Then it happened. I was at work and suddenly I wasn’t feeling well. I had horrible chills and wanted nothing more than to go home and get into bed. I left halfway through my shift, which is something that I thought I would never do. I coincidentally had COVID-19 testing scheduled the next day as part of my company’s “back to work” plan, so I went and got tested. By the next day, I had started to feel worse. I had a headache, body aches, and some mild shortness of breath. I had abdominal pain and diarrhea. Still, I was sure the test would come back negative. It didn’t. At 7:00 at night, I got a message that said my test was positive. I just stared at it. I had so many questions. What about my family? Whom had I exposed? What do we do next? What is going to happen to me?
Luckily, I had quarantined myself away from my family starting the minute I got sick. No one else had symptoms. I was in my room and office, using my own bathroom; they were bringing me food on disposable plates with disposable silverware. I even set up my own garbage can to keep my stuff separate.
I felt terrible, both physically and emotionally. My shortness of breath got worse. As a healthcare worker, I was fortunate to be stocked up with thermometers, pulse ox probes, a blood pressure cuff, etc. I watched my oxygen levels drop lower and lower. I had a fever every day despite taking Tylenol around the clock. I was winded walking to and from the bathroom in my own room. I was scared, but I tried to put up a brave front; I didn’t want my kids to be scared. I just kept wondering how much worse it would get before it got better. During this time, I did not consider sepsis in myself. I knew I was sick but sepsis was furthest from my mind. However, we all need to consider the signs of sepsis that may present with mental confusion, fever, shortness of breath, feeling of dread, amongst others. Perhaps I should also not just have been asking how bad will my Covid-19 experience become, but whether this infection would lead to sepsis. As a healthcare provider, I should have known to ask myself whether signs of sepsis were presenting.
After about five days, the nausea and vomiting started. I had been trying hard to take in enough fluids, but then I couldn’t take in anything. Even a sip of water would make me sick. I knew I needed to go to the hospital, but I couldn’t bear the thought of going. I couldn’t even imagine how I would get to the car and walk into the ER. And wait. The trip seemed too exhausting to even consider. My primary care doctor was in close contact with me that entire first week, and she did what she could to get me through, but there are no approved outpatient treatment options. I finally agreed to go to the ER.
With the vomiting, pounding head, and dropping oxygen levels , I was relieved to be getting help. The staff started me on oxygen. I had a chest CT scan that did not look great. I got steroids and antibiotics. The staff convinced me to stay.
I was admitted for a week. I had elevated inflammatory markers, including elevated cardiac and liver enzymes. With these clinical presentations and evidence of organ dysfunction - was I septic? I never thought about it, but reflecting back, I presented with the signs of sepsis. I needed fluid, I had pulmonary, cardiac, and liver dysfunction, and I required hospitalization which means I met the definition of sepsis.
The steroids did wonders. My appetite returned. I was able to wean down the oxygen from 3L to room air. My exercise tolerance improved to the point where I could shower without too much trouble. After the week, I felt stable enough to go home. I paid privately for home oxygen in case I needed it.
At home I still had shortness of breath requiring occasional oxygen, bad chest pain and body aches, diarrhea and the headaches that I just couldn’t get under control. I continued to get tested every three days until I finally had a negative test- a month after my first symptoms. I could finally hug my kids and leave my room. I had to push past an irrational fear that even though the test was negative I still might be contagious. I returned to work, probably way too soon. I worked five hours and then had to leave. I was so tired. Now, another month later, I can finish a whole shift, but it’s not easy. Walking from the parking lot is hard. I’m not even attempting a flight of stairs. The headaches finally subsided.
I would never have predicted that I would be someone who could develop sepsis from COVID-19. I have no idea what the end of this illness looks like because I haven’t gotten there yet. I am thankful that my experience was not as bad as many others; I survived. Sepsis awareness month is a great time for healthcare providers and people everywhere to remind ourselves that with every infection we need to ask “could this be sepsis?” and be thankful for the healthcare providers who take care of us.