Infectious disease expert takes COVID-19 questions
Steve Threlkeld
Steve Threlkeld, M.D., is a partner at Threlkeld, Threlkeld & Omer Infectious Disease
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The Daily Memphian asked Dr. Stephen Threlkeld, the infectious disease expert who treated the first patient hospitalized with the COVID-19 coronavirus in Shelby County, questions about how the disease progresses.
Question: What did you learn from treating the first case that required hospitalization in our area so far?
Answer: I hope it is of some reassurance to people that there will be individuals sick enough to be in the hospital but still able to receive proper supportive care and to be discharged home to do well. This was our experience in this case, and I think it demonstrates that even people with more significant disease from this virus can do very well.
Q: Is there a point where the illness makes a drastic turn for the worse?
A: Recognizing that many people will be asymptomatic or have minimal difficulties, the people who do poorly with this infection seem to worsen clinically after about a week of less severe symptoms.
This can also be associated with significant heart involvement and impaired heart function even as the lungs appear to be improving. Thankfully this is still a significant minority of patients infected with COVID-19.
Q: How long will treatment usually take once a person is diagnosed and under care?
A: Duration of symptoms and the required treatment will vary a great deal among patients. We are seeing the whole spectrum, from asymptomatic to deadly infections, and more aggressive treatment must be followed by careful monitoring in the home to ensure that the patient no longer can pass the virus to others.
Q: After having COVID-19, will people have some generic coronavirus immunity, or will the immunity be specific only to COVID-19?
A: The immunology related to coronavirus is fairly complicated. We certainly hope that we would develop enough immunity from this infection at least to blunt the severity in subsequent years, but we need much more data to be confident of this.
One piece of good news is that the other coronaviruses that continue to circulate among humans typically cause very mild illness like a common cold. As to whether infection with SARS-CoV-2 (which causes COVID-19) would offer any immunity to subsequent, similar viruses that jump into the human population from animals, we have no real information to predict that. It would depend on how closely the two were related, and of course we can’t know that at this point.
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