COVID 19 – What should we expect if we contract the virus?May 14, 2020
COVID 19 – What should we expect if we contract the virus?
My take on this question to date is expect the unexpected!!!
Written by Gail Crawford (Director and Tutor Sonographer – Integrated Ultrasound Education)
As like many of you, I have been trying to keep abreast of the signs and symptoms of COVID 19 or the “corona virus”. To date those predominantly advertised and marketed to the world by the World Health Organisation (WHO), and leaders in the medical field are:
- “Fever, dry cough, and tiredness”
Serious symptoms include:
- Difficulty breathing/shortness of breath, Chest pain, and/or loss of speech/movement.
With a lesser emphasis on:
- Nasal Congestion, headache, conjunctivitis, sore throat, diarrhea, loss of taste or smell and skin rash/discoloration.
They are stating that 80% of people will recover from the virus without hospital treatment and that predominantly the elderly and people with underlying medical conditions such as heart and lung problems, diabetes, high blood pressure and cancer are the people at most risk of serious complications.
A friend of mine, a health worker who would like to remain anonymous was recently diagnosed with Covid 19. For the purpose of this blog post we will call her “Anne”.
From contact tracing it appears Anne acquired the virus at work. But not necessarily from direct contact with a person/patient. It is assumed that she may have contracted it from a hard surface item such as paper, pen, desk etc (We now know that the virus can remain active of hard surfaces for up to 72 hours and porous surfaces such as paper for up to 24 hours) (Neeltje van Doremalen, et al – Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1).
I thought this would be a prime opportunity to ask a little more about her own personal experiences of the virus, and her fellow colleagues. Their symptoms and how they have felt both mentally and physically.
This is an outline of Anne’s Journey……
Anne had been working long hours up to her initial diagnosis. She is generally well, with mild asthma and has been post-menopausal for 3 years.
Day 1. – symptoms began to appear, so presumably contagious prior to this – “Sneezing” with normal temperature (36.5 degrees).
Day 2 – Sore throat, “Runny nose” and normal temperature (37.2 degrees). Normal temperature can range from 36.1 degrees up to 37.2 degrees.
Day 3 – Sore throat, “Runny nose”, cough, fatigue and only “Very mild temperature (37.5 degrees) – Low grade fever”.
It was at this stage that a test for Covid 19 was arranged.
Day 4 – Sore throat, “Runny nose”, “severe fatigue/lethargy”, diarrhoea, cough and only “Very mild temperature”.
Day 5 – Cough, extreme headache, diarrhoea, sore throat has eased, “Normal temperature” and “severe lethargy”. Results are POSITIVE FOR COVID 19.
That evening was REALLY DIFFICULT, Anne experienced shortness of breath and an unfounded “Anxiety”. She also said that many of her colleagues experience this atypical anxiousness. Enough to prevent her from wanting to fall asleep. We can already appreciate that the Covid 19 pandemic is posing a significant physiological threat, and has altered everyone’s daily lives significantly, however there is research now stating that we need to also review the “neuropsychiatric symptoms” caused by the disease, such as seizures, confusion and general “haziness”.
Day 5 – Her colleague also tested positive, but through this entire ordeal has only experienced mild hot flushes (Raised temperature). NO other symptoms.
Day 6, 7 & 8 – “Runny nose”, “Normal temperature”, Cough, diarrhoea, headache, “sever lethargy” and loss of taste and smell (anosmia).
Anne said that many of her colleagues had sever sinus pain early on and had lost their taste and smell. However, it was not till day 6 that it occurred for her. It appears for these colleagues it is taking a long period of time for them to regain their taste and smell (> 5 weeks).
During this entire time, she has been home quarantined, visited by a variety of emergency services including Fire brigade, Police, SES, Defence force to ensure she is abiding by quarantine laws. She has also been in regular contact with her assigned medical practitioner, who has been exceptional. Providing medical support in a physical and mental capacity. This has really helped in her “fight” against this virus.
Day 9 – Another day from “Hell” – Cough now productive, taste improved, diarrhoea stopped (Via medication), “Crazy heavy post-menopausal bleed” and ongoing lethargy. What has caused this bleed? This is a very atypical symptom seen in the literature; however, it appears that some of Anne’s colleagues have also experience similar symptoms. This bleed went on for 6 days.
The literature demonstrates a link between estrogen (Female hormones) and the virus, stating that estrogen could/can help in the fight against the virus and boost immunity. Thus potentially those with decreased estrogen levels could potentially be at greater risk of more sever Covid 19 symptoms (Such as Anne being menopausal). Interestingly one of the many trials being set up to minimise symptoms of the virus is whether female hormones, HRT or the pill could assist in the “fight”, especially for men.
So what caused Anne’s bleed?
There is developing literature outlining blood clothing disorders occurring in Covid positive patients, this is being supported by autopsies on these patients. It is being demonstrated that the Covid 19 virus may cause “atypical blood clotting”, which can result in “COVID Toes” linked to lower limb blood clots, pulmonary embolism and clots leading to stokes.
But on writing this blog post I can not located any up to date research papers on “Covid positive patients and post-menopausal bleeding PMP”, maybe it is a result of the virus causing an inflammatory response with the endometrium (Endometrial atrophy). Either way this needs to be investigated to exclude any other underlying causes.
“My take home message in regards to this symptom is that we may potentially see more patients over the coming months and years who may have been infected with the virus, presenting for pelvic ultrasound looking for causes of PMP bleeding”.
Day 10 – Productive cough, taste completely returned, “ongoing bleeding”, ongoing lethargy.
Day 11 – Now treated with Antibiotics for productive cough (preventing any change of pneumonia), ongoing lethargy.
Let’s fast forward to;
Day 29 – “Ongoing severe lethargy”, “cough eased, but still transient”. Chest cleared.
Now a COVID 19 Survivor testing negative to the virus!!!!
So from all of this what are my takings?
What is my advise…..?
Until a vaccine is developed it is a real possibility that at some stage, we will all get the virus. There is a large and varied range of symptoms, not just the “Typical” symptoms that have been documented to date in the literature. Please be vigalent and “Expect the Unexpected”.
Please feel free to contact me with any feedback or suggestions:
- Emily Troyer, Jordan Kohn and Suzi Hong, Are we facing a crashing wave of neuropsychoiatric sequelae of Covid19? Neurospsychiatric symptoms and potential immunological mechanisms, Brain Behav Immun. 2020 April13 www.ncbi.nlm.nih.gov/pmc/articles/PMC7152874
- Neeltje van Doremalen, Trenton Bushmaker, Dylan H. Morris, Myndi G. Holbrook, Amandine Gamble, Brandi N. Williamson, Azaibi Tamin, Jennifer L. Harcourt, Natalie J. Thornburg, Susan I. Gerber, James O. Lloyd-Smith, Emmie de Wit, Vincent J. Munster. Aerosol and surface stability of SARS-CoV-2 compared with SARS-CoV-1. New England Journal of Medicine, 2020.