- Joined
- Mar 1, 2020
Let me describe what happens to severe and critical COVID-19 patients.
First, they get a little flu. It seems like nothing. A few days go by, their lungs keep getting worse. A week later, they're in the hospital with bilateral viral pneumonia with patchy ground-glass abnormalities visible on CT scan. Their O2 saturation is down into the hypoxemic range, below 90% and sometimes as low as 75%. They have shortness of breath. They can't seem to get enough air. They show up at the ER and then they get moved and get inpatient treatment in the hospital.
If they're lucky, they go on a nasal cannula, get oxygen for a while until their lungs recover, maybe get some antivirals and antibiotics, and then, they get discharged. Just like SARS, they often have some lung scarring and as much as 20 to 30% reduction in lung function, which will eventually lead to chronic fatigue syndrome. They may have mental issues and chronic pain from being traumatized and from the virus attacking their nervous system. If they were given methylprednisolone to deal with inflammation, they may develop osteonecrosis of their joints. If male, they may have abnormalities in testosterone and luteinizing hormone indicating testicular dysfunction. In short, the experience has partly crippled them.
If they're not lucky, they go critical. They get intubated and put on a mechanical ventilator. Beyond this point, only about 1 in 5 patients survive.
Their pneumonia gets worse and progresses to ARDS. They have pericarditis and myocarditis; their heart muscle is dissolving into their bloodstream and they have elevated troponin and myoglobin levels in their blood. Bacteria starts infecting their lungs and their blood turns septic. The myoglobinemia and direct renal tubular damage of the virus precipitates acute kidney injury requiring dialysis to treat. They show hypokalemia, abnormal AST/ALT and elevated ferritin indicating mild viral hepatitis, and they have low lymphocytes, low platelets, and low white blood cell counts. Their tissues are assaulted by a cytokine storm, their T helpers overactivated and spewing inflammatory cytokines that are destroying and scarring their vital organs. The virus crawls up the parasympathetic nerves of their lungs, into the vagus nerve, and into the brain stem, where it causes dysautonomia and depresses their breathing. Their bloodstream begins to fill up with clots consisting of bits of their dissolved heart muscle, bacteria, and virus clumped together. These clots cause infarcts; heart attacks and strokes.
One of these clots ends up in their heart, they go into cardiac arrest, they code, and it's game over.
Treating severe and critical COVID-19 patients is a marathon that involves doing blood pressure and blood labs, liver labs, and following stringent infection control measures, while also administering antipyretics, antivirals, antibiotics, expectorants, and all sorts of other shit just to try and keep them alive. Our healthcare workers are getting burned out and sickened treating these people.
Do with this information what you will. Or don't, and die. See if I give a rat's ass.
