what is covid 19 shortness of breath?
March 18, 2020 4:59 PM   Subscribe

What does "Shortness of breath" means as a Covid 19 symptom specifically?

Years ago I was dx with asthma. I never used the inhaler i was prescribed to "use as needed" bc I never really needed it. About a week ago I started feeling some chest tightness, occasional stabs of chest pain and a sensation of having to take deep breaths so I got a new inhaler Rx for the first time in a decade. It's still in the bag (i have never used one.)
But I am not sure whether to regard my symptom as corona related. I keep feeling like I need to take very deep breaths, like I can't quite breath normally without thinking about it. I have some chest pains now and then. At the same time I'm able to go for a brisk walk with no problem.
I have no fever or cough. The breathing thing has been happening on and off for days.
My doctor is not answering phone calls, I've left messages and I'm obviously triaged.
TLDR: What exactly do they mean by "shortness of breath" for Covid 19 symptom?
posted by nantucket to Health & Fitness (23 answers total) 8 users marked this as a favorite
Wow, I'm having the *same* symptoms and was wondering the same thing myself, also was diagnosed with asthma and have an inhaler that I never need to use but have needed to every morning all the sudden. Also no fever, etc - but tons of fatigue and I do get somewhat winded just walking around. I told my doctor over the phone and they didn't seem concerned and told me to monitor for a fever; if temperature is normal then I'm clear.

I'm thinking it's either some other bug, weather changes, or I have like, a touch of COVID? Is that possible? I'll be watching this thread.
posted by windbox at 5:17 PM on March 18, 2020 [1 favorite]

This is also a very common symptom of simple anxiety or panic. So consider that possibility, especially if ther are no other symptoms.

Resources on "overbreathing," or aka hyperventilation, may help.
posted by Miko at 5:20 PM on March 18, 2020 [39 favorites]

I keep feeling like I need to take very deep breaths, like I can't quite breath normally without thinking about it. I have some chest pains now and then. At the same time I'm able to go for a brisk walk with no problem.

I don't have asthma, but I did have pneumonia a couple years ago. I got winded unloading the washing machine. And it wasn't just "hoo boy, I'm tired!" -- it was "holy shit, I can't breathe normally doing this totally mundane task." I was doubled over with exhaustion from doing laundry due to my breathing issues. It took me by surprise and was scary, and I'm using it as my personal benchmark during this pandemic because I have lately had some minor anxiety or acid reflux that's messed with my breathing and I have needed to walk myself back from "is this a coronavirus symptom???"

Being able to take a brisk walk with no problem sounds like a good sign to me. But I'm not a doctor and I only have my own prior experience to go on.
posted by phatkitten at 5:25 PM on March 18, 2020 [12 favorites]

According to the CDC description of symptoms: "If you think you have been exposed to COVID-19 and develop a fever and symptoms, such as cough or difficulty breathing, call your healthcare provider for medical advice," (emphasis mine) and there are additional descriptions of emergency warning signs included on the CDC page that cause me some concern based on what you have written here. I'm hoping that your area has a Covid-19 hotline that you can call with a description of your symptoms and pre-existing condition.

I'm not a doctor nor any kind of medical professional nor scientist, but as to the fever issue, I read this recently: "In one study, even among patients who required hospital admission for treatment of COVID-19, fewer than half (44%) had fevers at the time of presentation. This makes it difficult to identify patients in the community by way of routine screening measures." via Highlights of Expert Panel on COVID-19 from Harvard, MIT, Mass General Hospital (Dr. Melissa Bender, Just Security, Mar. 15, 2020).

According to AARP: This Is What a Coronavirus Infection Feels Like
Pain in the chest typically warrants an emergency department visit, no matter the illness in question, Wadman says. The same goes for progressive or sudden onset of shortness of breath or any sudden change in mental functioning. Fever and cough, however, may be managed at home or with a trip to the doctor’s office.
According to Johns Hopkins: Coronavirus (COVID-19): What Do I Do If I Feel Sick?
If your symptoms are severe or you feel like you need medical care, call before you go to a doctor’s office, urgent care center or emergency room. Describe your symptoms over the phone.
posted by katra at 5:26 PM on March 18, 2020 [1 favorite]

I’ve been playing “asthma or anxiety” for two weekS. I take a hot streamy shower or breathe through a hot cloth. I did get over bronchitis last week and did need my nebulizer.

So for me, at least, if I could think and my chest hurt, it was anxiety. If my brain function was super fuzzy, it was asthma.

After my asthma treatment I’d also take a hot shower but it helped. I tapered off the other day; if after a couple days I’d not improved I’d have called the doc.
posted by tilde at 5:26 PM on March 18, 2020 [4 favorites]

I’ve never had Covid-19 unless I do now, but I have had pneumonia 9 times, bilateral pneumonia twice, and asthma, and my understanding is that Covid-19 results in bilateral pneumonia. For me, the points at which the pneumonias went from “sick” to “get to doctor/hospital” were always hallmarked by realizing I was doing calculus like “if I have my tea without milk, I don’t have to rise from my chair and get all the way to the fridge.” That is, it wasn’t just a sense of breath being harder to draw (that too, but I got that from bronchitis or sore muscles and also have had it for anxiety) but not having access to the general strength of breath.

I don’t know if that helps. I’ve got symptoms consistent w/ Covid-19 but my province doesn’t recommend a test yet, so I’m self-monitoring and we’re all self-isolating. I just carried a laundry basket up the stairs and it went fine, so that’s a good enough measure for me.
posted by warriorqueen at 5:27 PM on March 18, 2020 [16 favorites]

'm hoping that your area has a Covid-19 hotline that you can call with a description of your symptoms and pre-existing condition.

Yup, being put on hold for hours and cut off from the seemingly amazing high tech hotline/nurse line in my area, then the same for the tech helpline for the medline ... when you call your own doctor, a "triage manager" tells you you're not "in crisis" so you are not able to communicate with the doctor... and this is an area that supposedly has few cases. Just a heads up to others: not unsurprisingly, systems are overwhelmed..
posted by nantucket at 5:44 PM on March 18, 2020 [2 favorites]

Pulse oximeters are not particularly expensive, may be acquired in any drugstore, and may give you either peace of mind or hard data to throw at a screener.
posted by praemunire at 5:54 PM on March 18, 2020 [6 favorites]

IANAD Do you have a thermometer? Fever is an indicator; take your temp. I have asthma, currently flared up, so I have a cough, but no fever or infection. There are almost certainly 'How to Use an Inhaler' videos on youtube. If you have access to a drugstore, try some menthol cough drops; menthol opens your lungs. A hot steamy shower or bath helps.

Stress can definitely give you that chest tightness, and a bath or shower will help that, too.
posted by theora55 at 5:58 PM on March 18, 2020 [1 favorite]

It sounds like you are experiencing symptoms of shortness of breath, SOB. You have an inhaler. Why not try it and see if it helps?

You may or may not have Covid 19, but the symptom of SOB is something that might be improved with the inhaler, whatever the cause. Using the inhaler can help your symptom, and inhalers were never a substitute for a diagnosis. You should probably be tested for Covid 19. I don't see a conflict - You can do both.
posted by citygirl at 6:07 PM on March 18, 2020 [7 favorites]

I've been experiencing pretty much what you describe and I'm fairly sure that it's run-of-the-mill postinfectious cough and not COVID-19. I say that partly because a lot of people were reporting similar bugs weeks before there was any documented or even suspected spread outside Asia (I'm in the US, and came down with the flulike thing over 4 weeks ago) and partly because I had the same symptoms last year following a diagnosed flu.

Postinfectious cough persists after other symptoms disappear and can last for weeks. It is essentially an irritation of the bronchial passages, and feels subjectively like a tightening of the chest, sometimes enough to interfere with sleep or feel scary; or, if you're an asthmatic, it feels something like an asthma attack only without the wheezing. I have a peak flow meter and using it has provided some reassurance, as despite the discomfort I'm not losing much oxygen volume (peak flow meters register how much volume you can exhale). Which is why, like you, I've been able to walk up hills and such without being out of breath despite my chest feeling crappy.

That said, even if what you and I have isn't COVID-19, the scary things are that (1) we probably still can't get tested to rule it out, and (2) my assumption is that having irritated bronchial passages could add to the impact of COVID-19 on the respiratory system. I.e. very important to try not to get another infection. Time is the only real healer of postinfectious cough, but prescribed short-acting asthma inhalers and Advair (fluticasone + salmeterol) may help. I find that OTC guaifenesin (Mucinex etc.), lots of fluid, and warm humid air are relieving and help loosen phleghm and tightness. And needless to say if your symptoms get worse try to get immediate help.
posted by Creosote at 6:12 PM on March 18, 2020 [5 favorites]

In one study, even among patients who required hospital admission for treatment of COVID-19, fewer than half (44%) had fevers at the time of presentation.

The report that citation quotes is from 1,099 patients from 552 hospitals – that's two people per hospital. Contrariwise, the WHO report that came from 56,000 lab-tested individuals had 88% with fever.

I am not saying OP shouldn't go to the hospital. But should they decide to do so, but hit multiple roadblocks while attempting due to the existing overloaded system, I would personally watch for a fever, while trying to treat the shortness of breath through the inhaler they reference and/or calming techniques. It is a very, very anxious time.
posted by WCityMike at 6:24 PM on March 18, 2020 [2 favorites]

This is a bit orthogonal to your question, but given that we are moving into a world where healthcare professionals and facilities will be swamped: if you have an inhaler that you might potentially really need at some point but have never used before, I would suggest you get a spacer for it. A spacer is basically a tube that functions as a holding chamber for the inhaler's spray that makes it easier to breathe the medicine in fully vs getting it on your tongue or whatever. I've read that a lot of people don't use inhalers correctly and that ends up making them much less effective (I've definitely experienced this when using one for my occasional asthma.) Spacers can be bought fairly cheaply and make inhalers more foolproof. I recently ordered this model (just the tube, not the mask) from a company on ebay for $16 shipped.
posted by needs more cowbell at 6:36 PM on March 18, 2020 [5 favorites]

my understanding is that Covid-19 results in bilateral pneumonia.

What Does the Coronavirus Do to the Body? (NYT)
The swelling and the impaired flow of oxygen can cause those areas in the lungs to fill with fluid, pus and dead cells. Pneumonia, an infection in the lung, can occur.

Some people have so much trouble breathing they need to be put on a ventilator. In the worst cases, known as Acute Respiratory Distress Syndrome, the lungs fill with so much fluid that no amount of breathing support can help, and the patient dies.
Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19) (CDC, Mar. 7, 2020)
Clinical presentation among reported cases of COVID-19 varies in severity from asymptomatic infection to mild illness to severe or fatal illness. Some reports suggest the potential for clinical deterioration during the second week of illness.[2,5] In one report, among patients with confirmed COVID-19 and pneumonia, just over half of patients developed dyspnea a median of 8 days after illness onset (range: 5–13 days). [2] In another report, the mean time from illness onset to hospital admission with pneumonia was 9 days.[1] Acute respiratory distress syndrome (ARDS) developed in 17–29% of hospitalized patients, and secondary infection developed in 10%. [2,4] In one report, the median time from symptom onset to ARDS was 8 days.[3]
Just a heads up to others: not unsurprisingly, systems are overwhelmed..

I was worried about that, and it is part of why I included sources that offered additional information, including the suggestion to call an urgent care or emergency room to report your symptoms. I realize that they are also getting overwhelmed, but they may also have additional resources for triage available and can at least create a record of your call for future reference. I'm just trying to share resources from credible sources that offer more context than the pull quotes I include, and I encourage you to obtain medical advice if at all possible.
posted by katra at 6:50 PM on March 18, 2020 [1 favorite]

Why not try your inhaler first before calling a hotline and waiting for hours or risking exposure to a deadly global pandemic at a doctor's office? If it helps, it's asthma. I have both anxiety and mild asthma so what you're describing is familiar to me. It can be hard to suddenly notice these things with coronavirus sweeping the globe, but what you're describing is very common and has a number of explanations that aren't serious at all.

Try the inhaler.
posted by Amy93 at 6:55 PM on March 18, 2020 [2 favorites]

when you call your own doctor, a "triage manager" tells you you're not "in crisis"

This seems like your answer.
posted by Miko at 6:57 PM on March 18, 2020 [2 favorites]

Try the inhaler that you were prescribed for asthma first, I'd say. Secondly, follow the recommendation of professionals which is, you're not in crisis. It's useful to remember that the vast majority of people don't have COVID-19 at the moment, and if you do catch it, the vast majority of people only have relatively minor symptoms, much like you're describing now.

If you're not in medical crisis, I'd self isolate and definitely stay away from surgeries and hospitals where you risk either catching an infection you may not currently have, or infecting others if you do have it.
posted by smoke at 7:11 PM on March 18, 2020 [6 favorites]

IANAD but seconding the anxiety thing - once you start thinking about your breathing it can screw with you, and make it seem like things are wrong when they aren’t.

Do you have access to any anti anxiety drugs? If you otherwise feel fine, perhaps try that. If you suddenly feel fine, then it’s anxiety.

I think if you were having Covid 19 symptoms you’d know it. The brisk walk with no trouble makes me think anxiety.
posted by christiehawk at 1:15 AM on March 19, 2020

But I am not sure whether to regard my symptom as corona related. I keep feeling like I need to take very deep breaths, like I can't quite breath normally without thinking about it. I have some chest pains now and then. At the same time I'm able to go for a brisk walk with no problem.

This sounds like anxiety. Shortness of breath is more like: climbing a flight of stairs makes you pant, even gently. Mopping the floor, same thing. Walking at anything above a slow pace, same thing.
posted by DarlingBri at 3:24 AM on March 19, 2020 [1 favorite]

Use. Your. Inhaler. Like, now. And keep using it as prescribed.

The feelings you've described are what I tell my husband when I'm having an asthma flare-up. I'm not saying that's what's happening to you, just that it sounds like what happens to me.

And then if you use your inhaler for a little while and things don't get better, you have more information to give to the triage person ("I used my rescue inhaler for X amount of time and I don't feel any improvement.") when you call again.
posted by cooker girl at 6:50 AM on March 19, 2020 [1 favorite]

A young woman with coronavirus started a Twitter Thread where she described her symptoms on a daily basis (link here does not go to Twitter, but to another site's threadroll of her thread). She described the shortness of breath as "like rocks on my chest".
posted by EmpressCallipygos at 7:54 AM on March 19, 2020 [1 favorite]

I'd have a more than usual tightness in my chest recently as well, and in my case it's likely seasonal allergies, and is relieved by my inhaler. But anxiety is real, and is really expressed through the body. My son is immunosuppressed and whenever I think about that for too long my chest tightens up too.
posted by jokeefe at 1:10 PM on March 19, 2020

Update: the inhaler did relieve much of the shortness of breath so I'm thinking it was mild asthma. (Anxiety probably doesn't help either). I marked as best answer those that suggested the inhaler, because that seems to have solved my question, but everyone's ideas were helpful and I appreciate it. Thanks to all who answered.
Health and easy breathing to everyone...
posted by nantucket at 1:43 PM on March 19, 2020 [3 favorites]

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