An MD in New Orleans

One doctor’s clinical perspective on fighting Corona-chan.

I am an ER MD in New Orleans. Class of 98. Every one of my colleagues have now seen several hundred Covid 19 patients and this is what I think I know.

Clinical course is predictable.
2-11 days after exposure (day 5 on average) flu-like symptoms start. Common are fever, headache, dry cough, myalgias(back pain), nausea without vomiting, abdominal discomfort with some diarrhea, loss of smell, anorexia, fatigue.

Day 5 of symptoms- increased SOB, and bilateral viral pneumonia from direct viral damage to lung parenchyma.

Day 10- Cytokine storm leading to acute ARDS and multiorgan failure. You can literally watch it happen in a matter of hours.

81{de336c7190f620554615b98f51c6a13b1cc922a472176e2638084251692035b3} mild symptoms, 14{de336c7190f620554615b98f51c6a13b1cc922a472176e2638084251692035b3} severe symptoms requiring hospitalization, 5{de336c7190f620554615b98f51c6a13b1cc922a472176e2638084251692035b3} critical.

Patient presentation is varied. Patients are coming in hypoxic (even 75{de336c7190f620554615b98f51c6a13b1cc922a472176e2638084251692035b3}) without dyspnea. I have seen Covid patients present with encephalopathy, renal failure from dehydration, DKA. I have seen the bilateral interstitial pneumonia on the xray of the asymptomatic shoulder dislocation or on the CT’s of the (respiratory) asymptomatic polytrauma patient. Essentially if they are in my ER, they have it. Seen three positive flu swabs in 2 weeks and all three had Covid 19 as well. Somehow this ***** has told all other disease processes to get out of town.

China reported 15{de336c7190f620554615b98f51c6a13b1cc922a472176e2638084251692035b3} cardiac involvement. I have seen covid 19 patients present with myocarditis, pericarditis, new onset CHF and new onset atrial fibrillation. I still order a troponin, but no cardiologist will treat no matter what the number in a suspected Covid 19 patient. Even our non covid 19 STEMIs at all of our facilities are getting TPA in the ED and rescue PCI at 60 minutes only if TPA fails.

It sounds like they need to implement the TrumpCure+ as soon as possible. And the early observers who observed the need to prevent the cytokine storm with massive doses of Vitamin C, Vitamin D3, and zinc appear to have been precisely on point.