The most dangerous period when contracting Covid-19

With some F0, from the 5th to 10th day, many cases suddenly became severe, the SpO2 index dropped sharply. This condition, if not detected in time, can be life-threatening.

During the first week of contracting Covid-19, Morgan Blue, 26, of Flint, Michigan, USA, felt weak, had severe back pain and had a fever. However, doctors at the local emergency room evaluate these symptoms not to alarm. She was sent home for further observation.

On the 8th day, Blue suddenly felt suffocated, the disease progressed rapidly. This caused her to be hospitalized immediately.

In Vietnam, according to Doctor Nguyen Huy Hoang, a member of a group of military medical doctors supporting Covid-19 patients in Hanoi, some F0's have no symptoms (no fever, people get better.), even negative after 4-6 days, but on 8-10 days, suddenly it turned severe, there was no difficulty in breathing, but SpO2 decreased to only 60-70% and some people did not survive, most of them had to be hospitalized.

According to experts, for many Covid-19 patients, the second week is the most dangerous period. Because at this time, the patient's body has the most severe reactions to nCoV. Symptoms come on suddenly, even if they've been fairly stable before.

Many F0 have an alarmingly low SpO2 but the body has no abnormal symptoms.

Decisive week

In the early stages, the patient feels cough, fever, sore throat, but in many views, this is not the most dangerous period. At this time, the lungs can still expand normally, there is no increase in dead space, airway resistance. Therefore, for the patient, breathing is not unusual.

The real critical period can occur on days 5-7 or even 10 days, even if the patient has a negative test result. The disease can progress rapidly and respiratory decompensation occurs. The healthy part of the lung will have to make up for the parts that have been attacked and damaged by the virus. In some people, hypoxia is already quite severe, but it progresses very quickly when the patient develops shortness of breath.

This condition, also known as 'silent hypoxia' or 'happy hypoxia', is diagnosed when the patient does not feel short of breath but the SpO2 falls below 94%. SpO2 in normal people is 94-100%. In Covid-19 patients with pneumonia, the oxygen level is only 60-70%, even 50%, threatening respiratory failure, leading to death.

Therefore, measuring SpO2 twice a day is considered a way to help detect abnormalities in people with Covid-19. If the patient suddenly breathes rapidly and deeply, they need urgent referral.

SpO2 readings below 94% are considered dangerous and need to be hospitalized for monitoring.

Reason?

The view that the 5th to 10th day is the most dangerous period for people with Covid-19 is also inconsistent. However, experts all see the sudden worsening aspect of the disease.

"The critical second week of having Covid-19 is pretty clear, but why it happened we're still not sure," said Ebbing Lautenbach, head of the Department of Infectious Diseases at the Perelman School of Medicine, University of University of Pennsylvania, said.

Meanwhile, the clinicians interviewed by the Washington Post speculated on the influence of certain individuals' genes, the effect of the virus on lung tissue, an overactive immune response, blood clotting, and so on. Research on it is also quite rare.

Mr. Russell G. Buhr, pulmonologist at Ronald Reagan UCLA Medical Center, USA, said the virus can kill the cells lining the air sacs of the lungs. This is the cell that helps the lungs stay open and exchange oxygen and CO2. At some point, the body cannot regenerate the dead cells in time, the patient's condition is from stable to life-threatening. That is also the reason why people with Covid-19 are at risk of being on a ventilator for up to 4 weeks, much longer than other respiratory diseases.

Another view focuses on the impact the virus can have on the cardiovascular system. Radiologist Eytan Raz, NYU Langone Health, hypothesized some of the clotting complications could be caused by an overactive immune response that occurs after the virus has 'settled', multiplied, and activated the army. against antibodies.

In an article published in the journal The Lancet on April 17, 2020, the authors show that nCoV has the ability to attack the lining of blood cells anywhere in the body. According to researcher Frank Ruschitzka, University Hospital Zurich, Switzerland, co-author, this could be the reason many organs, including lungs, kidneys, intestines are affected in severe patients. And this may also explain that people with cardiovascular disease, obesity, diabetes, smoking have a higher risk of getting worse in the second week.

According to Decision No. 4038/QD-BYT on "Temporary guidance on managing people with Covid-19 at home" of the Ministry of Health, if F0 detects any of the following symptoms, it is necessary to immediately notify the health authority. , the nearest hospital for emergency treatment and timely transfer:

1. Shortness of breath
2. Breathing rate increases
3. SpO2 ≤ 95% (if measurable).
4. Tachycardia >120 beats/min or
5. Low blood pressure: Systolic blood pressure
6. Frequent chest pain.
7. Change consciousness.
8. Purple, pale lips, fingernails, toenails, blue skin.
9. Can't drink, suck, vomit.
10. For children: High fever, red eyes, red lips, hemorrhage.
11. Any condition that doesn't feel right, worry

Medical experts emphasize that some people have low blood oxygen levels but do not have any symptoms. Therefore, F0 treated at home every day should actively measure SpO2 1-2 times according to the instructions to detect this risk.