Fascinating, long interview with a lung specialist (pulmonologist M.D.) and his own up-close-and-personal case of WuFlu and subsequent cytokine storm
https://www.salon.com/2020/04/05/what-it-feels-like-to-survive-covid-19s-dreaded-cytokine-storm/
What it feels like to survive COVID-19’s dreaded “cytokine storm”
A doctor and coronavirus patient in recovery describes his experience surviving COVID-19's worst side effect
Keith A. Spencer
April 5, 2020 11:30PM (UTC)
Of all the possible compounding effects of COVID-19, the disease caused by the novel coronavirus, the cytokine storm is one of the most feared. An immune system overreaction in which the body is flooded with the eponymous signaling molecules, those who suffer a cytokine storm are at risk of dying at the hand of their own immune system, as an indirect effect of the virus they are fighting.
This is the opposite of how we think of our immune system working: if we have a good, strong immune system, we should be safe from the novel coronavirus, right? Unfortunately in this case, too much of a good thing is not a good thing. This is true beyond the example of the cytokine storm, as there are other diseases, often milder ones, caused by a misbehaving immune system; lupus, allergic reactions and celiac disease are all examples of overactive immune responses.
The cytokine storm affects a substantial number of severe COVID-19 patients, enough that it has become the subject of a subset of medical research into COVID-19. Those unlucky enough to experience cytokine storm will have their bodies and especially lungs flooded with cytokines, immune system helper molecules, as their immune system struggles to fight off the invading virus and the dead lung cells it produces en masse. The overreaction results in the immune system building up too many of these kinds of cells, which can lead to respiratory distress or bacterial pneumonia and, ultimately, death.
Not everyone who experiences a cytokine storm will die, fortunately. Such is the case of Jonathan Raskin, a 69-year-old pulmonologist who practices medicine in New York City, and who contracted coronavirus a few weeks ago and is currently in recovery. After self-isolating at home, Dr. Raskin's temperature swelled to 102.8°; he spent several days in the hospital in a very bad state (by his own admission) before slowly recovering. As a pulmonologist, Dr. Raskin's insights into what was happening to his own body are particularly keen, as he had a medical understanding of what was happening as it happened to him.
Dr. Raskin was kind enough to be interviewed about recovering from COVID-19 over the phone, from the comfort of his apartment in Manhattan where he continues to recover and is now in better health.
So let's start from the beginning. Do you happen to know how you contracted the virus?
No, I don't. As a pulmonologist, I guess I'm an at-risk population, but I was unable to figure out where and how I acquired it. It was in the community I believe well before people were aware. As we are still unable to test and identify those infected, many of whom are asymptomatic, the issue and concerns remain.
Did anyone else in your office, like any nurses or other doctors get it?
My wife who is also a physician did become positive but she has had a different version of it. Fortunately despite being infected she was asymptomatic. She was offered the test, as she is a physiatrist who oversees a large rehabilitation center.
How did your symptoms progress?
First, I just had this intuition that I had it at some point in late February. Not for any clinical reason — I was feeling low energy, and I'm not a low energy type. There was no fever, there was no cough, I was simply asymptomatic but realized I was at risk so the thought was on my mind a great deal.
[On] Saturday March 7th, I had a chill. I took my temperature and it was over 101. Initially I started Tamiflu, as there was a chance it was influenza but shortly thereafter I realized the symptoms and presentation of influenza is quite different and I knew that the presentation of this virus was unique.
The primary symptoms I had are quite typical for those who find themselves truly afflicted with the illness: high fever, a dry cough and pain in my throat. Not a classic pharyngitis, rather a sort of aching pain which was intermittent. Subsequently, the fevers really took off and averaged 102.5 over the following days. Headaches, nausea, severe muscle and bone pain, change of bowel habits and a loss of taste and smell all evolved.
[Moar at website]