With all of the heightened questions and concerns regarding COVID-19 from CVS patients and their caregivers from around the globe, CVSA USA/Canada consulted the World CVS expert, Dr. Venkatesan.
CVSA Nordic is reposting their article here.
Coronavirus disease 2019, or “COVID-19,” is an infection caused by a virus called SARS-CoV-2. The virus first appeared in late 2019 in China, but it has spread quickly since then, and is increasing in incidence in Europe, the United States, and the rest of the world.(1, 2) COVID-19 mainly spreads from person to person, similar to the flu. This usually happens when a sick person coughs or sneezes near other people. Doctors also think it is possible to get sick if you touch a surface that has the virus on it and then touch your mouth, nose, or eyes. There is some evidence to suggest that the virus is also shed in your stools, but it is not clear that if the oro-fecal route is a mode of transmission.(3)
COVID-19 seems to spread most easily when people are showing symptoms. It is possible to spread it without having symptoms too, but experts don’t know how often this happens.
Symptoms will usually start a few days after a person is infected with the virus. But in some people, it can take up to 2 weeks for symptoms to appear.
Symptoms can include:
Although it is less common, some people have other symptoms, such as headache, sore throat, runny nose, or problems with their sense of taste or smell.
Some have digestive problems like nausea or diarrhea. A recent study of about 200 patients from China noted that a large number of patients (~ 50%) presented with diarrhea, loss of appetite, nausea, and abdominal pain. Diarrhea was noted in approximately 18% and other GI symptoms (loss of appetite, nausea and abdominal pain) were rare.(4) However, respiratory symptoms like cough and fever were also present later in almost all of these cases. There was some concern that this may cause a delay in testing for COVID-19 in these patients. Currently, the CDC is not recommending testing for COVID-19 when patients only have GI symptoms. If you have any GI symptoms that are not typical for you, please contact your primary care physician to see if you need to be tested for COVID-19. Other non-respiratory symptoms that patients with COVID-19 could have include a loss of smell or taste in some cases. Please discuss this with your primary care doctor if you develop these symptoms suddenly. (6)
Most people (>80%) will have mild symptoms. Some people will have no symptoms at all. But in other people, COVID-19 can lead to serious problems like pneumonia, not getting enough oxygen, heart problems, or even death. This is more common in people who are older or have other health problems like heart disease, diabetes, lung disease, or cancer.
Cyclic vomiting syndrome is NOT considered an immunocompromised state. This means that your immunity or ability to fight infection is similar to normal individuals. Rather it is a disorder of gut-brain interaction (DGBI). However, respiratory tract infections may trigger symptoms in some patients with CVS. There is no data to suggest that COVID-19 will be worse in CVS patients. If you have additional problems or autoimmune problems, you should be more careful. We recommend that you follow standard guidelines and try to avoid getting the infection. Simple guidelines would include:
Many patients will also experience an increase in anxiety and/or depression during the COVID-19 pandemic. This is quite common, particularly in these uncertain times. It is very important to try and manage your anxiety. Though we are advised about “social distancing”, you can do the following:
As you can imagine, the situation in both the ED and hospitals is dire with the increase in COVID-19 cases. Make sure you take your preventive medications regularly and follow the advice of your doctors. If you are having frequent symptoms, contact your doctor so that they can adjust your medications. Most of all, try and be patient as this is a difficult time for all of us.
In general, there are many medications and supplements that are thought to help with COVID-19 but lack strong evidence. Mild cases are treated like the flu. Stay hydrated and take Tylenol as needed. There is some suggestion that ibuprofen may worsen the disease, though this is not clear.
While some medications like Hydroxychloroquine and Azithromycin are being proposed as treatment in some cases,(5) DO NOT take this without a doctor telling you to. This can be harmful in some cases as this combination has some side effects including QT prolongation/cardiac arrhythmias and may interact with medications (like Elavil and ondansetron/Zofran) that you are already taking. The evidence for most medications to treat COVID-19 is based on weak evidence and experts are trying to figure this out.
Finally, follow the guidelines of your local health authorities. If you need information about COVID-19, you can visit the CDC.
Stay safe. And in these scary times, as Mr. Rogers would say “Look for the helpers. They are always there.”
Originally posted at cvsaonline.org