That's right folks. I was diagnosed with COVID19 also known as Kung Flu. Ive had it since last week. Ive had flus worse than this. But I find the complete lack of smell disturbing. Anyone have a cold or flu that knocked out their sniffer?
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Ahh this was insightful and this makes sense. Since youre seeing these covid patients i have to ask, do you ever get a follow up from them after they recover? Their heart? Lungs? Kidney function?
Yessir— I’m training for my Cardiology fellowship which unsurprisingly involves all of the above-mentioned organ systems. Basically, if your cough resolves, you are 99.99% in the clear. Some (diabetics and heart disease) patients are mild risk for possible infarction due to the clot formation even after their cough resolved, but even within that specific demographic it is less than 5-10%. They appear to be at that mild level of risk for a few weeks; if a heart attack were to happen, it would usually be within a week or two of discharge. Here is the patient at highest risk for that:
65+ year old male, smoker, obese (BMI >30) who doesn’t exercise, has uncontrolled diabetes (Hemoglobin A1C > 7 & doesn’t take their meds), and has heart disease that runs in the family.
Any of those factors increase the risk of a cardiac event. My recommendation is weekly follow up with primary care for 2-3 weeks post-discharge. After about a month, you can make it more infrequent until your risk has dropped sufficiently.
With COVID apparently causing problems to the vascular symptoms what are you seeing as far as strokes, rapid onset dementia, or just general brain fog? Or put another way. How is the brain responding to COVID?
I personally have not seen anyone who suffered any of those nor do I know any colleagues’ patients who have. The clots formed typically mimic that of atherosclerotic disease so we would expect more occlusion of the descending aorta, coronary vessels, popliteal arteries, and carotids in that order. For strokes to occur through a piece of the clot breaking off, it would depend on three things— if the clot were present in carotids, it’s likelihood of embolizing (traveling elsewhere), and the rate that it is broken down (most clots are broken down by plasmin-induced fibrinolysis - in case you are interested in researching it).
Rapid onset dementia is unlikely to occur from that type of embolism as the caliber of the carotids is typically too small to throw a massive clot all at once. I was always taught ROD/RPD was most likely due to an infectious agent like prion disease or genetics (supranuclear palsy- an aggressive subtype of Parkinson’s). If anything, I would assume there would be a chronic vascular dementia that takes multiple clots over years to occur, which is VERY unlikely from any infection since infections resolve typically in under a month.
Brain fogginess is typically due to poor blood perfusion to your brain. If you suffer a cardiac event, that’s a possibility. I know some people claim that it’s due to direct neural damage by Covid but that does not appear to be in any of the literature that I have read.