Mild COVID-19 may quickly progress to severe form: Watch out for emergency warning signs

Approximately 5 per cent of people with mild COVID-19 progress to a severe or critical form, including development of severe pneumonia, says a new study.

By: Longjam Dineshwori | | Updated: July 20, 2020 9:13 am

Patients with mild illness may experience flu-like symptoms including dry cough and mild fever. @Shutterstock

COVID-19 affects people differently. People infected with the COVID-19 virus may experience mild, moderate, severe, or critical symptoms. But there are also cases in which infected persons show no symptoms at all (asymptomatic patients). As per the current data, most (81%) of symptomatic COVID-19 cases are mild that can be resolved at home. Patients with mild illness may experience flu-like symptoms including dry cough, fever that may not reach 37.8°C, loss of sense of smell, tiredness, muscles aches, or a headache. Sore throat or runny nose may occur in some cases. Normally healthy people under 60 have mild symptoms. However, a person with mild symptoms can deteriorate quickly and become seriously ill, requiring hospitalization. This is more likely in at-risk groups. Also Read - 'Coronil is evidence based medicine': Ramdev's Patanjali issues fact check response to IMA

According to a new study, approximately 5 per cent of people with COVID-19 progress to a severe or critical form, including the development of severe pneumonia which leads to acute respiratory distress syndrome (ARDS). Further, ARDS can cause symptoms like shortness of breath, rapid breathing and bluish skin colouration. Also Read - COVID-19 vaccine for above 45: How to register and who is eligible? Everything answered

Two-stage progression of COVID-19

Based on clinical observations, researchers describe a two-stage progression of COVID-19, beginning with a mild to moderate form, followed by respiratory aggravation 9 to 12 days after the onset of the first symptom. Also Read - Hospitalised COVID-19 patients with sodium imbalance at high risk of respiratory failure, sudden death

Emerging evidence further suggests that this aggravation is caused by a large increase in cytokines — a large group of proteins, peptides or glycoproteins that are secreted by specific cells of the immune system.

However, the team from various European universities found that the production and activity of interferon (IFN) type I is strongly reduced in the most severe forms of COVID-19.

They also found that low levels of type-I IFN in plasma precede clinical worsening and transfer to intensive care.

Based on their finding, the researchers suggested that levels of circulating type 1 IFN help identify each stage of the disease, with the lowest levels likely to be seen in the most severe patients.

Overall, the study concluded that the production of type-I IFN is inhibited in the SARS-CoV-2 infection.

When to seek medical help

A majority of people with mild infections can be treated at home. But if you belong to a vulnerable group, it is advisable that you speak with a clinician (over the phone) about your symptoms as sometimes the mild infection can worsen swiftly.

Take note, people who are older than 60 years or who have health conditions like lung or heart disease, diabetes or conditions that affect their immune system are more vulnerable to severe COVID-19 infections.

If your symptoms are worsening, seek advice. Also watch out for emergency warning signs for COVID-19 such as trouble breathing, persistent pain or pressure in the chest, new confusion, inability to wake or stay awake, bluish lips or face. If you notice any of these signs, seek emergency medical care immediately. But call ahead before visiting your doctor so that the office can take precautions to protect the staff and other patients.

If you’re not in need of critical care, you may be put in a COVID unit and treated depending on the severity of illness. Some patients may require minimal intervention which includes checking their vitals like oxygen levels regularly. They may be given fluids to help them stay hydrated. However, patients with low oxygen levels may need help from a nasal cannula or an oxygen mask to boost their levels. If your symptoms worsen, you may be admitted to the ICU to be monitored more closely. In the absence of the COVID-19 vaccine, critical patients are being treated with various repurposed drugs like Remdesivir, Favipiravir and Dexamethasone.

Published : July 19, 2020 2:49 pm | Updated:July 20, 2020 9:13 am

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