coronavirus symptoms

One More Reason to Avoid COVID-19 Infection

“I feel like an old person; I’m only 46,” a bank examiner from Brooklyn, told the New York Post recently. “I don’t wish this on my worst enemy.” She contracted the virus March 23, and still experiences body aches, hot flashes, arthritis and her hair has been falling out in clumps.

As some people toss around phrases like “herd immunity” (the notion that the virus should spread through the population to eventually produce a general immunity) and blithely attend “covid parties” hoping to achieve the same effect, our concierge doctors thought we’d explore one of the lesser-known risks involved in that type of thinking.

‘Long haulers’

Many of those who survived the disease are beginning to speak out about the long-term effects they’re still experiencing months later.

Shelby Hedgecock first tested positive for COVID-19 in April, negative in May. Nevertheless, she tells CNN she is still having neurological issues, cognitive issues, shortness of breath, chest pain, loss of smell, and body aches and pains that send her to bed for days if she participates in even the gentlest forms of yoga.

“[My symptoms are] just all over the place, and I’m insanely tired,” she told CNN’s Chris Cuomo recently. Cuomo, who also contracted COVID-19 early in the pandemic, reports similar lingering coronavirus symptoms.

Amy Watson, 47, of Portland, Oregon, appears to have been responsible for introducing the phrase “long hauler” which is now attached to the syndrome. Now in her sixth month of dealing with such coronavirus symptoms as painful burning sensations on her arms, torso, head and neck, she created a COVID-19 patient support group called Long Haul COVID Fighters.

Strange debilitating symptoms

Survivors on numerous online COVID-19 support groups describe a constellation of nearly 100 lingering symptoms.

Natalie Lambert, an associate professor of medicine at the Indiana University School of Medicine, surveyed more than 1,500 members of a group called Survivor Corps.

“They’re not quite sick enough to be hospitalized, but they are suffering from very severe symptoms, sometimes for a very long time at home,” she told NBC News.

Respondents to her survey reported 98 different coronavirus symptoms they’d experienced since their diagnosis, including:

  • dizziness
  • anxiety
  • headache
  • rashes
  • joint pain
  • shortness of breath
  • heartburn
  • diarrhea
  • fevers
  • memory impairment
  • cognitive difficulties
  • sleep disturbances
  • vision problems

Alexandra Plazas-Herrera, 41, told the Post she suffered bleeding from her nail beds and the skin was peeling off her face a few months after catching COVID-19.

“It was super weird, like horror movie stuff,” she said, adding that she has also experienced a lingering fever, fatigue, persistent brain fog, poor coordination and inability to concentrate.

Many of those who report chronic symptoms had only mild or moderate cases of COVID-19; most were not serious enough to be hospitalized. A large number of them report they were healthy and “in the prime of their lives” before becoming infected. The syndrome also appears to affect all ages.

How common is this?

The Centers for Disease Control and Prevention (CDC) released a survey in July of 292 people who had tested positive for the virus. It found 35 percent of respondents had not returned to their previous state of health. Other surveys, mainly in Europe, put the incidence as high as 80 percent.

Twenty percent of those in the CDC survey were between the ages of 18 and 34 with no prior chronic medical conditions.

“Data categorically show it’s a real thing,” David Putrino, a doctor of neuroscience and the Director of Rehabilitation Innovation at Mount Sinai Hospital in Manhattan, told ABC News. “These individuals are experiencing fatigue, dizziness, nausea, GI symptoms, pain . . . in the spine and chest.”

No one knows yet how long these troubling coronavirus symptoms will last; some survivors report early symptoms receding and being replaced with new ones.

Unanswered questions

Because the virus is still so new, medical science as yet has no answers for these people.

Jake Goldenstein, 20, still can’t walk down the street without becoming completely winded. He also suffers from debilitating headaches, digestive issues, congested sinuses and a racing heart.

“They gave me all types of medications. I was on a nebulizer, I was on multiple inhalers, they gave me multiple [antibacterial] medications, literally all types of medications,” the former hiker and baseball player told the Post. “None of them really seem to help.”

Lea Lane, a travel writer for Forbes caught COVID-19 in March. She’s seen pulmonologists, cardiologists, gastroenterologists, vascular specialists and neurologists. She reports her new primary care doctor told her she has “post-viral syndrome,” and “hopefully it will someday go away.”

If you experience lingering symptoms of COVID-19 infection, of course we will do our best to help manage them. But for now, our best advice is to avoid becoming infected in the first place:

  • avoid places with large crowds, especially indoors
  • always wear a face covering in public
  • wash hands frequently for at least 20 seconds

Remember the primary means of transmission appears to be aerosolized virus particles emitted—including by those showing no symptoms—when talking, laughing, coughing, singing or just breathing. These aerosols can linger in the air for many minutes or even hours. So never go any place where you don’t feel safe.

Important Message

A Covid-19 Update from Dr. Poncy & Dr. Lubarsky

So much has happened in the last few weeks. Finally, though, it seems as though we can see a faint light at the end of the tunnel. There is so much conflicting data on how to move forward that we thought we would try to help you parse through it.

As I’m sure you have noticed, there has been noticeably less talk about hydroxychloroquine. Unfortunately, some recent studies have shown no positive effect with its use, and possibly increased risk. It’s too early to say since there are larger ongoing studies, but for now hydroxychloroquine doesn’t seem to be recommended for treatment of Covid.

There has been exciting news from Gilead in regards to their drug Remdesivir. Their most recent studies showed significant improvement in a vast majority of critically ill patients. That’s one to definitely keep an eye on and may be one to help us come out of this crisis.

There are recommendations that have not changed, and, frankly, ones that should continue indefinitely. Those include staying active, exercising, eating well, sleeping well and avoiding excessive alcohol use. Although we would discourage outdoor activities at peak sun exposure (10-2), we would strongly encourage you to go outside for walks, bike rides, etc. This helps build Vit D levels which are helpful for your immunity, improves physical fitness which has shown to correlate with improved Covid survival, and can have a significant positive impact on your mental health.

There is a lot of confusion about testing and test results. And, to be honest, the picture is not clear. Rapid Immunoglobulin testing has gained significant traction. Several of you have already had the test. While the accuracy of the testing nationwide is under investigation, we still have to make certain assumptions based on the information we have. If you have a positive IgM it suggests that you have had a recent exposure to Covid. IgG antibodies develop later following infection, and generally do not begin to appear until 7 – 10 days after infection. When IgG antibodies are present it often indicates a past infection but does not exclude recently infected patients who are still contagious, especially if detected with IgM antibodies. It is unknown how long IgM or IgG antibodies to SARS-CoV-2 will remain present in the body after infection and if they confer long term immunity. Therefore, we suggest, if you are positive for IgM (with or without IgG) that you follow strict isolation guidelines for 2 weeks assuming you can be contagious. If you are positive for IgG only, then hopefully congratulations is in order. We do not suggest letting your guard down and encourage you to follow statewide mandates. However, there is a good chance you have some degree of immunity which could have implications going forward. There are several options for testing for active Covid infections. If you have symptoms that are concerning please call (561) 642-1000 to schedule a test at FITTEAM ballpark of the palm beaches. Another option, while a little pricey, is a home test provided by Access labs in Jupiter. If interested please go to https://accessmedlab.com/covid19.

Some of you who have tested positive have generously volunteered to donate plasma. While the protocol is not exactly clear, we have been made aware that Oneblood is taking plasma donations at their center in Pompano. If interested, please check their web site at Oneblood.org.

We are very thankful to you, our wonderful patients, for your patience and understanding during these difficult times. Although we are encouraging you to stay away from the office to avoid unnecessary exposure, we are still available and ready to take care of any issues, Covid related or not. We look forward to seeing you face to face in the near future when things settle down.

 

Sincerely,

Morgan and Amir

rare disease afm

Mysterious Illness Spreading, But Still Very Rare

Your concierge family practice doctors in Jupiter, Florida, at MD 2.0., have been hearing concerns from our patients about the recent publicized increases of a rare polio-like disease occurring mainly in children. The Centers for Disease Control and Prevention (CDC) is investigating as many as 127 cases of acute flaccid myelitis (AFM) in at least 22 states this year. Some news outlets place the number of states affected closer to 30, because reporting cases to the CDC is voluntary, and this information may not have reached the CDC yet.

The symptoms of AFM are very similar to polio, a disease that was eradicated in the U.S. through the use of universal immunization. AFM affects a person’s nervous system, specifically the spinal cord, causing weakness in one or more limbs. It tends to begin about a week after a slight fever or respiratory illness, but can suddenly appear as weakness in the arms and legs. Other symptoms can include slurred speech or difficulty swallowing, or a “drooping” appearance in the face. Many patients recover quickly, while others continue to have paralysis requiring ongoing care.

More than 90 percent of the cases the CDC has confirmed have occurred in children under age 18; the average age is four. Although one death from AFM was reported last year, no deaths have been associated with the illness so far this year.

Cause still unknown

AFM was even rarer prior to its first major U.S. outbreak in 2014 when 120 cases were confirmed. The illness seemed to slack off in 2015 with only 22 confirmed cases, then spiked again in 2016 (149 cases), dropped in 2017 (33 cases), and now in 2018, we have 62 confirmed cases so far with an additional 65 suspected cases being investigated by the CDC. So not only do the cases seem to be rising then declining from year to year for reasons that are still unclear, but they also seem to cluster in the fall months. There are no state clusters, however, suggesting the illness is not spread from person to person but arises spontaneously.

The most frightening thing about AFM is that scientists have been unable to pinpoint a cause. All the confirmed AFM patients have been tested for poliovirus, and have definitively tested negative. The CDC has also tested every case for evidence of a wide range of known pathogens (germs) or viruses and has been unable to detect a consistent pattern among those affected.

What is known

Scientists continue to look for a common thread. Given the persistent controversy over vaccinations, it should be noted that those affected have differing histories on vaccinations: Some of the patients were vaccinated, some were not. (Incidentally, in October an unvaccinated child in Florida became the first person to die from this year’s flu.)

Unless it can be found that all those who contracted the illness share a common trait, such as being or not being vaccinated or contracting the same type of cold or flu, or having traveled to a certain place or having come in contact with some pollutant, the cause of the syndrome will remain a mystery.

What is also known is that the chances of developing AFM is less than one in a million, according to the CDC.

Should you worry?

The likelihood of you or your child developing this distressing illness is miniscule, but there is a chance, especially since this is a year in which the cases are spiking. But we believe there is little cause for concern. As a parent, you should take the typical precautions you always do to ensure your child stays healthy: obtaining the recommended vaccinations, ensuring they wash their hands regularly and practice accepted hygiene methods, eating well, exercising, and getting enough sleep.

Just be aware that AMF strikes with little warning, and watch your child for any signs of the symptoms described above. If you have any concerns or questions, please don’t hesitate to contact us immediately.

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