I have now taking care of COVID patients on the full spectrum of acuity: asymptomatic, mild, moderate, severe, and critical.

A thread on what I have learned about the differences between them.

Asymptomatic. Sometimes this only means the patients feels no symptoms. I have seen several asymptomatic patients with abnormal tests (d-dimer, interleukin 6, ekg’s, echos). Asymptomatic to me is a designation that the patient doesn’t have traditional symptoms.

Mild to Moderate. These are the ones most likely to have #LongCovid They are sick enough to need medical attention, but not sick enough for a hospital bed. Sent home to quarantine. I will have a separate thread on quarantine care. These patients actually need the most attention.

Moderate in the hospital. These patients are doing seemingly well. Maybe on a few liters of oxygen. Then high flow. Then intubation. I see these patients decompensate over the course of days. In the hospital the first couple of nights determine the course of this population.

Severe/ Critical. These patients are in the ICU. Usually intubated, on bipap, or high flow. Usually with multiple lung infiltrates. Our treatment options are evolving, but back in March, many of these cases felt hopeless. The ones who made it out had degrees of organ dysfunction

Now, that I’ve seen the full spectrum of acuity. I understand how important early treatment is in the preservation of quality of life. This is why testing and tracing should be a priority. I believe everyone needs treatment. Even the asymptomatic.

As cases continue to soar. We need a treatment plan that minimizes the risk and prevents the progression from asymptomatic to severe.