If you’ve been diagnosed with COVID-19, you may be wondering when (or if) you should go to the emergency room (ER). While many individuals with COVID-19 will only experience mild to moderate symptoms, some will experience more severe disease.
“Depending on the severity of your illness, you may be able to treat yourself at home by taking over-the-counter medications, increasing your fluid intake and getting more rest. However, there are some symptoms that would best be evaluated in an ER setting,” says Alex Benjamin, MD, Chief Infection Control Officer, Lehigh Valley Health Network (LVHN). “Knowing what to watch out for can help you decide whether you need advanced care or prevent you from unnecessary ER visits.”
Symptoms and risk factors
COVID-19 can cause a variety of symptoms, but the most common are:
- Fever or chills
- Shortness of breath or difficulty breathing
- Body aches
- New loss of taste or smell
- Sore throat
- Sinus congestion or runny nose
- Nausea or vomiting
While many individuals will only experience these symptoms on a mild to moderate scale, your risk of developing more severe symptoms increases if you have or are any of the following:
- Chronic kidney disease
- Chronic lung disease (including chronic obstructive pulmonary disease, asthma, interstitial lung disease, cystic fibrosis and pulmonary hypertension)
- Dementia or other neurological conditions
- Type 1 or type 2 diabetes
- Down syndrome
- Heart conditions including heart failure, coronary artery disease, cardiomyopathies or hypertension
- HIV infection
- Liver disease
- Sickle cell disease or thalassemia
- Stroke or cerebrovascular disease
- Undergone a solid organ or blood stem cell transplant
- Overweight or obese
- A current or former smoker
- A substance use disorder
When to seek emergency care
While many individuals with COVID-19 will not develop severe illness, there are a few symptoms that should be evaluated urgently at the closest ER. They include:
- Shortness of breath while resting
- A persistent or worsening cough, fever and/or difficulty breathing
- A change in mental status (such as confusion)
- Persistent chest pain or pressure
- Extreme sleepiness, trouble waking up or difficulty staying awake
- Pale, gray or blue-colored skin, lips or nail beds
These symptoms can be life-threatening. If you begin to experience them, you should seek immediate medical care.
A specific complication recently identified in kids with COVID-19 is multisystem inflammatory syndrome in children (MIS-C), which involves inflammation of certain organs (including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs).
This condition can be deadly, so if your child develops a fever and any of the following signs and symptoms, you should contact their doctor right away for further guidance and recommendations for emergency care:
- Abdominal (gut) pain
- Bloodshot eyes
- Chest tightness/pain
- Feeling extra tired
- Low blood pressure
- Neck pain
If you are caring for an elderly person with COVID-19, please remember that they may not have the same symptoms. For example, a fever may not be a reliable indicator of COVID-19 in this population.
An older person may become less active, seem more withdrawn, talk or communicate less, and/or eat and drink less than they normally do. This may lead quickly to dehydration.
Many elderly people present to the ER only after having a fall at home or in their care facility, so it’s best to monitor their symptoms closely.
Not sure? Call your doctor’s office
Being diagnosed with COVID-19 and experiencing any symptoms can be unsettling. If you aren’t sure how severe your condition is, you can get advice and recommendations from your primary care provider’s office.
“Clinicians have become very familiar with the symptoms of COVID-19, so they can help you determine the best options for care,” says Benjamin.
If your symptoms are moderate but don’t need to be treated as an emergency, your physician may still want to evaluate you fully. From there, they can recommend medications or tips to help you feel better.
In many instances, patients can be evaluated through a virtual visit, which can save you a trip to your doctor’s office when you aren’t feeling well.
“The ability to evaluate patients virtually keeps them safe in their home environment. Patients with COVID-19 may not have the physical energy or the resources to come into the office, and during work hours, family or friends may not be able to bring them to their doctor’s office,” says Benjamin.
If you have a preferred LVHN physician, you may also be able to schedule a video appointment with them specifically (depending on the type of appointment and evaluation needed). If you are interested in this option, you should contact your physician’s office directly.