If I get COVID-19, what can I do at home, and what do I need to watch out for?

 

If I get COVID-19, what can I do at home, and what do I need to watch out for?

By: Dr. John Kitsteiner, MD; Emergency Director Greeneville TN

First, don’t panic. Keep in mind that the vast majority of people who develop COVID-19 (symptoms from the SARS-CoV-2 virus) do very well.
Most people feel bad for a few days and recover with no significant problems.

Symptoms:
Symptoms vary tremendously between individuals.
Some people have almost no symptoms other than a little fatigue and body aches for a few days.
Some people have a mild sore throat.
Some people have nausea and vomiting and/or diarrhea.
Some people have cough and shortness of breath.
Some people develop fevers.
Some people lose their taste and/or smell.

The symptoms can develop in almost any order. For example, some people’s first symptom is loss of taste/smell; for others, loss of taste/smell comes at the end, after they are actually feeling better.

Most people have a combination of the symptoms listed above. Most people say that it feels like a mild to bad influenza infection.

What to watch out for:

1. Dehydration.
If you have vomiting and/or diarrhea, getting dehydrated is a risk.

Water is the number one choice to keep yourself hydrated. But how much water to drink? You may have heard that 64 ounces of water a day is recommended, but there’s actually no good science to support that amount. The best gauge is to look at the color of your urine. Urine should be clear to light yellow in color if you are well-hydrated. If it is dark, then you may not have enough water in your system. So drink some more water, slowly through the day, until your urine color lightens. Gatorade and Powerade and Pedialyte are helpful in making sure you keep your electrolytes at the proper level, but you need very little of these drinks per day compared to water. Avoid caffeinated soda and alcohol; this will increase your chances of dehydration.

If you only have diarrhea, you can usually stay hydrated as long as you keep drinking. If the diarrhea is very bad, you may use over-the-counter Imodium. But go slow with Imodium, as it works very well, and you could end up constipated from it.

It’s a lot harder to stay hydrated when you are vomiting. If you are only vomiting a couple times a day, you can still stay hydrated if you drink small sips every 5-10 minutes all day long. Never let your stomach get too filled, as this can trigger vomiting. The good news is that water is absorbed quickly from your digestive tract. So if you are sipping water all day long, you will be keeping your hydration up, even if you are vomiting a few times a day. If you are vomiting more than that, then you may need some anti-nausea medicine. Talk to your doctor about this.

If you are concerned that you are severely dehydrated (dark urine, can’t keep fluids down, feeling lightheaded/passing out when you stand up, and/or low blood pressure with high heart rate, then talk to your doctor, go to your Urgent Care, or go to the Emergency Department).

2. Low Oxygen.
This is the number one reason for being admitted to the hospital when you have COVID-19.

There are a couple of reasons that this may happen: viral pneumonia, secondary bacterial pneumonia, pulmonary embolism (blood clots in your lungs), a combination of these things, or the development/worsening of another medical problem like COPD/emphysema, asthma, congestive heart failure (CHF), etc.

A simple pulse oximeter can help you monitor your oxygen level at home. These are small medical devices that you place on your finger, and it reports your heart rate (pulse) and oxygen saturation (SpO2). They cost between $15-$50 for a home use device. Normal heart rate (pulse) is 60-100 beats per minute, but some people have lower heart rates. Normal oxygen saturation is in the upper 90% range, ideally 100%. If you have COPD/emphysema, then your oxygen saturation may normally be in the 90-94% range. If your oxygen saturation is dropping below 90%, then there may be a problem.

REMEMBER: it can take a few seconds/minutes sometimes to get a good reading on the pulse oximeter, so read the instructions, watch some videos online, and become familiar with how to properly use and read a pulse oximeter.

Bottom Line: if your pulse ox reading is staying below 90%, then call your doctor. If you are staying in the low 80% range (or lower!) then go to the Emergency Department.

3. Blood Clots.
This is a complication of COVID-19.
Clots can form in your legs or arms (these are known as a Deep Vein Thrombus (DVT)). These can break free and get stuck in the lungs (these are known as a Pulmonary Embolus/Emboli (PE)). These can be life-threatening, so you need to take this seriously if it is suspected. One-sided leg pain and/or swelling can be a symptoms of a DVT. Shortness of breath (especially with chest pain), passing out (or almost), low oxygen saturations, with low blood pressure and fast heart rate, can be symptoms of PE.
If you feel okay, but have these symptoms, then call your doctor. If you are concerned that this is an emergency, call 911 and/or go to the Emergency Department.

4. Miscellaneous.
There are a number of other complications that can arise with COVID-19 (liver failure, kidney failure, heart failure, clotting problems, etc). Most of these will only be identified and diagnosed with labs or imaging (X-rays, CT scans, etc.), but fortunately, they are not common.

Simple Home Recommendations:
1. Don’t panic!
2. Stay hydrated.
3. Eat good food.
4. Get rest. Sleep can be difficult with COVID-19. That’s been a common complaint. But try to listen to your body and sleep when you need it.
5. If you have a cough and/or shortness of breath, I recommend that you lie on your stomach (lying “prone”) for 10-15 minutes each hour when you are awake. This helps to keep oxygen saturations up, and it helps to keep fluid from building up in the lower and back portions of the lungs.
6. If you have mild to moderate symptoms, don’t worry. The vast majority of people are going to do very well with COVID-19.
7. If you have more significant symptoms, or if you have risk factors (obesity, older age, heart or lung problems, diabetes, etc.), then stay in touch with your physician.
8. If you have any concern that you have an emergency, call 911 and/or go to the Emergency Department.