“It started off as just a little bit of a dry cough … “
As physicians across the country diagnose and care for a growing number of people with COVID-19, distinct patterns are emerging, giving clues about how the illness manifests itself in patients.
1. It starts with minor physical complaints.
Very often, people start off with minor physical complaints — slight cough, headache, low-grade fever — that gradually worsen.
“Patients tend to have symptoms for about a week before either getting better, or getting really sick,” said Dr. Joshua Denson, a pulmonary medicine and critical care physician at Tulane Medical Center in New Orleans.
Denson, who estimated he’s treated 15 to 20 patients with the coronavirus, described that first phase of the illness as “a slow burn.”
Other physicians are seeing similar progression.
“It seems like there’s a period of time where the body is trying to sort out whether it can beat this or not,” Dr. Ken Lyn-Kew, a pulmonologist in the critical care department at National Jewish Health, a hospital in Denver, told NBC News.
2. You start to feel better.
“We’re learning about this disease as it’s happening, minute-by-minute.”
And sometimes, patients start to feel better before their health quickly deteriorates.
“That’s what we’re seeing with these patients who get a lot worse,” Lyn-Kew said. “They’re doing OK, and then all of a sudden they’re really fatigued, a lot more shorter of breath and having chest pains.”
3. Then it suddenly gets worse.
In North Carolina, Dr. Christopher Ohl has also seen rapid, unexpected development of severe symptoms.
“They say, ‘Hey, you know, I think I’m getting over this,’ and then within 20 to 24 hours, they’ve got fevers, severe fatigue, worsening cough and shortness of breath,” said Ohl, an infectious disease expert and professor of medicine at the Wake Forest School of Medicine in Winston-Salem, North Carolina. “Then they get hospitalized … ”
Though severe coronavirus cases have been reported among younger and middle-aged adults, doctors say older adults, the elderly and those with chronic health conditions seem to be most at risk for the sudden decline.
Denson said nearly all of his most critically ill patients have a combination of three specific underlying medical problems: obesity, high blood pressure and type 2 diabetes …