Decisive “day 10”: the date may be key to mark the evolution of patients with coronavirus

The emergence of a new coronavirus SARS-coronavirus-2 It was a challenge for medicine, science and technology. Among the many studies and daily reports, one of the biggest consensus that exists today is the variety of symptoms with which it can occur. Progression of the disease has also been found to indicate tenth day like the boundary between the onset of recovery or worsening of symptoms.

I know well British Prime Minister Boris Johnsonwho was diagnosed with the disease on March 27th. Since then, the president has been in quarantine, conducting teleconferences with the rest of his government team or with British citizens.

However last sunday just 10 days after being diagnosed with the disease, Johnson was to be hospitalized at St. Thomas’s Hospital in London, where his condition gradually worsened until he was placed in the intensive care unit, where he remains today, with an uncertain diagnosis.

report done World Health Organization (WHO) at the end of February, symptoms and their progression were evaluated in over 50,000 Chinese patients. Results? 88% of patients developed fever and more than two-thirds had a dry cough. 20% developed respiratory distress, similar to the proportion of people who also had sore throats, headaches, and pain in the body or joints.

Alejandra Marcotti, an infectious disease specialist at the Aleman Clinic, explains that with what is known so far, it was possible to establish some disease recommendations, One of them is that of everything infected, 80% do not have serious symptoms and you can conduct the course of the disease at home, quarantine them, with some hygiene measures and with the help of simple medicines.

” presentation box this disease, that is, the symptoms with which early days (2-4) it is very volatile. In people with mild and severe respiratory symptoms, such as a runny nose (nasal congestion), sore throat; others represent anosmia (loss of smell) and adhesion (difficulty in taste); others who experience muscle pain; some patients who do not have respiratory symptoms and who show a digestive picture only with abdominal pain and diarrhea; others only have a fever, ”the specialist points out.

Franco Utili, Ambulance Doctor and Director of the School of Medicine W. San Sebastianexplains that among patients who are not at risk, such as patients with underlying diseases, their condition depends on the immune response of each person. “People who have a more aggressive immune response do more harm to their lungs, ”he says.

Knowing which patient can become complex is a difficult issue to solve. “There is certain criteria that guide and that they may indicate that the picture may be more aggressive, ”says Marcotti.

One of the tools that exists today is measurement of certain parametersthrough blood samples such as C reactive protein and fibrinogenwhich indicate – sometimes even before the onset of clinical symptoms – who may have a more exaggerated inflammatory response of the immune system and which ultimately leads to a deterioration in the condition of patients.

“When the patient is on an outpatient basis, the most important thing is to pay attention to symptoms of breathing problems, the appearance of a large amount of cough, persistent fever after the fifth day, and respiratory failure are symptoms we should consult with, ”says the infectologist.

Until now, the experience of specialists and literature indicate that tenth day disease in patients with symptoms may be key.

When antibiotics weren’t yet Doctors said that on the ninth day, a patient with pneumonia indicated whether a person had passed the disease, It seems that something similar is happening with Covid-19, Utili says:If a person holds the 10th in good condition, the critical part probably passed and this will not develop serious complications. This is a turning point. If someone who is at home has passed the 10th and begins to feel better, this is probably because he transmitted his picture as a viral picture and without serious complications, ”the ambulance doctor says.

According to Marcotti, period of greatest observation or concern about the symptoms of the disease between 3 and 10 in the afternoon symptoms started. During this time, the symptoms may worsen. “Rarely, when complications occur after the 10th day,” he says.

In patients who hospitalizedsays Utility sign of exacerbation is increased oxygen demand, “If the patient begins to saturate less oxygen, this may indicate complications associated with the magnitude and severity of the disease.”

Roberto Olivares, Head of the Department of Infectious Medicine at the Davila Clinic, explains that the initial symptoms resemble a viral respiratory pattern: “Typically, patients have a fever, dry cough, sore throat; They may also have decay, muscle pain, and loss of smell and taste. Other patients (less commonly) may experience diarrhea, which usually occurs during the first week of evolution.

From the second weekOlivares says in some patients, symptoms persist or worsen (cough or fever)In addition, a symptom indicating that the picture is becoming severe is difficulty breathing (feeling short of breath). “This happens between 7 and 14 days, plus less evolution, and these patients who have respiratory failure have a smaller group that also experiences shock (this is the most severe) associated with respiratory failure.”

An emergency surgeon notes that they saw people who are suffering from a fever before starting to suffer change in taste and smell (apparently in 30% of cases), tend to have more benign disease evolution. In fact, in some places, in addition to measuring temperature, they conduct simple sensitivity tests for various aromas (such as vinegar). If a person does not smell this, it is because he loses his sense of smell, and this may be a sign of Covid-19 and may occur before fever.

Therefore, this specialist recommends that the odor sensitivity test can be applied at the points where the authority today produces sanitary cords or sanitary barriers at which people’s temperature is measured.