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Top 10 Things I learned Treating COVID ICU Patients | COVID ICU

Doctor Mike Hansen

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Published on Jul 02, 2020
Top 10 Things I learned Treating COVID ICU Patients | COVID ICU

Some intensive care units in various hospitals throughout this county have designated units for COVID patients. As an intensive care doctor, I've seen many COVID patients in our designated Covid ICU. It's one thing to read about Covid in the medical literature, but seeing actual patients with this disease is another experience altogether. I've learned many things, but I'll focus on the top 10 that stand out to me.

โฉ Timestamps, click to skip ahead!
00:00 Top 10 Things I learned Treating COVID Patients
00:36 COVID Symptoms
01:08 Vitamin D deficiency on COVID Patients
02:13 COVID is Contagious
03:53 Lonely at Hospital
04:11 COVID Treatments
07:00 COVID Testing
07:33 A Lot of COVID Patients are obese
09:03 Mechanical Ventilation for COVID
11:02 COVID Recovery
11:53 Unpredictability and Variability

Doctor Mike Hansen's Programs โฉ

So, starting at the bottom with the number 10 is signs/symptoms. The most common COVID symptoms that I'm seeing are fever, cough, shortness of breath, and body/muscle aches. I haven't seen many patients with the other symptoms we often hear about, such as loss of taste and smell, nausea, and diarrhea. I have not seen any rashes related to COVID, probably because I only see adult patients. I will say that even though confusion and delirium are widespread in the ICU in general, there does seem to be more of that with Covid.

Many COVID patients who require hospitalization have low levels of vitamin D, Which is consistent with what we are seeing in many recent studies that have been coming out. But of course, correlation doesn't necessarily mean causation, so does it just so happen that many patients with moderate or severe COVID happen to have low vitamin D levels? Maybe, maybe not.

And does that mean that we should give every hospitalized patient with Covid big doses of vitamin D when they hit the door? Maybe.

And does that mean people, in general, should supplement with vitamin D? And what is the ideal level of vitamin D for the population, especially when it comes to COVID? Should we target the current general recommendation for everyone, irrespective of COVID, with a goal of 20 mg/ml? Or should we aim for higher, like 30, or perhaps 40? No one knows for sure the answers to these questions. But studies are being done on this. And as we speak, there are 3 RCT for vitamin D and Covid.

Covid is VERY contagious. One of my patients was in the hospital for unrelated reasons. She actually had sepsis due to an infarcted gut, meaning part of her intestine was not getting enough blood flow. It was severe enough to the point that some of the tissue in her intestine had died. When this happens, the bacteria in the intestine can invade the intestine's walls and get into the bloodstream. This is bad news because these bacteria can then spread throughout the body, known as sepsis. So besides antibiotics, this is treated with surgery, where the dead gut tissue is removed, meaning part of the intestine is taken out.

And this is what happened to her. And she got better. But after she initially got better, she started having more difficulty with her breathing. Her oxygen levels were dropping, despite us giving her more and more Oxygen. So we got a CXR and later a CT scan of the chest, which showed bilateral infiltrates, meaning areas of inflammation in both lungs. And this is the pattern we typically see with COVID pneumonia, where it tends to go to the periphery of the lungs and more so at the bottom of the lungs.

Doctor Recommended โฉ
COVID PCR test ๐Ÿ‘‰
Masks ๐Ÿ‘‰
Measure your Oxygen ๐Ÿ‘‰
Measure your Temperature ๐Ÿ‘‰
Measure your Blood Pressure ๐Ÿ‘‰
Measure your Weight ๐Ÿ‘‰
To help with Sleep ๐Ÿ‘‰
Vitamin D ๐Ÿ‘‰

Doctor Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine
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#covid #covid19 #icu
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