
  That's possible, but the research studies showing clinical benefits from ivermectin have generally been small or had other methodology limitations. Other studies have shown no statistically significant effect. This is an area where we need some larger RCTs with multiple arms for variations in timing and dosage to definitively resolve the issue. https://www.mdpi.com/1999-4915/13/6/989 https://www.mdpi.com/1999-4915/13/6/989 For now the smart option for most people is to get vaccinated rather than expecting ivermectin to save them.
  - raxxorrax 5y ago
    Could be political. It was for Hydroxychloroquine.
- CobaltFire 5y ago
  Hypocritical to call the FDA claims baseless when you provide no basis for your claim that it would prevent many of these stories. From what I've read the in vitro response requires something like 100x the safe dose for a human, which causes many other health issues. The in vivo response hasn't even been studied, unless you have some information I don't?
  - vokep 5y ago
    I've personally seen it help someone who was getting significantly worse day after day. The effect was undeniable, and makes it infuriating to see claims of the drug as being dangerous or needing more study. Because the FDA is the FDA doesn't mean what they're publishing isn't misinformation. The dose used was about the same as would be used for malaria, within hours of the first dose there was already massive improvement in breathing and overall energy. After further doses it wasn't long before complete recovery. To deny easy access to this sort of thing, for doctors not to offer it as an option when a patient is found to have covid, is criminal. Where is the basis of any of the FDA's claims? Because the mechanism of action isn't fully understood? Does it matter when it saves lives?
thisisnotatesty 5y ago
The worst of these early COVID symptoms can be eliminated almost entirely by taking NAC (N-Acetyl-Cysteine). NAC breaks down mucus (also good if you have COPD). Even better, there are no negative side effects with giving it a shot unless you have some sort of super weird medical condition. Look into it. Take 500-600mg at the first sign of breathing issues.
- thehappypm 5y ago
  Just stop.
- synthos 5y ago
  Or just take the proven to work vaccine.
- nradov 5y ago
  There are theoretical reasons to think that NAC might be a useful therapy. However a recent clinical trial failed to find any benefit. https://academic.oup.com/cid/article/72/11/e736/5910353 https://academic.oup.com/cid/article/72/11/e736/5910353
oenetan 5y ago
https://archive.is/EBF79 https://archive.is/EBF79

51 points by rmason 5y ago

> Stage 1. You’ve had debilitating symptoms for a few days, but now it is so hard to breathe that you come to the emergency room. Your oxygen saturation level tells us you need help, a supplemental flow of 1 to 4 liters of oxygen per minute. We admit you and start you on antivirals, steroids, anticoagulants or monoclonal antibodies. Your chances of survival and healthy recovery greatly increase if you begin treatment early in the symptomatic phase with antivirals, corticosteroids, and antithrombotics. Mistake number 1 is having severe symptoms and waiting for days before seeking treatment. Most people are seemingly unaware of this advice, but many front line doctors have been using these techniques to significantly reduce hospitalization and death since the beginning of the pandemic. [1] Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19) https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?article=1139&context=infectiousdiseases_articles https://scholarlycommons.henryford.com/cgi/viewcontent.cgi?a... [2] Timing of Antiviral Treatment Initiation is Critical to Reduce SARS-CoV-2 Viral Load https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/psp4.12543 https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1002/psp4.1... [3] Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection https://rcm.imrpress.com/EN/article/downloadArticleFile.do?attachType=PDF&id=5074 https://rcm.imrpress.com/EN/article/downloadArticleFile.do?a... [4] Early multidrug treatment of SARS-CoV-2 infection (COVID-19) and reduced mortality among nursing home (or outpatient/ambulatory) residents https://www.sciencedirect.com/science/article/abs/pii/S0306987721001419 https://www.sciencedirect.com/science/article/abs/pii/S03069...

jdhn 5y ago
I don't know why you're getting downvoted. I remember reading a story about a woman who thought she had worsening allergies before getting a covid test, and then going to the hospital. With the way this spreads, if you have any breathing symptoms, it's worth getting a covid test, and then trying to start treatment if it comes back positive instead of just waiting for it to get worse.
- criticaltinker 5y ago
  Yes it’s extremely important that people are aware of the benefits of beginning treatment early. Waiting for a positive test isn’t even strictly necessary. Apparently some people here find that to be disagreeable? I would love to hear their perspective and reasoning.
- 1shooner 5y ago
  >trying to start treatment This is contrary to the directions given by the healthcare system, which generally tells covid-positive patients to wait until they have trouble breathing to seek medical care. So they may be getting downvoted because they're essentially recommending cutting in line ahead of people that need more immediate care from strained ED / ICU infrastructure.
  - criticaltinker 5y ago
    You don’t need to go to the ED / ICU, just about any clinic will write you a prescription. In fact early ambulatory treatment is one of the best ways to avoid straining healthcare infrastructure. No cutting in line necessary.
    - 1shooner 5y ago
      That's great to hear, it's just not what GPs are telling their patients.
nradov 5y ago
The first symptom of many diseases is denial.
blub 5y ago
But how can one tell that they need treatment, just by o2 level? I’ve heard of cases where they felt terrible and then it cleared up and they were fine.
- nradov 5y ago
  A decreased SpO2 doesn't necessarily indicate that you need treatment. It means you should get a diagnostic test and then consult with your physician on what if any treatment is needed.

deleted 5y ago

[deleted]

jleyank 5y ago

Buy or borrow a fingertip blood oxygen level to see where you are at. Covid has been different (see below) in that people feel ok while their blood O2 levels are on the way down - they're breathing normally, CO2 does not build up in the blood and so no internal "feelings" appear. Thus, by the time you notice that you can't do much at all, you've been sick for a few days and are behind the curve on treatment. Pay f*ckin' attention when you think you have a cold or the flu right now... https://www.science.org/doi/abs/10.1126/science.368.6490.455 https://www.science.org/doi/abs/10.1126/science.368.6490.455

nradov 5y ago
Some modern smart watches from vendors like Garmin and Apple also have blood oxygen sensors. They're generally less accurate than dedicated fingertip sensors, but good enough to catch significant decreases. Both types can sometimes read way off depending on skin tone.
CobaltFire 5y ago
I've been using my Garmin for this and though the absolute numbers may be slightly off, it's useful to have a running track for reference to what it says you are.
landemva 5y ago
Treatment... what is the standard of care? I had it and have a letter from my Dr. that says so and that I have recovered. Dr. said the standard of care is to send people home until they choke, then rush to the hospital for a breathing tube. The standard of care could be to lose weight now, before you get it.
- nradov 5y ago
  Here is the treatment protocol. https://www.covid19treatmentguidelines.nih.gov/about-the-guidelines/whats-new/ https://www.covid19treatmentguidelines.nih.gov/about-the-gui...

vokep 5y ago

Many of these stories would be prevented if ivermectin was more readily available. Yet the first thing that comes up when googling it is the FDA making baseless claims of it being dangerous. Of course it can be dangerous when people have to turn to questionable sources instead of being able to get it from their doctor with instructions for use.

nradov 5y ago
That's possible, but the research studies showing clinical benefits from ivermectin have generally been small or had other methodology limitations. Other studies have shown no statistically significant effect. This is an area where we need some larger RCTs with multiple arms for variations in timing and dosage to definitively resolve the issue. https://www.mdpi.com/1999-4915/13/6/989 https://www.mdpi.com/1999-4915/13/6/989 For now the smart option for most people is to get vaccinated rather than expecting ivermectin to save them.
- raxxorrax 5y ago
  Could be political. It was for Hydroxychloroquine.
CobaltFire 5y ago
Hypocritical to call the FDA claims baseless when you provide no basis for your claim that it would prevent many of these stories. From what I've read the in vitro response requires something like 100x the safe dose for a human, which causes many other health issues. The in vivo response hasn't even been studied, unless you have some information I don't?
- vokep 5y ago
  I've personally seen it help someone who was getting significantly worse day after day. The effect was undeniable, and makes it infuriating to see claims of the drug as being dangerous or needing more study. Because the FDA is the FDA doesn't mean what they're publishing isn't misinformation. The dose used was about the same as would be used for malaria, within hours of the first dose there was already massive improvement in breathing and overall energy. After further doses it wasn't long before complete recovery. To deny easy access to this sort of thing, for doctors not to offer it as an option when a patient is found to have covid, is criminal. Where is the basis of any of the FDA's claims? Because the mechanism of action isn't fully understood? Does it matter when it saves lives?

thisisnotatesty 5y ago

The worst of these early COVID symptoms can be eliminated almost entirely by taking NAC (N-Acetyl-Cysteine). NAC breaks down mucus (also good if you have COPD). Even better, there are no negative side effects with giving it a shot unless you have some sort of super weird medical condition. Look into it. Take 500-600mg at the first sign of breathing issues.

thehappypm 5y ago
Just stop.
synthos 5y ago
Or just take the proven to work vaccine.
nradov 5y ago
There are theoretical reasons to think that NAC might be a useful therapy. However a recent clinical trial failed to find any benefit. https://academic.oup.com/cid/article/72/11/e736/5910353 https://academic.oup.com/cid/article/72/11/e736/5910353

oenetan 5y ago

https://archive.is/EBF79 https://archive.is/EBF79