The COVID Cliff

May 12, 2020

We continue to learn about COVID-19, and recently healthcare providers have observed what could be called a “COVID cliff”. Many patients suffer with the virus for a week to 10 days, and then begin to recover. Others, just when they were starting to feel better (or at least expect to), hit the COVID cliff and get much, much sicker. Dr. Diego Maselli said this is a pattern seen in some other infections. “There is a smoldering effect, and suddenly the patients get sicker quickly,” he said.

“The disease process is very variable,” said Dr. Maselli, medical director of respiratory therapy at University Hospital. “We have seen patients that are stable for up to a week - even 2 weeks - and within 24 to 48 hours they deteriorate quickly.”

In caring for COVID-19 patients, he said, the team at University Hospital follows their inflammatory markers through blood tests, as well as watching their vital signs and how much oxygen they require.

“Not all the patients behave the same way. But definitely some present with rapidly deteriorating vital signs and increased oxygen requirements. This typically will show with increased respiratory rate and high fever and a lot of malaise - feeling terrible - with body aches.”

Dr. Maselli noted that some patients who had been recuperating at home have had to be hospitalized late in their illness because of sudden and rapid deterioration.

The disease manifests in different ways, and most who have the illness do not need to be hospitalized. But for people recovering at home, and people who are helping to care for them, Dr. Maselli said the key things to monitor are the patient’s temperature and respiratory rate. If those change suddenly, seek medical help.