COVID symptoms that require medical care

If you have a COVID-19 infection, you will be told to isolate and stay away from others until you get better. But while many people get better at home thanks to a combination of medication, rest, hydration and time, others require additional medical intervention.

Although we know the hallmark symptoms of COVID – such as coughing and fatigue, for example – there are some COVID-19 symptoms that are not normal and should not be treated as such.

“What’s really important is making sure people look out for certain signs and symptoms that warrant hospital-level care [care from] a health care provider so they don’t have to deal with serious illness, even hospitalization and death,” said Dr. Syra Madad, an infectious disease epidemiologist at Harvard’s Belfer Center for Science and International Affairs.

Below, experts share which COVID-related issues should be immediate warning signs, plus some advice on what to do:

According to Dr. Natasha Bhuyan, national medical director of One Medical, red flag symptoms include shortness of breath and difficulty breathing.

“What we always say is that if someone is really having trouble breathing and is gasping for air, that would be a trip to the ER,” Bhuyan said.

If you have COVID, there is a phase where the virus multiplies rapidly, followed by an inflammatory response phase where your body fights the virus, explains Dr. Mahdee Sobhanie, an infectious disease physician at The Ohio State University Wexner Medical Center. “And… sometimes that inflammation can affect other places, and what we always worry about is the lungs.” If you have COVID and notice you’re having trouble catching your breath when you walk, sit or talk, that’s a reason to go to the emergency room, he noted.

Sobhanie also noted that chest pain is another red flag that should trigger an emergency visit. The same goes for bluish-colored lips, Madad said.

If you have a pulse oximeter at home (or a smartwatch that informs you of your oxygen saturation) and you notice that your oxygen levels are low, Sobhanie says you should seek medical attention.

Problems such as dizziness, confusion, or lightheadedness also require immediate medical attention. “Some of the really concerning symptoms…maybe someone in your household has COVID, and now he or she is confused, or they’re not making sense or they’re disoriented, I think those are reasons to go to the ER,” Bhuyan said.

Finally, look for a high fever above 103 degrees Fahrenheit. High fever can sometimes warrant a visit to the emergency room, but can often be managed by your primary care physician, Bhuyan added. If you are unsure, it is always best to seek help right away as a precaution.

“I think you also need to be very aware of the other underlying conditions you have. The patient population that I always worry about is immunocompromised patients… and those patients, if they ever have COVID, they need to talk to their doctors immediately because their doctors like to be very proactive early on when it comes to COVID,” Sobhanie said .

According to the Centers for Disease Control and Prevention, people at high risk include people over 50, people with underlying health conditions such as chronic obstructive pulmonary disease and heart disease, and people with weakened immune systems, as Sobhanie mentioned above.

“If you’re experiencing worsening symptoms, such as a worsening sore throat or cough, or worsening fever or headache, I think that’s certainly another warning sign that you should seek health care,” Madad said.

In this case, you should let your doctor know what symptoms you are experiencing and whether they are getting worse, she said.

“What we normally expect is that people may feel a little tickle in their throat for the first day or two, they may feel like they are getting sick, [and] Usually on day three or four the symptoms are more severe and are at their peak,” Bhuyan said. “People usually get better from there.”

It may take seven days to feel better, or it may take 10 to 14 days, and that’s normal, she said. “But… if someone actually starts to get worse on day six or day seven, it is critical that they reach out [a] primary care provider.” This could be a sign that the COVID infection is progressing into something like bacterial pneumonia in their lungs, Bhuyan added.

All in all, it’s never a bad idea to let your doctor know about your COVID infection.

“I think when you first get the first symptom of COVID — which could be fever, fatigue, a runny nose — the best plan is to call your doctor right away and try using Paxlovid, [which is an antiviral medication]Sobhanie said. To qualify for Paxlovid you must be at high risk of developing a serious disease. This risk is calculated based on your age and underlying health conditions. Talk to your doctor to see if you are a candidate for the medication.

Additionally, it is always good to keep your doctor informed about a COVID-19 infection so that he or she can help you on the road to recovery and monitor your progress.

“The COVID vaccine is effective at preventing hospitalization and death…that said, someone could get the COVID vaccine, or they may have already had a COVID infection, and could still get COVID,” Bhuyan said. The purpose of the injection is to reduce the severity of the disease, not to prevent it completely.

Sobhanie said it’s not too late in the season to get your COVID vaccine. But you should talk to your doctor about the best timing for your injection. If you have recently had a COVID infection, you will need to wait a while before getting your shot. (The CDC says you should wait three months after infection before getting vaccinated.)

In addition to vaccination, Madad recommended returning to the “Swiss cheese model of COVID defense.”

“That’s something we’re all used to during the COVID-19 pandemic. The Swiss cheese model consists of layers of infection prevention that you stack on top of each other. As we know, no layer is 100% protective,” Madad said.

This includes wearing a face mask in busy areas, wearing a face mask in poorly ventilated areas, keeping your distance from others in busy places and staying up to date on your vaccinations.

Looking at data on viral activity across the country at this time, Madad noted that there are high levels of COVID-19, influenza and Respiratory Syncytial Virus (or RSV) everywhere.

“It is not too late to get vaccinated. You keep looking [high] levels of this respiratory viral activity,” Madad said.

And the above measures also apply when it comes to protecting yourself against all respiratory viruses that are in circulation this winter.