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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

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

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Can I Take Vitamins and Supplements To Boost My Immune System?

May 5, 2020 | COVID-19, Diet and Nutrition, Health Hub, Your Health

The COVID-19 pandemic has caused healthy people to think about ways to stay as healthy as possible. There are many ideas about how to stay healthy including drinking more water, getting more sleep and exercise. One place people are turning to for help is through vitamins and supplements.

However, should everyone begin a vitamin regimen? And, where should we start with taking vitamins?

In this Q&A, Hannah Kittrell, MS, RD, CDN, Clinical Research Associate and Director of the Mount Sinai Physiolab, provides some advice on which vitamins people should begin taking and discusses if supplements can really boost your immune system.

We hear a lot about taking vitamins, herbs, elderberry syrup, and other supplements to boost your immune system during the pandemic. Is it possible to ‘boost’ your immune system?

It depends on how you define “boost”, but there are certain nutrients that are vital for optimizing immune function. The immune system is a complex, interconnected system that requires all of its parts to work in harmony to function at its best. It is easy to “boost” a single entity, but something as complex as the immune system, not so easy.

There are specific nutrients that contribute to a healthy immune system, such as zinc, selenium, iron, copper, folic acid, vitamins A, B6, B12, C, and E, and the essential fatty acid omega-6 (linoleic acid). Deficiencies of these micronutrients may impact the immune system in a negative way.

To note, adequate amounts of these micronutrients can be easily obtained through eating a well-balanced diet composed of whole foods, with lots of fresh fruits and vegetables. Supplementation may be indicated in the case of deficiency, but you should always check with your doctor or a clinical dietitian prior to starting a supplementation regimen.

Where should you start in your vitamin regimen? A multivitamin? Vitamin C?

A general multivitamin is fine to start, however, adequate amounts of vitamins and minerals can be obtained through eating a well-balance diet. However, people who are likely deficient may also warrant supplementation. We recommend taking a look at your last blood test, which would show any recent deficiencies. Additionally, a comprehensive dietary evaluation conducted by a dietitian would determine dietary habits that can be improved upon.

What vitamins and minerals should we be certain to take in adequate amounts?

It is difficult to generalize vitamin/mineral needs for a large group of people, as supplementation recommendations are based on deficiencies or likely deficiencies for reasons such as access to food, malabsorption, or medical conditions, and can vary greatly from one person to the next.

However, there are certain micronutrients that are of importance for certain groups:

Children—Iron, vitamin D, vitamin A, vitamin C, calcium

Women—Iodine, vitamin D, vitamin B12, calcium, iron, folate

Adults— Iron, iodine, vitamin B12/B6, vitamin D, vitamin C, calcium, vitamin A, magnesium

Seniors—Vitamin B12, calcium, vitamin D, iron

Based on a nutrition report from the Centers for Disease Control and Prevention, the top five most common nutrient deficiencies among people who live in the United States include vitamin B6, iron, vitamin D, vitamin C, and vitamin B12. These deficiencies are mainly due to poor nutrition. And, again, if you follow a healthy food plan and eat adequate amounts of fruits and vegetables, in a variety of colors, then you should not have to worry about any micronutrient deficiencies.

How can we best support our immune system during quarantine?

The best way to support your immune function is by living a healthy lifestyle.

Be sure to get enough sleep. That is seven hours for adults, nine hours for teenagers, and 10 hours for children 12 and under.

Drink plenty of water—two cups shortly after waking and six to eight more throughout day—and stay active.

Also, everyone should try to eat a well-balanced diet with lots of fresh fruits and vegetables, as well as high quality sources of protein and fat like nuts, seed, legumes and beans, eggs and fish.

I Have A Cavity. Is It Safe to See My Dentist?

May 4, 2020 | COVID-19, Dental and Oral Health, Health Hub, Your Health

Although many are under stay at home measures due to the novel coronavirus pandemic, there are still some everyday issues that cannot be avoided—like dental pain. But, can you see a dentist during this time? John L. Pfail, DDS, Chief of the Department of Dentistry at the Icahn School of Medicine at Mount Sinai, explains which procedures can be addressed and which will have to wait.

Are dental procedures still being done in the office?

Currently, the American Dental Association (ADA) and the New York State Dental Society will only allow emergency procedures. COVID-19 is spread through respiratory droplets from the nose and throat. Some dental procedures can create large amounts of these droplets in the air, for example through cleanings and fillings, which could spread the virus.

Out of an abundance of caution, elective surgery, routine restorations like fillings and all procedures involving the use of an ultrasonic scaler—which is used to clean teeth as well as remove stains and plaque—have been postponed. If patients are experiencing mild discomfort, they should contact their dentist who can evaluate and advise if they should wait until a possible reopening of offices in late May.

What types of procedures are considered an emergency?

Emergency procedures depend upon the level of pain or discomfort the patient is experiencing. However, these procedures would include the following:

Emergency treatment for pain and swelling

Depending on severity these would include medicated restorations—fillings, drainage of swellings and infections, as well as the removal of the inflamed nerve tissue of a tooth—pulpotomy

Extraction of severely mobile, fractured, or decayed teeth

Denture adjustments of sore spots

These spots should be attended to as they can lead to open wounds that may become further complicated, causing infection.

Refilling prescription medications

Please consult with your dentist. With the advent of telemedicine, you may not need to come in to the office to be seen.

I have an emergency dental procedure. Is the office safe?

Yes, it is very safe as dental offices follow strict protocols on infection control and asepsis–being free of any disease causing organisms, this includes viruses and bacteria.

Additionally, the ADA is currently completing new guidance for when dental offices reopen for all procedures. Social distancing will be maintained, patients will be screened with temperature checks, and visitors will be limited. These are just a few of the changes that will be noticed in the dental office.

Watch Mount Sinai's COVID-19 Facebook Live series

Will Using A Steroid-Based Nasal Spray Increase My COVID-19 Risk?

Updated on Jun 30, 2022 | Allergy, Cold and Flu, COVID-19, Ear Nose Throat, Health Hub, Your Health

The Centers for Disease Control and Prevention considers those who are actively being treated with high-dose corticosteroids to be immunocompromised. Most nasal sprays for allergies do not fall into this category. Consult your primary care physician regarding the specific medication you are taking.

Allergy sufferers are hyperaware of every cough, sneeze, and sniffle entering the height of this allergy season. Those with allergies are not only concerned with distinguishing their allergy symptoms from the novel coronavirus that causes COVID-19, but many are now worried that the medications they take to manage their symptoms might put them at increased risk.

Steroid-based nasal sprays have come under particular scrutiny because the active ingredient—corticosteroids—can reduce the strength of the body’s immune system, which is concerning during a pandemic. Fortunately, nasal spray users need not worry. Anthony Del Signore, MD, PharmD, Director of Rhinology and Endoscopic Skull Base Surgery at Mount Sinai Downtown-Union Square, explains why allergy sufferers should keep using their medications.

Should I stop using my steroid-based nasal spray?

If patients are getting the relief that they usually receive from taking these medications, I typically say to continue using them. Often, symptoms of nasal drainage, nasal obstruction, or sinus infections will increase if you come off of the medications.

It is also important to remember that with topical intranasal sprays, as well as topical nasal rinses with steroids in them, the absorption of the steroid is quite low. And, there is conflicting evidence as to whether or not steroids taken this way will actually cause any decreased defense against the virus.

A lot of the data and recommendations that we’re getting is for systemic steroids, which are steroids taken by mouth or administered intravenously. That’s where we are seeing the decrease in the immune system.

As a result, I am staying away from prescribing oral steroids for the time being. But topical nasal sprays, as well as topical rinses, I’m okay with.

I take an allergy pill. Are there steroids in my medication?

We do not typically give oral steroids to patients complaining about the typical symptoms of seasonal allergies. Instead, we recommend nasal rinses/netipot, oral antihistamines, and intranasal antihistamines as well as intranasal steroids, with pretty good effect and results.

Oral steroids are usually reserved for more serious conditions like asthma, lupus, or severe systemic allergic reactions. And, if you have a more serious condition that requires the use of these oral steroids, you have to weigh the risks and the benefits. I would counsel these patients to practice social distancing, good hygiene, and taking other precautions. These preventative measures can often tip the scale so that the benefits outweigh the risk of the steroids.

What should patients do if they are concerned that their medications will decrease their ability to fight off COVID-19?

There’s a lot of information out there, and patients may be having a tough time finding the right answers. If patients have any questions during these tumultuous times, they should consider setting up an in-person or telemedicine appointment to talk with their health care provider. After getting a global view of the patient and seeing what other risk factors they have, proper recommendations can be made that may at least help to put fears at ease at a time that’s very uncertain for many.