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  • Pinay Doctor Explains What To Expect If You Get Hospitalized For COVID-19

    Treatment and recovery time varies from patient to patient and can be very unpredictable.
    by Dahl D. Bennett .
Pinay Doctor Explains What To Expect If You Get Hospitalized For COVID-19
PHOTO BY Shutterstock/Anatta Tan
  • There is no one sure route to treating COVID-19. But, while there are basic signs that doctors look out for, treatment and recovery at the hospital is unique for every individual because so many different factors have to be taken into consideration.

    We’ve probably all wondered what happens to a COVID-19 patient once he or she (if lucky enough) is admitted in the hospital. We asked Internist Dr. Pia Hugo, who has been on the frontlines since the pandemic broke in March 2020, to walk us through the process and what patients can expect.

    On the average they take in 4 to 5 COVID patients a day, says Dr. Hugo who is currently under the Post-Residency Deployment Program of the Department of Health (DOH) and is assigned as a Medical Officer at RPHS Antipolo Annex II which is a COVID hospital.

    “If the patient warrants tertiary hospital care, we advise transfer and we try to coordinate to other hospitals through our networks,” she says. For those who are willing to wait at their observation tents, they continue to manage them until there is a vacancy at their wards, she adds.

    Patients who qualify for admission

    COVID-19 can present a myriad of symptoms but many of those who are tagged as COVID patients even without tests at the triage will often have the following symptoms:

    • Fever
    • Cough
    • Dyspnea
    • Headache
    • body pains
    • diarrhea
    • severely labored breathing
    • or decreased sensorium

    “The primary thing we look at is the patient’s oxygen saturation at room air,” says Dr. Hugo. If a patient’s saturation persistently remains below 95%, this is the time he or she is admitted for oxygen support and further management.

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    Doctors also look at the general well-being of the patient. Is he weak looking and unable to take medications orally? Does he have comorbidities such as hypertension, diabetes, is bedridden or has had a stroke? “All these factors puts a patient at higher risk for morbidity and mortality,” Dr. Hugo says.

    What to expect once admitted

    From the triage, a patient with COVID is moved to the emergency room. The first step is to get the laboratory tests done but even without the results, a patient may be placed on medication depending on the clinical picture he presents.

    These treatments include intravenous fluid administration, loading doses of antibiotics and steroids, and hooking the patient to oxygen for breathing support, explains Dr. Hugo.

    If symptoms are mild to moderate, a patient will either be placed in a room or a ward. If symptoms are severe, especially where intubation is needed to support breathing, a patient goes straight to the intensive care unit or ICU. (Know the difference between mild, moderate, and severe COVID-19 symptoms here.)

    Once the laboratory tests come back, that is the time that doctors will make the necessary modification in the medications of the patient. For one, not all COVID patients are necessarily given drugs like Remdesivir.

    “All COVID-19 doctors are guided by the ‘Philippine COVID-19 Living Recommendations,’ a locally formulated guideline integrating the present evidence for the treatment of COVID-19 infections around the world,” explains Dr. Hugo.

    It is called ‘living’ because it is constantly changing as if it were ‘alive.’ “It is always being updated based on new evidences or researches so as to keep it up to date to the current acceptable standards for treating COVID patients,” she adds.

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    An example of its application would be dropping the drug hydroxychloroquine from the list of current COVID-19 treatments. This has been changed to drugs like Dexamethasone, antibiotics (Azithromycin), Tocilizumab, Favipiravir, among others.

    “Each one has their own indication and potential adverse effects and should not be taken without supervision of a healthcare professional,” warns Dr. Hugo.

    Condition for hospital release

    Generally, the most significant marker of recovery of a patient is his oxygen requirement, says Dr. Hugo. “Once the patient is able to tolerate lower levels of oxygen support, we can prime for discharge or, if confined in the ICU, transfer to a regular room.”

    Other factors considered are stable vital signs and controlled comorbidities. “Once a patient no longer needs hourly monitoring and assessment, we also consider them as candidates to be transferred out,” she adds.

    Recovery period for room and ward patients

    Recovery time varies from patient to patient and in fact can be very unpredictable, admits Dr. Hugo. “One day you could be doing well at room air, the next day you could be gasping for breath due to declining oxygen levels. Nowadays, it doesn’t matter if you’re in your 30s or in your late 60s. We have younger patients dying and older persons surviving despite having co-morbidities,” she says.

    On the average, however, recovery period for patients with mild to moderate symptoms may be anywhere from 10 to 21 days. However, some, even if they have been discharged, may develop long-haul symptoms — they may get tired easily or experience shortness of breath after an exertion.

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    Dr. Hugo adds that other variables also contribute to a patient’s recovery outside of disease progression alone. These include lack of certain diagnostic procedures and facilities, the ability of the patient to afford bigger and more equipped hospitals, as well as late consultations wherein the patient is already in critical condition. 

    With these realities and unpredictability on the ground, it is best to avoid being hospitalized by following the safety protocols. But, if we want some certainty, then we should get vaccinated against COVID-19.

    As Dr. Hugo puts it, “We have more unvaccinated patients who are diagnosed with critical disease than vaccinated ones. So, we really advocate everyone to be vaccinated, no matter the brand of vaccine.”

    A doctor shares here when you should rush your child to the hospital if they exhibit COVID-19 symptoms.

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