Different types of presentation of covid 19:

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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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