COVID-19 | Mount Sinai Today

I Think I Have COVID-19. How Can I Take Care of Myself At Home?

May 8, 2020 | COVID-19, Your Health

Most people who have COVID-19 can recuperate at home, while remaining in contact with their doctor. Abigail R. Chen, MD, Senior Medical Director at Mount Sinai Doctors Downtown, tells you what you need to know to address COVID-19 symptoms at home.

Can I stay at home if I have COVID-19?

Generally, yes. Most people who test positive for COVID-19 will have mild symptoms–like a cough or sore throat. If you are experiencing mild symptoms, you can certainly recuperate at home by treating with over-the-counter medications. Below, I outline how to address the most common COVID-19 symptoms at home.

For information on protecting others in your home, read through the CDC guidelines.

How do I treat fever from COVID-19?

The best way to treat fever from COVID-19 is with acetaminophen—the active ingredient in Tylenol and other over-the-counter painkillers. Some early reports suggested that ibuprophen—the active ingredient in Motrin, Advil, and others—may make COVID-19 worse. However, the U.S. Food and Drug Administration has found no link between ibuprofen use and severe COVID-19. Remember to follow the dosage and timing directions on the package.

What should I take for a cough?

Most of the time, coughs that come with COVID-19 are dry and do not bring up phlegm. They can be severe and may even disrupt your sleep—but may still be able to be handled at home. The best approach to a cough can be a cough suppressant like dextromethorphan –the active ingredient in Robitussin, Nyquil, and other over-the-counter medications. If your cough is making it difficult to sleep, try a semi-reclining position (about a 45-degree angle). Since the cough associated with the virus is dry, you do not need an expectorant—such as guaifenesin—which helps to clear mucus from the airways. If your cough is really making you uncomfortable, talk with your doctor, who can give you a prescription-strength medication, or let you know if you need to go to the hospital.

What can I do about fatigue?

The key is to listen to your body. It is not uncommon to feel fatigued even days or weeks after many other symptoms have resolved. If your body is telling you to sleep more than usual, you should respect that and lay down rather than getting back on your computer. If you are having difficulty sleeping, try adjusting your position. Many people have some level of insomnia these days, due to the stress of the stay at home orders.

What if I lose my appetite?

Many people with COVID-19 find their appetite has disappeared. It is important to remain hydrated and take in some calories to give your body strength to fight the virus. Many people find that traditional soups—such as chicken soup or rice porridge (also called congee or jook)—can be helpful. These soups are bland, easy to digest, and offer some nutrition to help your body get energy. But soups do not provide all the hydration you need. You should make sure to drink as much water or other liquid as you can. Once you feel better, try to eat a little more to give your body strength to continue to heal.

What if I have a sore throat?

If you find your throat hurts from coughing, acetaminophen may be able to help. Many people find it also helps to drink something warm or very cold; pick what feels best on your throat.

How do I address shortness of breath?

This is the most dangerous of the COVID-19 symptoms. When you are taking care of COVID-19 at home, your doctor will pay careful attention to how you are breathing. Typically, every video appointment will begin and end with questions about shortness of breath. If you notice a change in your breathing—for instance, if you normally have no trouble with a flight of stairs and now find yourself huffing and puffing—it may be time to go to the hospital. Your doctor can advise you.

What if I lose my sense of taste and smell?

This is one of the more unusual symptoms of COVID-19. It can appear even with the mildest of cases. Make sure to tell your doctor if you have lost either your sense of smell or taste. While we cannot give you back your ability to savor chocolate or sniff flowers, these symptoms can help your doctor determine whether you have seasonal allergies or the COVID-19 virus. To learn more about this unusual symptom, read this post from Mount Sinai rhinologist Patrick Colley, MD.

How often should I check in with my doctor?

You should keep in touch with your doctor regularly. If your doctor does not recommend a follow-up appointment, you should feel comfortable asking for one. It is important to understand that recuperating from COVID-19 is not a linear trajectory. You may start to feel better and then, after a few days, feel worse again. It is important, though, to have a doctor monitor your symptoms; he or she can tell you if what you are experiencing is standard or concerning. These days, many doctors are available by email, as well as phone and video.

Are there certain people who should be extra vigilant?

The elderly and people who have hypertension, obesity, and diabetes should be especially careful about discussing any COVID-19 symptoms with their doctor. These conditions have been closely linked to relatively severe cases of the virus. If you have any of these conditions and are experiencing any symptoms that resemble COVID-19, please keep in contact with your doctor.

What if my doctor tells me to go to the hospital? Do I have to?

If your doctor does advise you to go to the hospital, please do so. These days, many people fear hospitals and doctors’ offices. But health care facilities are taking special care to protect you. If you need hospital-level care, it is important that you get it.

How Mount Sinai is Keeping Patients Safe

Is It Safe to Go to the Hospital for Emergency Care?

May 8, 2020 | COVID-19, Your Health

These days, we are all worried about contracting COVID-19. We know people who have symptoms of the virus often go to a hospital’s emergency department—most known to patients as the emergency room—to seek immediate care. For this reason, many people are nervous about going to the hospital for any other reason. But, that is not always the best approach. Brendan Carr, MD, Chair of Emergency Medicine for the Mount Sinai Health System, explains what you need to know about going to the emergency department during the COVID-19 pandemic.

Should I go to the hospital for emergency care?

In a medical emergency, you should seek help—and that means going to the emergency department. If you delay seeking help for conditions that need immediate attention, we may not be able to do as much for you. If you have a problem with your heart or your breathing, if you have chest pains or symptoms of a stroke, it is important to be evaluated as soon as possible, for the best outcome. We want to help, but we cannot do anything for you if we do not know there is a problem.

I am concerned about safety. What is being done at hospitals to ensure that it is safe for patients?

Throughout the Mount Sinai Health System—and at most other hospitals in the country—we have spent a lot of time changing our set-up and workflow to protect against exposure to COVID-19. We are very diligent about how we clean all the high-traffic areas. We make sure that all staff members wear masks and we give patients masks as they go into the emergency room. We are doing everything we can to protect you from possible exposure.

To help us help you, there are some things that you can bring when you come. Have a list of all your medical problems and the medications you take. It can help to bring the medicines themselves. While this advice is always true, it is especially important during this pandemic. In addition, you might want to bring a cell phone and phone charger so that you can reach out to friends and family about what is happening. You also may end up spending a fair amount of time at the hospital, so it cannot hurt to bring a book or some sort of entertainment to make your wait easier.

Should I go to the hospital, urgent care, or schedule a video visit with a medical provider?

It depends on what is happening. If you are experiencing something that you have been treated for in the past and you have an idea of what is wrong—or it is a minor problem—then it is totally appropriate to go to an urgent care center. You can also call your doctor’s office to arrange for a video appointment. We provide a number of virtual care options through Mount Sinai Now, including virtual urgent care and the ability to text with a physician about your health concerns. If your doctor thinks you need a higher level of care, they will refer you to the emergency department or to a specialist.

Are there special precautions I should take if I have to go to the hospital?

Think about going to the emergency department the way you think about doing all the other important things in your life. There is always a risk of exposure when you leave the house, but we still go to the grocery store and to the pharmacy. Going to the hospital when you are worried that you are ill or injured is another part of taking care of yourself. We are here for you and are doing everything we can to keep you safe. It is important to follow all the safety rules in the emergency department that you would anywhere else. Wear a mask, wash your hands regularly, and practice social distancing.

How Mount Sinai is Keeping Patients Safe

Outcomes Data Published from Large, Diverse COVID-19 Patient Study in NYC

May 7, 2020 | COVID-19, Featured, Research

Li Li, MD, Sema4’s Vice President of Clinical Information and an Assistant Professor at the Icahn School of Medicine at Mount Sinai

Sema4 scientists released results from an analysis of patients tested for SARS-CoV-2 at five hospitals in the Mount Sinai Health System. Spanning more than 28,000 patients, this is one of the largest and most racially diverse COVID-19 studies performed in the United States to date. The study findings were posted as a preprint on medRxiv.

The team at Sema4 analyzed de-identified electronic medical records from 28,336 patients tested for SARS-CoV-2 at Mount Sinai Health System hospitals in Manhattan, Brooklyn, and Queens between February 24 and April 15. Of those patients, 6,158 tested positive for the coronavirus and 3,273 were admitted to the hospital.

Consistent with other reports, this study confirmed that COVID-19 prevalence in African Americans and Hispanics is disproportionately high in New York City. However, for patients admitted to the hospital, the analysis found no differences in mortality rates based on ethnicity, indicating that inpatient care helps to address this health care disparity.

The team also identified several risk factors linked to increased mortality rates for COVID-19 patients, including age, oxygen levels, body mass index, and elevated creatinine, among others. Asthma was associated with longer hospital stays, but did not appear to be linked to increased mortality rates. The study, which found higher mortality rates at hospitals where patients had more severe cases upon entry, can also be used to guide neighborhood-based testing for SARS-CoV-2.

Li Li, MD, Sema4’s Vice President of Clinical Information and an Assistant Professor at the Icahn School of Medicine at Mount Sinai in the Department of Genetics and Genomic Sciences, who was one of the lead scientists on the project, commented: “In a thorough review of published studies investigating COVID-19 mortality rates, we found unintentional biases, such as small sample size, that limited the broader utility of the data. By including all patients tested at these five member hospitals and performing advanced statistical modeling including multivariate analyses, we have removed that bias and generated findings that should be more useful in improving the understanding of which clinical features track with disease progression and associated outcomes.”

COVID-19 and Mount Sinai: The Photographs that Tell a Story

May 6, 2020 | COVID-19

There are many, many significant moments over Mount Sinai’s nearly two centuries of history that have defined who we are as individuals and as an institution. Today, our hospital campuses—and our everyday jobs of caring for the sickest patients and developing the treatments to save them—are being vastly transformed. The work that we do so professionally and respectfully, and with compassion and ingenuity, has taken on new urgency. It is the hurried work that the world now sees—in real time, primarily through dramatic photographs. The photographs that we present here speak—always respectfully—for our patients, for our doctors and nurses and clinical staffs, for our scientists, and for everyone at the Mount Sinai Health System. As we all continue to work under extraordinary circumstances, we will bring you the compelling pictures that will help us to remember what we do and who we are. In this installment, see how the Abilities Research Center at the Department of Rehabilitation and Human Performance was converted into a well-being oasis for our front-line staff, and how The Mount Sinai Hospital continued to be physically transformed.

Week of April 4 -10

Week of March 30 - April 3

Can Breathing Exercises Help Me Recover from COVID-19?

May 6, 2020 | COVID-19, Health Hub, Your Health

COVID-19 is a serious disease, and doctors and scientists are working hard to learn more about how it affects different patients in order to develop the best treatments and help speed recovery. For many patients who are recovering, a loss of lung function is one of the key hurdles they face.

There are some steps you can take, in consultation with your doctor and other respiratory experts, that can help you in your recovery, including some exercises, according to Neil Schachter, MD, Medical Director of the Respiratory Care Department at the Mount Sinai – National Jewish Respiratory Institute, who has written two books on chronic lung disease.

But one thing to keep in mind: Any exercises you do are not actually repairing your lungs or strengthening your heart. Rather, they are helping to develop your muscles and your body to work more effectively with your lungs, which will help you breathe better and improve your circulatory system, according to Dr. Schachter, the Maurice Hexter Professor of Pulmonary Medicine and Timothy Harkin, MD, Associate Professor of Medicine and Director of Bronchoscopy, (Pulmonary, Critical Care, and Sleep Medicine) at the Icahn School of Medicine at Mount Sinai.

Also, it’s not necessarily as simple as buying a treadmill or going out for a jog every morning, and your recovery will depend upon the severity of your disease and the damage that may have occurred to your lungs. That damage to the lungs impairs your ability to breathe and to supply oxygen to your body, which is what may make simple chores seem harder, or leave you catching your breath.

If your symptoms were mild enough that you recovered at home and did not need medical attention, your body will likely recover on its own. But if your symptoms were more severe you may need to take measures to help in your recovery, and certainly if you were hospitalized, in which case you will be speaking to your health care provider.

The basic principal behind recovery of lung function, though, remains the same. The good news is that, unlike traditional chronic lung ailments like chronic obstructive pulmonary disease (COPD) and pulmonary fibrosis, the damage from COVID-19 may be reversible and there is the ability to recover lung function, though there are many unknowns. And you can aid that recovery with a program of mild exercise.

With his respiratory therapy patients, Dr. Schachter advises doing what athletes do, using gradual training exercises, and he uses the analogy of Rocky Balboa, the fighter in the Rocky series of movies.

In the very first movie, Rocky begins training for the big fight by running on the streets of Philadelphia. But he’s out of shape, so on his first outing, he runs about a block and he’s out of breath. But he sticks with the routine, and about a month later we see him run up the steps of the Philadelphia Museum of Art with his arms raised in a victory salute.

For those who have had mild symptom from COVID-19s, and those without other significant medical issues, this type of exercise program can help reverse the effects of weeks of sitting around the house battling the virus. So it could be daily walks inside your home, then gradually increasing to walks in the neighborhood, doing some stretching exercises, and perhaps using a cycling machine or walking on a treadmill at home while gyms remain closed. You might start with just a few minutes, and then gradually build up to 30 minutes.

Those who had more serious injuries to their lungs, or may have other medical conditions that could slow their recover like asthma or diabetes, should speak with their health care provider about a program of exercises that fits their needs.

Normally you might consult with a specialist like Dr. Schachter, who works with a team of rehabilitation therapists and physical therapists and oversees a dedicated gym at Mount Sinai for those in recovery programs. But for now, a telehealth visit would allow a health care provider to assess how much trouble you may be having with daily routines, like showering, and make some recommendations. If you need additional oxygen, they can help with that.

Get more answers from Mount Sinai to your COVID-19 questions

Watch Mount Sinai's COVID-19 Facebook Live series for more tips from our experts

Renowned Immunologist Miriam Merad, MD, PhD, is Elected to the National Academy of Science

May 5, 2020 | COVID-19, Featured, Research

Miriam Merad, MD, PhD

Miriam Merad, MD, PhD, a pioneering immunologist at the Icahn School of Medicine at Mount Sinai, has been elected to the National Academy of Science (NAS), an honor that recognizes her transformational contributions to the fields of myeloid cell biology and innate immunity. Dr. Merad, the Mount Sinai Professor in Cancer Immunology and Director of the Precision Immunology Institute, joins an elite group of international scientists with membership in the NAS.

In a landmark study published in Science in 2010, Dr. Merad showed that macrophages—large white blood cells—arise from embryonic precursors that take residence in tissues prior to life where they play a distinct role in organ physiology and pathophysiology. This study, cited several thousand times, has had important clinical implications. Dr. Merad and her team also established the contribution of this macrophage lineage to cancer progression and response to treatment, and to inflammatory bowel disease, in studies published in prominent journals such as Science, Cell, and Nature.

In addition to her work on macrophages, Dr. Merad is known for her work on dendritic cells, a group of cells that control adaptive immunity. She identified a new subset of dendritic cells, which is now considered a key target of antiviral and antitumor immunity. In a May 2020 study in Nature, she and her team revealed novel therapeutic targets to enhance dendritic cell-mediated antitumor immunity.

“I am thrilled to have been elected to the National Academy of Science and proud to represent Mount Sinai in immunology,” says Dr. Merad, who joined Mount Sinai’s faculty in 2004. She says her parents—both scientific and medical professionals who were educated in France and practiced in Algeria—raised her “to respect the transformational power of science.”

She adds that Mount Sinai helped foster her passion by giving her the freedom to grow and pursue her work. “Mount Sinai has a culture that empowers junior faculty. I tell junior scientists, ‘If you want to be transformative and innovate early in your career, this is the place to be,’” she says.

Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and President for Academic Affairs, Mount Sinai Health System, says, “Dr. Merad’s discoveries have helped changed the course of medical treatments and her work continues to shed light on the way the human immune system responds to disease.”

In May, after receiving word of her election to the NAS, Dr. Merad shared the news with all of the former and current postdoctoral fellows in her lab. Many of her original fellows, who continue to collaborate with her on research, are now established investigators in institutions that include Stanford University, the University of Massachusetts-Amherst, the University of Toronto, the University of Zurich, and Charité in Berlin. “I told them that this election recognizes the many hours they spent in my laboratory and I thanked them for everything we have done together,” she says.

A NEW COVID-19 RESEARCH EFFORT

Under Dr. Merad’s leadership, Mount Sinai has become an international hub for the study of the human immune system. She developed Mount Sinai’s Human Immune Monitoring Center (HIMC) as one of the world’s most sophisticated research centers; it uses cutting-edge single-cell technology to understand the contribution of immune cells to major human diseases or treatment responses. HIMC participates in several major consortia funded by the National Institutes of Health.

This center will now play a key role in helping Dr. Merad and her colleagues understand why some patients develop severe forms of COVID-19 and some do not. For the past six weeks, she has led a major effort at Mount Sinai with her colleague Alexander Charney, MD, PhD, Assistant Professor of Psychiatry, Genetics and Genomic Sciences, Neuroscience, and Neurosurgery, to collect blood samples from 500 hospitalized COVID-19 patients. The collection is still ongoing.

She says, “We will use the HIMC to analyze the inflammatory response that is triggered in our patients as a result of COVID-19, as well as the adaptive immune response to the virus.” Her goals for the project include the ability to predict which patients will develop a severe inflammatory response and then find ways to prevent and treat it.

Yet, she adds, even when some patients recover from the disease, they continue to have negative effects. “We do not know if it’s because inflammation persists and does not resolve. There is still a lot to learn. We will be following these patients for a long time because we need to monitor the resolution of inflammation and the quality of the immune response that these patients develop and see whether this response is protective.”