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I am an ER MD in New Orleans. Class of 98. Every one of my colleagues have now seen several hundred Covid 19 patients and this is what I think I know.
https://texags.com/forums/84/topics/3102444?fbclid=IwAR3s13SRnw7YNgtu-7LZyrMUSMIRRWScU67lwbuwZM8fna-6R8k4tqrtO3w ^

Posted on 03/25/2020 6:48:00 PM PDT by BusterDog

"Clinical course is predictable. 2-11 days after exposure (day 5 on average) flu like symptoms start. Common are fever, headache, dry cough, myalgias(back pain), nausea without vomiting, abdominal discomfort with some diarrhea, loss of smell, anorexia, fatigue.

Day 5 of symptoms- increased SOB, and bilateral viral pneumonia from direct viral damage to lung parenchyma.

Day 10- Cytokine storm leading to acute ARDS and multiorgan failure. You can literally watch it happen in a matter of hours.

81% mild symptoms, 14% severe symptoms requiring hospitalization, 5% critical."


TOPICS: Extended News; News/Current Events
KEYWORDS: coronavirus; course; covid19; death; doctorspeaks; symptoms
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To: Vermont Lt

Sounds like they’re describing Joe Biden on a typical day.


21 posted on 03/25/2020 7:01:21 PM PDT by Alberta's Child ("And somewhere in the darkness ... the gambler, he broke even.")
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To: BusterDog

https://texags.com/forums/84/topics/3102444

This link should get you to the source


22 posted on 03/25/2020 7:05:09 PM PDT by 13foxtrot
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To: Texas Eagle

It means people are demonstrating signs of oxygen deprivation without difficulty breathing, disorientation, dehydration and diabetic ketoacidosis (high levels of ketones... Blood acids).


23 posted on 03/25/2020 7:06:43 PM PDT by PresidentFelon
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To: Texas Eagle

Explain it to us like we’re ten year olds.

==

Low oxygen and much difficulty breathing.

Impaired brain functions, kidney failure.


24 posted on 03/25/2020 7:08:29 PM PDT by Jane Long (Praise God, from whom ALL blessings flow.)
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To: BusterDog

Question: How many undiagnosed have gotten it and stayed home until they were better and only had mild to moderate symptoms?


25 posted on 03/25/2020 7:09:37 PM PDT by Blood of Tyrants (A socalist is someone that wants everything you have except your job.)
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To: BusterDog

This virus is no flu. This stuff is nasty.


26 posted on 03/25/2020 7:10:09 PM PDT by Crucial
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To: PresidentFelon

Ketosis due to lack of nourishment?


27 posted on 03/25/2020 7:10:26 PM PDT by RushIsMyTeddyBear ("Progressives" (elitist Communists) "Love you to death".)
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To: BusterDog

Good post. Thanks


28 posted on 03/25/2020 7:10:51 PM PDT by Track9
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To: Steely Tom
I wonder why the cytokine storm ?

That's your immune system overeating to the virus in your lungs.

The same think happens when you have psoriasis.

29 posted on 03/25/2020 7:10:53 PM PDT by FreeReign
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To: BusterDog

Yikes. Lungs, brain, heart, kidneys. Heard a few days ago it is damaging testes. What a bad virus. Have any other viruses attacked so many organs?


30 posted on 03/25/2020 7:11:10 PM PDT by ProtectOurFreedom
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To: arkfreepdom

You in there with Noah!? How are the animals doing?


31 posted on 03/25/2020 7:11:12 PM PDT by goldbux (No sufficiently rich interpreted language can represent its own semantics. — Alfred Tarski, 1936)
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To: Texas Eagle

Low oxygen in blood, confusion, kidney failure due to dehydration.


32 posted on 03/25/2020 7:11:22 PM PDT by Blood of Tyrants (A socalist is someone that wants everything you have except your job.)
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To: Texas Eagle

75% oxygen level??? I would think that would be lethal.


33 posted on 03/25/2020 7:11:27 PM PDT by Husker24
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To: goldbux

Arkansas ;)


34 posted on 03/25/2020 7:12:58 PM PDT by arkfreepdom
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To: AAABEST

How many have mild symptoms that aren’t officially diagnosed and get better with no doctor or hospital visit?


35 posted on 03/25/2020 7:13:04 PM PDT by Blood of Tyrants (A socalist is someone that wants everything you have except your job.)
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To: BusterDog

Geezus, I think everyone here is on the internet. Do we not know how to look up the meaning of a word on said internet?


36 posted on 03/25/2020 7:13:43 PM PDT by Pollard (shadowbanned)
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To: BusterDog

Looks like another doc ?? chimed in, in the replies, along with a reply by orig doc....

I agree that it is striking how fast they crash when they do. It happens right in front of you in very short order.

The rate of superimposed bacterial PNA is very low, less than 1% based on Chinese data, and so I really don’t feel there is any benefit to azithromycin. Especially given even strep pneumo in major population centers laughs at azithro these days.

CXR findings in general have little correlation with disease severity in pneumonia, and that goes for COVID as well. A patient <65 who isn’t hypoxic or hypotensive with a RR <30 essentially never needs to be admitted for pneumonia outside of unique circumstances (regardless of imaging), and even then it’s usually “just in case”. I will say this disease does make one hesitate because of its unique course, but there are predictors other decompensation as you said that can guide you.

I don’t love the Plaquenil option and the data sucks to be honest, but I have used it some. Remdesivir really seems to work well in the severe cases from my anecdotal perch.

Also, some of these patients have incredible IL-6 levels. I’ve never seen numbers this high even in my AIDS patients with KICS. One guy had a level above assay which were pretty sure has never been reported by our lab before.

Obviously we dont know what they were for Spanish flu patients 100 years ago but the cytokine storm was the hallmark of that disease. We’re seeing something similar here.

Patients requiring supplemental oxygen beyond regular nasal cannula, which in COVID usually ends up being a ventilator. We don’t really try NIPPV as the OP said because it doesn’t help much and risks aerosolizing the virus. I’ve had one patient saved from a vent by high flow nasal cannula, which in terms of pure oxygen delivery is the most we can provide prior to intubation, but generally these people are either on NC or getting intubated because the hypoxia becomes so profound so quickly if they crash.

That is correct. Once on the vent if they survive expect them to be on 10-11 days.


37 posted on 03/25/2020 7:15:15 PM PDT by Jane Long (Praise God, from whom ALL blessings flow.)
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To: Pollard

??

Are you saying Buster should translate? Or, complaining about those who are not? ;-)

Just curious.


38 posted on 03/25/2020 7:16:02 PM PDT by Jane Long (Praise God, from whom ALL blessings flow.)
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To: BusterDog

sheesh...why did I read that

next time I feel the urge to go out I think I will just read that again.

Sounds like you better find a way to nip this in the bud at home PDQ because you have no idea where the Wuhan Roulette ball will fall

I am going with that Zinc Picowhatever.

Quercetin for the transporter

Vitamin C

Tumeric, Zicam, Copper and some other stuff


39 posted on 03/25/2020 7:16:41 PM PDT by RummyChick
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To: Vermont Lt

I understood you’re sarcastic tone brother.


40 posted on 03/25/2020 7:16:49 PM PDT by NELSON111 (Congress: The Ralph Wolf and Sam Sheepdog s<how. Theater for sheep. My politics determines my "hero")
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