Doctors update warning signs of severe COVID

First of all, “anxiety-induced shortness of breath occurs rapidly, seemingly out of the blue, while COVID-19 shortness of breath tends to develop gradually over a few days,” the researchers noted. And when shortness of breath comes from a panic attack, it typically occurs when a person is at rest or trying to fall asleep.

In contrast, COVID-19 shortness of breath “gets worse with physical exertion, including performing simple daily activities like walking, climbing stairs or cleaning,” the researchers said.

Shortness of breath tied to COVID-19 is a real warning sign that a person might need to seek medical help because of a dangerous dip in oxygen levels in the blood. “Blood oxygen levels can drop precipitously with exertion, even in previously healthy people,” the team said.

Doctors can quickly monitor blood oxygen levels using a simple finger-clip device called a pulse oximeter. Once COVID-19 shortness of breath has been diagnosed, these patients might be released back home, but will still require “very close monitoring and frequent follow-up to check how the shortness of breath is evolving, and whether a patient may be deteriorating and may need to go to the hospital,” the team said.

“Early recognition and proper triage are especially important given that, in the first days of infection, people infected with [the new coronavirus] may experience symptoms indistinguishable from a variety of other acute viral and bacterial infections,” Cohen added.

Cohen’s team published their findings April 20 in the Mayo Clinic Proceedings journal. The study is based on more than 1,000 patients seen at a COVID-19 outpatient clinic in Boston.

Reading over the new report, New York City emergency medicine physician Dr. Robert Glatter said, the findings “mirror the clinical picture of patients that I continue to see.”

Some patients come to his department at Lenox Hill Hospital without any drop in blood oxygen, but with “fatigue, muscle aches [and] often loss of smell,” Glatter said. These patients are still able to eat and drink and they’re typically discharged back home.

“There is also a subgroup of stable patients — with mild symptoms and mild hypoxia [low blood oxygen] — who, after careful evaluation, can be safely discharged and monitored in the home-setting with pulse oximetry and frequent telemedicine follow-up to check for progression of symptoms,” he added.