I've read a few case reports of COVID-19 cases. They talk about a slowly progressing disease, not particularly severe although the patients are miserable, until about day 10. At that time you get the severe pneumonia. I think it's probably a "cytokine storm", and I wanted to call it the "crisis", though I'm not sure that's an official term. Today I started to wonder about where I heard that before. And then I remembered:
"the patient complained of the sudden onset of chills and fever, cough, sometimes with blood-tinged sputum, and pain in one side of the chest; physical examination revealed dullness to percussion with one’s fingertips over the affected lung area and a characteristic change in the breath sounds heard with the stethoscope at the same spot. Given this amount of information you could begin making predictions. The prognosis for a young adult was the most surely predictable: an acute illness lasting ten to fourteen days, with a high fever each day, more chest pain and more cough, perhaps with alarming manifestations of exhaustion and debilitation near the end of this period, and then, suddenly and as triumphantly as the bright sunshine after a thunderstorm, one of the great phenomena of human disease — the crisis. On one day or another, after two weeks of his seeming to come closer and closer to death’s door, the patient’s temperature would drop precipitously within a few hours from 106 degrees to normal, and at the same time, with a good deal of sweating, the patient would announce that he felt better now and would like something to eat, and the illness would end, like that."
from Lewis Thomas, The Youngest Science.
Curious to know how they treated it? Streptococcal pneumonia was treated (1938) by first finding out what type of Streptococcus the patient had, and then injecting rabbit anti-Streptococcal serum. We wouldn't do that today, it's pretty risky. But I'm looking forward to convalescent patient serum, and perhaps humanized monoclonal antibodies for SARS-CoV-2.
If you've never read Lewis Thomas, you should. A biologist, an MD and a poet.
Originally from FB (2020-03-29).
