Fever, fatigue, fear: For some recovering COVID-19 patients, weeks of illness, uncertainty≒ 発熱、疲労、恐怖：回復したCOVID-19患者の中には、数週間の病気、不確実性、不確実性を伴うものもあります。

Fever, fatigue, fear: For some recovering COVID-19 patients, weeks of illness, uncertainty

https://www.nbcnews.com/health/health-news/fever-fatigue-fear-some-recovering-covid-19-patients-weeks-illness-n1197806

"I think I'm in the clear, but I'm not sure," said a patient with a persistent fever. "It feels never-ending. I am at a loss."
Image: COVID - RECOVERING AT HOME
COVID-19 patients who are not sick enough to be hospitalized have little guidance on how to recover.Adrian Lam / NBC News
May 5, 2020, 6:27 AM JST
By Erika Edwards
Kate Porter has had a fever nearly every day for 50 days. She can't shake the extreme exhaustion that hit when she became infected with the coronavirus nearly two months ago.

The longevity of her symptoms are unlike anything she's ever experienced. "I know it sounds crazy," Porter said, "but is this permanent?"

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Since her diagnosis, Porter, 35, has been in her Beverly, Massachusetts, home with her 12-year-old daughter, Adria, who also had symptoms of COVID-19.

Kate Porter
Kate Porter and her daughter both tested positive for COVID-19.Courtesy of Kate Porter
Neither has underlying health conditions that would suggest a complicated or drawn-out recovery from the virus, and neither has had to be hospitalized.

According to data collected by Johns Hopkins, more than 180,000 people in the U.S. have recovered from COVID-19. The Centers for Disease Control and Prevention considers a person recovered if three days have passed since a fever broke without the assistance of medication, and respiratory symptoms, such as cough or shortness of breath, have improved. Negative tests can also signal recovery, but tests can be inaccurate.

After an initial positive COVID-19 test, Porter has since tested negative for the virus, yet symptoms persist.

Day 47 with a fever. Second Covid test - negative. Blood work - normal. My body officially isn’t fighting this virus anymore, yet my fever and sinus tachycardia tell a different story.
Helplessly sad isn’t even the right description at this point. pic.twitter.com/n489uDSBZa

— Kate Meredith (@katemeredithp) May 3, 2020
"I'll feel great one afternoon and think, 'I'm going to read, I'm going to do laundry,'" Porter told NBC News. Inevitably, the fever and fatigue return.

It happens repeatedly, Porter said. "It's like a mind game."

Andrew Dumont, 32, of Seattle, has also tested negative for the virus after a previous positive COVID-19 test. Two months since first falling ill, Dumont still suffers from numbness in his limbs and shortness of breath — prompting two visits to the emergency room twice in the past week.

CT scans and lung x-rays showed no additional infections.

"It's really scary, because you're just kind of left at home by yourself essentially trying to treat it," Dumont said.

Intense outpatient management

COVID-19 patients who are not sick enough to be hospitalized have little guidance on how to recover. There is no specific drug or treatment, other than rest, fluids and fever-reducing medicine such as Tylenol.

But because the virus can smolder in the body for days or weeks before potentially worsening, some physicians are increasing their vigilance for those recovering at home, alone.

"We do frequent telephone calls, checking in and telling patients what to watch out for," Dr. Lara Hall, clinical lead for the Cambridge Health Alliance Respiratory Clinic near Boston. "The thing we really worry about is shortness of breath."

Experts say trouble breathing is a sign that COVID-19 may be wreaking havoc in the body, and usually requires an emergency response.

Some coronavirus patients report symptoms persistent, lasting weeks
Hall estimates her clinic has seen about 2,400 patients with symptoms of the coronavirus since it opened nearly seven weeks ago. About 70 percent of those patients have tested positive.

Some patients may require more frequent check-ins. "If someone's over 65 and they have diabetes or high blood pressure or heart disease or obesity, chronic lung disease," Hall said, "those are people in a high risk category that we're calling every day."

"We call this intense outpatient management," she said. Some patients may need to be seen again at Hall's clinic, while others may be urged to seek care at an emergency room.

'I dread going to sleep'

Many COVID-19 patients recovering at home recount similar anecdotes of how the virus acts each day and night.

Mornings tend to begin normally, but as the day progresses, viral symptoms creep in "like clockwork," Porter said.

Temperatures begin to rise. Cognition becomes hazy. Porter describes it as a "weird forgetfulness" as she struggles to find words.

Kate Porter
Kate Porter has had long-lasting symptoms of COVID-19, including fever, extreme fatigue and heart rhythm abnormalities.Courtesy of Kate Porter
"Nighttime is when things start to flare up a bit more, and I just get nervous."

As night falls, fear takes hold. Despite debilitating exhaustion and fatigue, many patients are unable to get a good night's sleep.

Coronavirus deaths: U.S map shows number of fatalities compared to confirmed cases
"Honestly, I dread going to sleep," Porter said. She frequently wakes up during the night with her whole body shaking, as if she's been exposed to freezing temperatures. After a subsequent fitful rest, she often wakes up with her hair, sheets and clothes drenched in sweat.

The ongoing symptoms make Porter and other patients worry they've developed a secondary infection. However, subsequent COVID-19 tests have been negative, and other diagnostic screenings have been unable to uncover additional problems.

"I think I'm in the clear, but I'm not sure," Porter said, as she continues to log daily fevers. "It feels never-ending. I am at a loss."

Dumont, too, has suffered sleepless nights because of COVID-19.

"My breathing has been so bad that last week there were three nights where I couldn't even lay down," he said. "I stayed awake without any ability to sleep."

Doctors become patients

Even doctors with a keen understanding of how viruses typically act understand recovering patients' concerns.

"As a physician, I know what can happen," Dr. Michael Saag, a renowned infectious disease expert at the University of Alabama at Birmingham, said. Saag was diagnosed with COVID-19 in March and described the illness as a "horror" that included fever, muscle aches, fatigue and difficulty thinking.

"I would sit awake, counting the minutes until morning almost, wondering if my breathing was going to get worse and I'd end up on a ventilator," he said.

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Dr. Buddy Creech, an infectious disease expert and director of the Vanderbilt Vaccine Research Program at Vanderbilt University Medical Center in Nashville, expressed similar fears after he, too, was diagnosed with COVID-19.

"I was just kind of watching it happen, documenting my symptoms," Creech said. "It was legitimately terrifying."

Creech's wife and three children were also diagnosed with the illness, with symptoms that varied in degree. None had to be hospitalized, and the five family members stuck it out together at first, resting and staying hydrated.

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"We had flu-like illness with chills, muscle aches, headaches, but when I would take Motrin or Tylenol, I would feel great," Creech recalled. "We had an epic game of Monopoly going on."

The family started to recover after about a week. But Creech's apparent recovery did not last.

"One of my colleagues warned me that the second week can go sideways," Creech said. Indeed, on day seven, he developed a more substantial cough and a fever that lasted weeks.

"I felt like I was having this inflammatory response that I simply couldn't control," he said.

Patients like Porter and Dumont, who have had long-term symptoms, understand the value of sharing their stories.

"I was desperate for someone to tell me I'm not crazy," Porter said. "It's scary to go through this for so long when there's so many unknowns about the virus."

Dumont shared his COVID-19 symptoms on Twitter, and said he's since received hundreds of messages on the social media site from other patients with similar stories.

'We fall into the category of not critical and dying, but not asymptomatic," Dumont said.

"That's a very lonely, unclear place to be."

Image: Erika Edwards
Erika Edwards
Erika Edwards is a health and medical news writer and reporter for NBC News and "TODAY."

発熱、疲労、恐怖：回復したCOVID-19患者の中には、数週間の病気、不確実性、不確実性を伴うものもあります。

"平気だとは思うが、自信がない "と、しつこい熱がある患者さんが言っていました。 "それは決して終わらないように感じます。 途方に暮れています。

covid - 自宅で療養中
COVID-19 入院するほどの病気ではない患者は、回復する方法についてほとんど指導を受けていない。

2020年5月5日 6:27 AM JST
エリカ・エドワーズ

ケイト・ポーターは ５０日間 ほぼ毎日発熱していた 約２ヶ月前にコロナウイルスに感染した時の極度の疲労感が忘れられない。

彼女の症状は今までに経験したことがないほど長く続いています "狂っているように聞こえるかもしれませんが、これは永久的なものなのでしょうか？"とポーターは言いました。

"コロナウイルス発生の全容

ポーターさん（35歳）は診断を受けて以来、マサチューセッツ州ビバリーの自宅で12歳の娘アドリアと一緒に過ごしており、同じくCOVID-19の症状が出ていた。

ケイト・ポーター
ケイト・ポーターと彼女の娘はともにCOVID-19の陽性反応を示した。
どちらも、ウイルスからの回復が複雑になったり、長引いたりすることを示唆するような基礎的な健康状態を持っておらず、入院する必要もありませんでした。

ジョンズ・ホプキンス大学が収集したデータによると、米国では18万人以上がCOVID-19から回復しています。 疾病対策予防センターは、薬の助けを借りずに熱が下がってから 3 日が経過し、咳や息切れなどの呼吸器症状が改善された場合を回復した人と見なしています。 陰性の検査も回復の合図となりますが、検査は不正確な場合があります。

最初のCOVID-19検査で陽性となった後、ポーターはウイルス検査で陰性となりましたが、まだ症状は続いています。

47日目に発熱 ２回目のコビド検査は陰性 血液検査は正常 私の体はウイルスと戦っていないのに 熱と副鼻腔頻拍が違うことを物語っている

どうしようもなく悲しいというのは、この時点では正しい説明ではありません。

- ケイト・メレディス (@katemeredithp) 2020年5月3日

"ある日の午後には気分が良くなって、『本を読んで、洗濯をしよう』と思うようになる」とポーターはNBCニュースに語った。 必然的に、熱と疲労が戻ってくる。

それは繰り返し起こる、とポーターは言った。 "それはマインドゲームのようなものです。"

シアトルのアンドリュー・デュモンさん（３２歳）もまた、以前のＣＯＶＩＤ-１９検査で陽性反応が出た後、ウイルスの陰性反応を示した。 最初に病気になってから2ヶ月、デュモンはまだ手足のしびれと息切れに苦しんでいます-過去1週間に2回緊急治療室を訪れています。

CTスキャンと肺のX線検査では、他の感染症は見つかりませんでした。

"それは本当に怖いことです。

激しい外来管理

COVID-19入院するほどの病気ではない患者さんには、回復のための指導はほとんどありません。 安静、水分、タイレノールのような熱を下げる薬以外に、特定の薬や治療法はありません。

しかし、ウイルスは悪化する前に数日から数週間、体内でくすぶっている可能性があるため、一部の医師は、自宅で一人で回復している人への警戒を強めている。

"我々 は頻繁に電話で確認し、何のために気をつけることを患者に伝えることを行う」博士ララ ホール、ボストンの近くのケンブリッジ健康アライアンス呼吸器クリニックの臨床リード。 "私たちが本当に心配しているのは息切れです"

専門家によると、呼吸困難はCOVID-19が体内で大混乱を引き起こしている可能性があるサインであり、通常は緊急対応を必要とします。

コロナウイルス患者の中には数週間続く症状を報告する者もいます

ホール氏によると、彼女のクリニックは約7週間前にオープンして以来、コロナウイルスの症状を持つ約2,400人の患者を診察してきたという。 これらの患者の約７０％が陽性反応を示している。

一部の患者は、より頻繁な診察が必要な場合があります。 "65歳以上で糖尿病や高血圧、心臓病や肥満、慢性肺疾患などを患っている人は、"毎日電話をかけているハイリスクカテゴリーの人たちです "とホール氏は言う。

"私たちはこれを強烈な外来管理と呼んでいます "と彼女は言った。 一部の患者は、ホールのクリニックで再び見られる必要がありますが、他の人は、緊急治療室でのケアを求めるように促されることがあります。

"眠るのが怖い
在宅で回復しているCOVID-19の患者の多くは、ウイルスが昼夜を問わずどのように作用するかについて、似たような逸話を語っている。

朝は普通に始まる傾向があるが、日が進むにつれて、ウイルスの症状が「時計じかけのように」忍び寄ってくる、とポーターは言う。

気温が上昇し始めます。 認知がぼんやりとしてきます。 ポーターは、彼女が言葉を見つけるのに苦労しているので、それを「奇妙な物忘れ」と表現しています。

ケイト・ポーター
ケイト・ポーターはCOVID-19の発熱や極度の疲労、心拍数異常などの症状が長く続いていた。
"夜になると、物事が少しずつ大きくなり、緊張してくる。"
夜になると、恐怖が襲ってきます。 衰弱した疲労と倦怠感にもかかわらず、多くの患者は熟睡できないのです。