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WHAT HAPPENS WHEN YOUR PATIENT GOES HOME?

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Dec.14.2020
 COVID-19

COVID-19

COVID-19 is a respiratory infection that is caused by a virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease is also known as coronavirus disease or novel coronavirus. In some people, the virus may not cause any symptoms. In others, it may cause a serious infection. The infection can get worse quickly and can lead to complications, such as:
  • Pneumonia, or infection of the lungs.
  • Acute respiratory distress syndrome, or ARDS. This is a condition in which fluid buildup in the lungs prevents the lungs from filling with air and passing oxygen into the blood.
  • Acute respiratory failure. This is a condition in which there is not enough oxygen passing from the lungs to the body or when carbon dioxide is not passing from the lungs out of the body.
  • Sepsis or septic shock. This is a serious bodily reaction to an infection.
  • Blood-clotting problems.
  • Secondary infections due to bacteria or fungus.
  • Organ failure. This is when your body's organs stop working.
The virus that causes COVID-19 is contagious. This means that it can spread from person to person through droplets from coughs and sneezes (respiratory secretions).

What are the causes?

This illness is caused by a virus. You may catch the virus by:
  • Breathing in droplets from an infected person. Droplets can be spread by a person breathing, speaking, singing, coughing, or sneezing.
  • Touching something, like a table or a doorknob, that was exposed to the virus (contaminated) and then touching your mouth, nose, or eyes.

What increases the risk?

Risk for infection

You are more likely to be infected with this virus if you:
  • Are within 6 ft (2 m) of a person with COVID-19.
  • Provide care for or live with a person who is infected with COVID-19.
  • Spend time in crowded indoor spaces or live in shared housing.

Risk for serious illness

You are more likely to become seriously ill from the virus if you:
  • Are 50 years of age or older. The higher your age, the more you are at risk for serious illness.
  • Live in a nursing home or long-term care facility.
  • Have cancer.
  • Have a long-term (chronic) disease such as:
    • Chronic lung disease, including chronic obstructive pulmonary disease or asthma.
    • A long-term disease that lowers your body's ability to fight infection (immunocompromised).
    • Heart disease, including:
      • Heart failure.
      • Coronary artery disease, a condition in which the arteries that lead to the heart become narrow or blocked.
      • A disease that makes the heart muscle thick, weak, or stiff (cardiomyopathy).
    • Diabetes.
    • Chronic kidney disease.
    • Sickle cell disease, a condition in which red blood cells have an abnormal "sickle" shape.
    • Liver disease.
  • Are obese.

What are the signs or symptoms?

Symptoms of this condition can range from mild to severe. Symptoms may appear any time from 2 to 14 days after being exposed to the virus. They include:
  • A fever or chills.
  • A cough.
  • Difficulty breathing or feeling short of breath.
  • Feeling tired.
  • Headaches, body aches, or muscle aches.
  • Runny or stuffy (congested) nose.
  • A sore throat.
  • New loss of taste or smell.
Some people may also have stomach problems, such as nausea, vomiting, or diarrhea.
Other people may not have any symptoms of COVID-19.

How is this diagnosed?

This condition may be diagnosed based on:
  • Your signs and symptoms, especially if:
    • You provide care for or live with a person who was diagnosed with COVID-19.
    • You were exposed to a person who was diagnosed with COVID-19.
  • A physical exam.
  • Lab tests, which may include:
    • Using a swab to take a sample of fluid from the back of your nose and throat (nasopharyngeal fluid), from your nose, or from your throat.
    • Testing a sample of saliva from your mouth.
    • Testing a sample of coughed-up mucus from your lungs (sputum).
    • Blood tests.
  • Imaging tests, which may include X-rays, CT scan, or ultrasound.

How is this treated?

Your health care provider will talk with you about ways to treat your symptoms. For most people, the infection is mild and can be managed at home with rest, fluids, and over-the-counter medicines. There are currently no prescription medicines that have been approved for treatment of people with mild cases of COVID-19. Some medicines that treat other diseases are being used on a trial basis to see if they are effective for treating mild cases of COVID-19.
Treatment for a serious infection usually takes place in a hospital intensive care unit (ICU). It may include one or more of the following treatments. These treatments are given until your symptoms improve.
  • Receiving fluids and medicines through an IV.
    • Some medicines have been approved for the treatment of people with serious infection who are being treated in the hospital. In addition, certain medicines that treat other diseases are being used on a trial basis to see if they are effective for treating severe cases of COVID-19.
  • Supplemental oxygen. Extra oxygen is given through a tube in the nose, a face mask, or a hood.
  • Positioning you to lie on your stomach (prone position). This makes it easier for oxygen to get into the lungs.
  • Continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BPAP) machine. This treatment uses mild air pressure to keep the airways open. A tube that is connected to a motor delivers oxygen to the body.
  • Ventilator. This treatment moves air into and out of the lungs by using a tube that is placed in your windpipe.
  • Tracheostomy. This is a procedure to create a hole in the neck so that a breathing tube can be inserted.
  • Extracorporeal membrane oxygenation (ECMO). This procedure gives the lungs a chance to recover by taking over the functions of the heart and lungs. It supplies oxygen to the body and removes carbon dioxide.

Follow these instructions at home:

Lifestyle

  • If you are sick, stay home except to get medical care. Your health care provider will tell you how long to stay home. Call your health care provider before you go for medical care.
  • Rest at home as told by your health care provider.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes, and chewing tobacco. If you need help quitting, ask your health care provider.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Drink enough fluid to keep your urine pale yellow.
  • Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?


Some vaccines to prevent the virus that causes COVID-19 have been authorized for emergency use. This means that the vaccines are still being tested, but they have been deemed safe for use and have been effective in preventing COVID-19 in trials. These vaccines may not be available to everyone right away. The vaccines will likely be given to certain groups at higher risk first until there is enough supply available for everyone. Until the vaccines are available for everyone, it is important to continue to take steps to protect yourself and others from this virus.

To protect yourself:

Take precautions to avoid infection.
  • Stay away from people who are sick.
  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  • Avoid touching your mouth, face, eyes, or nose.
  • Avoid going out in public. Follow guidance from your state and local health authorities.
  • If you must go out in public, wear a cloth face covering or face mask. Make sure your mask covers your nose and mouth.
  • Avoid crowded indoor spaces. Stay at least 6 ft (2 m) away from others.
  • Disinfect objects and surfaces that are frequently touched every day. This may include:
    • Counters and tables.
    • Doorknobs and light switches.
    • Sinks and faucets.
    • Electronics such as phones, remote controls, keyboards, computers, and tablets.

To protect others:

If you have symptoms of COVID-19, take steps to prevent the virus from spreading to others.
  • If you think you have a COVID-19 infection, contact your health care provider right away. Tell your health care team that you think you may have a COVID-19 infection.
  • Stay home. Leave your house only to seek medical care. Do not use public transport, if possible.
  • Do not travel while you are sick.
  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use alcohol-based hand sanitizer.
  • Stay away from other members of your household. Let healthy household members care for children and pets, if possible. If you have to care for children or pets, wash your hands often and wear a mask. If possible, stay in your own room, separate from others. Use a different bathroom.
  • Make sure that all people in your household wash their hands well and often.
  • Cough or sneeze into a tissue or your sleeve or elbow. Do not cough or sneeze into your hand or into the air.
  • Wear a cloth face covering or face mask. Make sure your mask covers your nose and mouth.

Where to find more information

Contact a health care provider if:

  • You have symptoms of COVID-19.
  • You have been exposed to someone who has COVID-19, even if you do not have symptoms.

Get help right away if:

  • You have trouble breathing.
  • You have pain or pressure in your chest.
  • You have confusion.
  • You have bluish lips and fingernails.
  • You have difficulty waking from sleep.
  • You have symptoms that get worse.
These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital. Let the emergency medical personnel know if you think you have COVID-19.

Summary

  • COVID-19 is a respiratory infection that is caused by a virus. It is also known as coronavirus disease or novel coronavirus. It can cause serious infections, such as pneumonia, acute respiratory distress syndrome, acute respiratory failure, or sepsis.
  • The virus that causes COVID-19 is contagious. This means that it can spread from person to person through droplets from breathing, speaking, singing, coughing, or sneezing.
  • You are more likely to develop a serious illness if you are 50 years of age or older, have a weak immune system, live in a nursing home, or have a chronic disease.
  • There is no approved medicine to treat mild cases of COVID-19. Your health care provider will talk with you about ways to treat your symptoms.
  • Take steps to protect yourself and others from infection. Wash your hands often and disinfect objects and surfaces that are frequently touched every day. Stay away from people who are sick, and wear a mask if you are sick.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.