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Group 4 Patients – Severely Symptomatic

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In the last several videos we’ve been talking about the different groups of COVID-19 patients based on symptoms, treatment, and outcome. And we now know that despite the rising numbers of cases globally, there’s still around 85% of patients who will have completed uneventful recovery and never require in-person clinical care from a primary care doctor, urgent care or emergency room. Even those patients in group three who have moderate symptoms, and even some of the group three patients who are part of a high risk group, will likewise recover without ever needing in-person clinical care. But group four patients are different. They’re patients with severe symptoms. This group represents about 6 to 10% of all COVID-19 patients, but they also represent the group with the highest mortality of all the four groups. These patients may first have only mild to moderate symptoms, which is why it’s important to monitor symptoms closely. But patients in this group will typically experience a rapid deterioration in their respiratory status due to the development of a very unique, rapidly progressing and dangerous pneumonia leading to severe acute respiratory syndrome or SARS.

In these cases, the doctor or other clinician will be relying on patient history and symptoms in addition to a high clinical index of suspicion, meaning that common testing will likely show no evidence of the pneumonia and a traditional test x-ray may in fact be negative. But when the clinical suspicion is high, these patients may also get additional imaging such as ultrasound or CAT scan to confirm the diagnosis. All patients in this severe group will require hospitalization and close monitoring. And although many will still recover, the recovery will typically take longer. Many patients will however need to be admitted to the intensive care unit, and some may require being placed on a ventilator to give the lungs an opportunity to heal and recover. The majority of patients in this group have pre-existing conditions, though that’s not always the case, which is why it’s very important to monitor your symptoms closely if you’re sick and to do everything in your power to limit your exposure and reduce your risk of getting sick. If your symptoms appear to be getting worse, seek guidance and care promptly, making every effort to alert the emergency department ahead of your arrival. As we continue to learn more about COVID-19, our hope is to reduce the number of patients in this group and to develop strategies to improve their recovery and their outcome. In the meantime, wash your hands, keep those inanimate surfaces clean, avoid touching your face, practice social distancing, work from home if you can, and limit social gatherings of any kind. Practicing these things will help you ride out this COVID-19 pandemic, keeping yourself and your family healthy and safe.

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