Thread by @rishdotblog

My dad in India was recently in the ICU for 8 days, with a severe case of Covid+Dengue. He is 57 years old and also has diabetes. He's now recovering and is out of ICU, but is still hospitalized

Sharing what I learnt through the process in case it's useful for someone else [1/n]

He had extremely high fever (104+°F) when he first started presenting symptoms on Nov 9, and his platelets were falling rapidly. My mom got him tested for both Dengue and Covid, where he tested negative for Dengue and positive for Covid [2/n]

On Nov 13, we got him admitted to a nearby hospital where his platelets kept falling. He was then tested positive for Dengue in another test that the hospital did [3/n]

We also got to know that he would likely have a very severe case of Covid. Biomarkers for inflammation were really high (C-reactive protein, Ferritin, and IL-6 were all extremely heightened) [4/n]

Because of dengue, his platelets kept falling (they reached 17k at their nadir) and we had to get him a platelet transfusion to ensure no internal bleeding. After the transfusion, his platelet count slowly started to increase [5/n]

Next, he was given steroids and favipravir to reduce Covid symptoms. But they didn't have the desired impact. His C-reactive protein rose sharply (reaching 71 at its peak), ferritin increased to >2000 and blood oxygen levels fell rapidly to mid 80s [6/n]

At this point, a CT-scan of his lungs also showed damage and significant inflammation in his lung tissues [7/n]

He was then admitted to the ICU on Nov 23 and given supplemental oxygen, a course of remdesivir, an immunosuppressant (Tocilizumab), and convalescent plasma that had Covid antibodies [8/n]

After this, he began to recover. His C-reactive protein levels fell rapidly, and supplemental oxygen was first reduced, and then removed

His blood sugar has been extremely high throughout his stay (both as a result of Covid and steroids), and he needed insulin injections [9/n]

Key lessons were:
1) If your Covid test is +ve, also get your C-Reactive Protein, Ferritin, and IL-6 levels tested. If these are extremely elevated, seek medical help immediately

2) If you have diabetes or other comorbidities, don't take Covid lightly and wear an N95 mask [10/n]

3) If you don't have a health insurance topup, please get one. For reference - a 20 day hospital stay in Ghaziabad will cost my family INR 10 lac

4) Procure the right medication early in a hospital stay. It is in short supply, so buy before things get absolutely critical [11/n]

5) Make requests for convalescent plasma early. We waited 2 days before finding a donor, because many potential donors didn't have sufficient levels of plasma antibodies

6) Test regularly in the hospital – especially for fast changing markers like C-Reactive Protein [12/n]

7) When recovering, keep an eye out for Lymphocytes. An extremely low level means that your body is struggling in its immune response to the virus

8) Do regular Liver and Kidney function tests to ensure that internal organs are not failing [13/n]

9) If visiting relatives who're in the hospital, have a PPE kit on at all times and maintain physical distance

10) If you don't yet have covid, keep a high level of vitamins C and D by taking supplements to reduce your chances of getting a severe version of the disease [14/n]