Chief Medical Officer Dr. John Brown Explains COVID-19 Disease Progression and Common Treatments
Care for COVID-19 is complex and unique for each patient based on their specific situation. Testing positive often means at-home treatment but still requires coordination with a primary care provider. Hospitalization may be needed for those with more advanced stages of the disease.
Vaccination remains both the safest and most effective way to prevent COVID-19 infection, as well as the best way to avoid serious illness, more invasive treatments and hospitalization. However, in the event a person tests positive, Gritman Chief Medical Officer Dr. John Brown notes there are three basic stages of treatment. A plan of care is developed for each patient based on their overall health, underlying medical conditions, patient preferences and consultation with their other physicians and primary care provider.
Stage 1: Initial Symptomatic Infection
A typical COVID-19-positive patient will initially present with symptoms in the 5-10 days after exposure. Symptoms include cough, fever, mild labored breathing, runny nose, sore throat and digestive-related symptoms that can last up to two weeks. Most patients will recover at home.
At-home treatments in Stage 1 may include:
- Acetaminophen (Tylenol) or other pain relievers/fever reducers
- Isolation from others
- Plenty of fluids
Additional treatments may include:
- Monoclonal antibody therapy: People vulnerable to severe illness and hospitalization as a result of COVID-19 infections (including immuno-compromised patients and those with chronic lung, heart and kidney diseases) are eligible to receive the monoclonal antibody treatments. Consult with your primary care provider as soon as you are ill to determine if monoclonal antibody therapy is the right treatment for your circumstances.
Gritman has treated more than 100 patients with monoclonal antibodies since the treatments became available.
Dr. Brown notes that monoclonal antibody therapy is only helpful for treatment during the first stage of infection. Once a person develops symptoms of the second or third stage of infection, no clear benefit from monoclonal therapy has been established.
Stage 2: Worsening COVID-19 Infection
Patients who don’t respond to Stage 1 treatments will start to present with increased labored breathing and will begin to have low oxygen levels or an increase in baseline oxygen use. At this time an X-Ray can be taken to check for the appearance of COVID pneumonia, along with other testing as deemed necessary by your doctor.
Stage 2 treatments may include a same-day doctor visit, monitored home care and could involve a hospital admission. They may include:
- Steroids (only given when oxygen therapy is required as an inpatient)
Stage 3: Hospitalized COVID-19 Infection
Patients in Stage 3 are admitted to the hospital and sometimes the Critical Care Unit for individualized care based on symptoms and responses to treatment. Patients can also develop complications of their COVID-19 infection that may lead to microscopic blood clots and failure of multiple organ systems—including the heart, lungs, kidneys and central nervous system. This requires even more intense treatment.
Stage 3 treatments may include:
- Hospitalization on oxygen, often with positive pressure delivery
- Intubation and/or use of a machine like a ventilator
- Individualized care within the Critical Care Unit
- Remdesivir is also given, in accordance with FDA recommendations.
Once a patient reaches Stage 3 of treatment, the risk of complications or death increases dramatically, Dr. Brown said.
Prevent Hospitalization: Get Vaccinated
As a health care organization, Gritman strongly encourages vaccination against COVID-19 as the safest choice in preventing hospitalization or death. Combined with facemasks, frequent hand washing, keeping social distance, and limiting indoor gatherings with people from outside your immediate household, vaccination remains the best step available to limit infection. Find a vaccine location near you at vaccines.gov.
Vaccination has also shown to prevent serious injury and hospitalization, and helps preserve capacity to provide for all other types of care at the hospital. Over 82% of our hospitalizations have been among people who had not been vaccinated.
Patients aren’t able to get the COVID-19 vaccine during an active infection. Dr. Brown recommends all who are eligible to receive the vaccine as soon as possible before getting infected. The COVID-19 vaccine can be administered to an infected individual once the infection is resolved. If you are COVID-positive, please talk this through with your provider.
“If you have hesitancy about receiving one of the COVID-19 vaccines, please discuss your concerns with your primary care provider,” he said.