SYMPTOM UPDATE

COVID TOES and OTHER UNUSUAL PRESENTING SYMPTOMS

It is important to remember a few things.
Most people who get infected have no or only mild symptoms but those people can be just as infectious/contagious as really sick people.
Although the trifecta of symptoms, fever, cough and breathing difficulties, are the most common symptoms of the disease, it is important to appreciate that there are other, much less common presenting or associated symptoms.
All of the symptoms associated with Covid, also occur with many other conditions. Covid is definitely in the forefront of our consciousness today but our population is plagued with various other chronic diseases and it is important not to ignore these.

COVID TOES. There is a lot of debate about this condition and whether it is actually associated with Covid-19 or not. Rather than describing specific findings, which are varied, I would just say that any weird, unexplained, unresolving rash of the toes, heel foot or, anywhere else on your body in general, should be investigated. Some studies suggest that the isolation from the pandemic is actually the cause (more barefoot walking and some other cockamamie explanations) but I know personally of a case which occurred before the lockdown in a teacher who had no other symptoms as no other reasonable explanation but she was Covid positive. She went on to develop neurological symptoms (a drop-foot) and is slowly recovering from that. As an aside, she is terrified to go back to teaching, primarily because of the lack of direction and a competent plan. I also know someone who had an unexplained rash on the toes and was covid negative. From what I have read, as an isolated symptom, most people who have covid toes don’t get all that much else but every case is a little different. Various rashes all over the body have been noted.

SMELL AND TASTE CHANGES. As I have mentioned before, we have known for many years that the run-of-the-mill cold-causing coronaviruses are very toxic to the olfactory nerve fibers, the ones responsible for perception of smell which is our primary source of taste as well. What is unusual about Covid-19 is that, unlike the loss of smell which occurs from other coronaviruses which in many cases is permanent, the changes with Covid-19 do not appear to be permanent in most cases. In fact, most cases seem to get better in a few weeks. Not in everyone, but in most. Despite this being my specialty, I personally have not seen anyone with smell and taste changes thought to be associated with Covid 19. That’s probably because, as an isolated symptom, it is pretty uncommon.

NAUSEA, VOMITING and DIARRHEA. About 1/3rd of more serious cases have a constellation of gastrointestinal symptoms. Why? Probably because 70% of our immune system resides in our gut and the gut microbiome balance is crucial for good health. The bug itself may throw off that balance and the immune overreaction could wreak havoc on the gut motility, leading to various symptoms. Keep pushing as many different kinds of fruits and vegetables in your diet as possible. The best predictor of good gut health is the amount and variety of plants in your diet. Again FIBER is key and you only get fiber from plants.

ACHES and PAINS. Basically, any symptom you can get with the flu, or any other infection, can be seen with Covid-19.

NEUROLOGICAL SYMPTOMS. Dizziness, headaches, brain fog and muscle weakness have all been seen, again in more serious cases. On occasion, these symptoms can be profound. As I mentioned in the covid-toes section, other neurological findings have also been seen.

I had an earlier post about a severe inflammatory condition, Kawasaki’s Disease, seen in some kids with Covid-19. It is important to remember that all of these symptoms and conditions have occurred long before Covid came onto the scene. Not everything can be blamed on Covid. We need to remember all the other diseases which continue to run rampant in our chronically sick population. As far as Kawasaki’s Disease, the low rate of this condition is no higher during this pandemic than is seen in any other year.

Our President has commented many times how the scientists have been wrong with their advice and predictions. My earlier advice was wrong. Everyone’s advice was wrong. We are all learning about how this virus works, how the disease presents and progresses and we will continue to learn not only over the next year, but probably for decades since some people will likely have long-term or delayed effects. We have already seen that asymptomatic young people have evidence of scarring in their lungs which may lead to earlier lung problems later in life.

We DO know how to slow the spread.
1) Wear a MASK. Any kind. Cover your nose! Most of the virus first hits and propagates in the nose. You catch it through the nose. You spread it through the nose.
2) DISTANCE if you must go out or are socializing.
3) WASH your hands and use sanitizer judiciously.
4) Don’t touch your face.
5) Get healthier (eat better, move, sleep better, manage stress…)

MOST IMPORTANTLY, look out for your family, friends and neighbors and stay positive. We will get through this together.

Have a great weekend.

Stay safe and be well.
AC 😎✌️🌱❤🐖🏃🏻🧘🏻‍♂️🌎😷