Different types of presentation of covid:
- Asymptomatic - We encounter these type of cases when testing the contacts
of positive persons.
- Upper Respiratorytrack Inflamatary
Symptoms -
Some covid patients present with
predominant symptoms of URI like stuffy nose, throat pain, anosmia (loss of
smell ), myalgia with or without a brief and
mild fever. Usually these people have a benign course of illness. Still
they need to be observed for atleast one week
-The Classical type -
This type is the most
aggressive form of illness and carry a high mortality rate. The typical symptoms are one or two days of
fever followed by a cough which is usually a dry cough. On the second of
cough, pt starts developing breathing
difficulty on exertion. Breathing difficulty slowly progresses over the next
one or two days.
By this time they would have
developed severe hypoxia which is disproportionately severe to the degree of
symptoms(Silent Hypoxia ).If neglected further they end up with sudden cardiac
arrest and death which usually happens towards the end of first week or
beginning of second week.
So cough is an ominous symptom
of severe covid. The mortality can be greately reduced if they present early to
the hospital.
- Persistent Fever -
These type of patients have
fever for more than 2days and many a times it can be upto 12 days. This type
is comparatively less aggressive than
the classical type. Some patients do not develop further illness once fever is
stopped.
But many will develop cytokine
storm and death which usually happen little late (later than the classical
type). In survivers the recovery is slow and prolonged ( usually 3-5
weeks).Actually we see more number of these kind of patients nowadays.
This type had fever initially, Once the fever got over, they would develop
extreme weakness over the next three to five days. They didn't have the complaints of breathing difficulty.
If evaluated further they would have hypoxia and radiological
evidence of Pneumonia. Of course they developed
breathing difficulty later and by this time they had developed severe disease.
So any patient with H/O extreme tiredness following a fever ( in some
cases myalgia) should be evaluated
further even if he does not have dyspnea.
-G I Symptoms -
Few
patients present with anorexia,,vomiting, diarrhea and abdominal
pain as the presenting complaints. These
patients if not suspected and treated earlier would develop severe Acute Respiratory Distress Syndrome.
They carry a poor prognosis usually.
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