Covid-19 is not an easy flu – Report by a german doctor on the treatment of a Covid-19 patient

The day before yesterday I was visiting the home of the very first patient in my clientele, who has been infected with the new disease Covid-19 caused by the coronavirus Sars-Cov-2 almost 3 weeks ago.

With the kind consent of this patient, Mr. S., I describe his moderate course of the disease in order to counteract what I believe to be a dangerous tendency to play down Covid-19.

I have known Mr. S. for 6 years. He is 52 years old, married, has 1 child, lives in his own house with a garden in a suburb of Munich, he is sporty, does not smoke, does not drink much alcohol, is a lot in the fresh air. He doesn’t take any medication, works a lot and travels a lot for work. He has been with me again and again over the past few years with lighter flu infections, sore throat, difficulty swallowing, 7 years ago he had a real influenza, 15 years ago he had glandular fever.

On March 11th, 2020, Mr. S. got temperature after a professional trip to NRW. Sars-Cov-2 was detected in the nasopharyngeal smear. This means that Mr. S. is suffering from the disease Covid -19, which is currently circulating worldwide. He has a cough, no shortness of breath, a high fever up to 39.8 ° C and is severely weakened. There is no specific therapy for this virus infection. I recommend bed rest, drinking a lot, sleeping a lot, possibly lowering fever with acetaminophen and calf wraps, if necessary ibuprofen. I stay in contact with the family telemedically every 2nd or 3rd day. We see things as a whole, attentively relaxed. When the fever has still not gone down after a week despite maximum protection, we become a little restless. Mr. S. keeps having a temperature up to almost 40 ° C, he is completely weakened. An increasing dry cough has now developed. On March 20, 9 days after the initial diagnosis and 10 days after the first symptoms, shortness of breath and a brownish sputum are added. Mr. S. comes to the hospital.

When admitted to the hospital, Mr. S. has a high fever with a body temperature of 39.5 ° C, the pulse is clearly activated at 98 / min, the blood pressure is slightly increased at 150/90, the heartbeats are rhythmic and pure, above the lungs there is an ubiquitous wheezing and hum on the left more than on the right, and on both sides basal fine-bubble rattling noises. Oxygen saturation in the blood is significantly reduced at 84%. In the laboratory there are moderately increased inflammation values, other pathogens of pneumonia such as chlamydia and mycoplasma are excluded serologically, the blood cultures remain negative repeatedly and other viral pathogens of pneumonia such as influenza viruses and RSV viruses cannot be detected.

The CT scan of the lungs shows the typical finding of Covid-19 pneumonia: blotch-like, frosted glass-like infiltrations over both lungs as an imaging expression of a pronounced inflammatory secretion in the intercellular space of the lungs. With Covid-19, the fluid accumulations are typically not found in the bronchi like bronchitis or in the alveoli like pneumonia, but outside the bronchi and alveoli in the space between the lung cells. This edema in the intercellular space creates this cough without expectoration and it makes the oxygen exchange between blood and inhaled air extremely difficult.

Mr. S. is admitted to the hospital for monitoring. It receives oxygen through the nasal cannula, bronchodilating inhalations, it increasingly deflowers and stabilizes itself without further complications. After 5 days, he can be released into home quarantine and my primary care. The day after his release, I visit him at home to record the current condition and plan further care. The investigation values ​​have stabilized very well. Mr. S. now has an oxygen saturation of 95%, the pulse is at 70 / min, the breathing noise is somewhat weakened but the lungs are free on both sides. For me, the pale complexion and the severely weakened, shuffling gait are very impressive. Mr. S, whom I know as an active, fit 50-year-old, dragging themselves up the stairs to the first floor. Nevertheless, the course is favorable overall, the worst complications have been averted, Mr. S. will probably get through this illness without consequences. I expect full restitution after another 4-6 weeks.

Mr. S. has a moderate course of Covid-19. He is one of the 15% of those infected with Sars-Conv-2 who have to go through a difficult course. Since the population, unlike the influenza epidemics, has practically no immunity to this viral disease and cannot be produced quickly, we have to expect a very high number of moderately to severely ill people worldwide. It is obvious that with such a serious illness, not much has to be done to cause a fatal outcome. Another infection, another risk factor like age, smoking, blood pressure,

My Opinion we are experiencing a worldwide natural disaster of enormous proportions.
I find the measures taken so far to mitigate the consequences to be proportionate and correct. I think it is wrong, as is increasingly being done on various sides, to speak of „pandemic madness“, „scaremongering“, „hysteria“, „big pharmacy deception“ or „totalitarian state behavior“. In my opinion, the current situation is not due to the media-effective self-presentation of some prominent pandemic advocates, but to the dramatic global situation. In my opinion, every effort should be made to alleviate the enormous health, economic and emotional consequences of this disaster. I think it’s right to do everything humanly possible to save every human life as much as possible. I think it is wrong and an expression of perfidious eugenics to say that it would now „only“ affect the old and the weak. I call on all those who are now counteracting the general efforts with their text and video messages to do what they can to alleviate the consequences of this natural disaster in their environment.

I have been a resident physician for general medicine and palliative medicine in my own private medical practice for 15 years and I have an overview of around 4,000 patient stories, mainly in the south of Munich.

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