COVID evaluation available online

The three COVID-19 vaccines available in the United States are the Pfizer-BioNTech vaccine, Moderna vaccine, and Novavax vaccine. Both the Pfizer and Moderna vaccines are FDA approved for people 6 months and older, and the Novavax vaccine is available for individuals aged 12 years or older and is approved under the Emergency Use Authorization (EUA) Act.

The Moderna and Pfizer vaccines are mRNA vaccines The newest option, Novavax, is a monovalent recombinant protein vaccine and does not contain RNA particles. The Johnson & Johnson COVID-19 vaccine is no longer available in the United States.

Possible COVID-19 vaccine side effects may include:

• Pain, swelling, or redness at the injection site

• Swollen lymph nodes in the armpit

• Joint or muscle pain

• Headache

• Tiredness

• Nausea and vomiting

• Fever and chills

• Myocarditis or pericarditis (very rare)

• Anaphylaxis (extremely rare)

Side effects after vaccination should go away in a few days. Most people experience no side effects. The coronavirus vaccines are generally considered safe, and allergic reactions are rare. Everyone who receives a COVID-19 vaccine should be monitored for 15 minutes by medical personnel after the vaccine is administered.

A COVID-19 vaccine card is usually provided tovaccine recipients, which serves as a record to keep track of vaccination information.

COVID-19 medications include Pfizer’s Paxlovid (nirmatrelvir/ritonavir) and Merck’s Lagevrio (molnupiravir). At this time, Paxlovid is approved by the FDA for use in people with mild to moderate COVID who are at high risk of complications from the infection. Lagevrio is approved under the emergency use authorization (EUA) Act from the FDA for the same indication as Paxlovid. COVID-19 medication can help prevent severe illness in high-risk patients to help keep them out of the hospital. These medications are not helpful for people with COVID infection who are at low risk of complications and are not helpful for anyone who is beyond five days from onset of their symptoms.

These antiviral medications are for people who have recently experienced mild to moderate COVID-19 symptoms and are considered part of high-risk groups. These pills can reduce the risk of the illness progressing to severe disease, leading to hospitalization, respiratory failure, and even death

• The Pfizer COVID medication, Paxlovid, is three pills taken twice daily for 5 days and must be started within 5 days of onset of COVID symptoms. Each carton contains 30 tablets divided in 5 daily-dose blister cards. If you have chronic kidney disease, it is important to discuss this with your doctor, who may recommend a lower dose of Paxlovid for you.

• The Merck COVID medication, Lagevrio, is four capsules taken twice a day for 5 days. Similar to Paxlovid, it is also intended to be started within 5 days of the onset of mild to moderate COVID symptoms and is only intended for people at high risk of complications from COVID. Lagevrio does not require dose adjustment for people with chronic kidney disease and has fewer potential medication interactions than Paxlovid.

There are no oral medications designed to be taken at home for people with severe COVID illness, including great difficulty breathing, persistent high fever, or persistent low oxygen levels. People with severe COVID are best cared for in a hospital.

The COVID-19 oral medications works by disrupting the function of the SARS-CoV-2 virus. The Pfizer COVID-19 pill works by blocking a step in the SARS-CoV-2 replication process, preventing viral RNA from replicating. The Merck COVID-19 pill creates mutations in the coronavirus’s genetic code while it replicates; eventually, the coronavirus will have too many mutations to function, causing the virus to die.

Side effects of the COVID-19 pills depend on the specific medication. Paxlovid in particular has a significant number of drug interactions between it and other common medications. This is one reason why it’s important to have a thorough discussion with your physician about your medical history and all current medications you are taking if you are considering a prescription for COVID pills.

The current supply of both oral COVID treatments is pretty good in local pharmacies, but it is difficult for your doctor to know if your insurance will cover the full cost of your medication. Patients are advised to call or go online to their insurance company’s website to check this.

Due to a lack of scientific data at this time, PlushCare physicians do not prescribe ivermectin, hydroxychloroquine, or azithromycin/other antibiotics to treat COVID-19.

According to the Centers for Disease Control and Prevention (CDC), COVID-19 symptoms may include:

• Fever or chills

• Cough

• Shortness of breath

• Muscle or body aches

• Fatigue

• New loss of taste and smell

• Headache

• Sore throat

• Congestion or runny nose

• Pink eye

• Nausea

• Vomiting

• Diarrhea

This does not include all possible symptoms. COVID-19 symptoms can range from mild to severe. If someone experiences any of the emergency warning signs of COVID-19, they should get emergency medication attention immediately. These serious symptoms may include: difficulty breathing, inability to wake or stay awake, chest pain, or pale, gray, or blue-colored skin or lips.

It is important to note that COVID has some of the same symptoms as the flu, common cold, allergies and sinusitis. The only way to confirm a COVID-19 diagnosis is by taking a COVID-19 test.

Over the years COVID symptoms have changed, and it is less common to experience severe fatigue, loss of smell or taste or high fever. COVID can look like any other common cold or flu bug, or even like mild allergy symptoms, which is one reason why it persists. Many people don’t realize that their annual sinusitis or bronchitis is caused by COVID this year. For this reason, our doctors always recommend an at-home COVID test if there are any signs of an upper respiratory infection.

COVID-19 can affect people of all age groups, including children. Children are also at risk of contracting mild to severe COVID-19 illness. While COVID-19 symptoms in children typically appear in a milder and more cold-like form than in adults, there is still a potential for long-term COVID effects in children. Children are also more likely than adults to develop pink eye (conjunctivitis) with their COVID infection.

Some people may experience long COVID, also called long-haul COVID, which means having COVID-19 symptoms or related health problems for more than one month after initially recovering from a COVID illness. The long-term effects of COVID-19 can vary, and are still being studied in clinical trials in order to better understand them.

Possible long-term effects or symptoms after initially recovering from the coronavirus disease may include:

• Fatigue

• Cough

• Shortness of breath

• Joint pain

• Chest pain

• Difficulty concentrating

• Rapid heartbeat

• Headaches

• Depression or anxiety 

• Loss of taste or smell

• Intermittent fever

Mental health struggles after moderate and severe cases of COVID-19 can be especially challenging for patients who were hospitalized.

A rare yet serious COVID complication which may affect people, primarily children, is multisystem inflammatory syndrome. This causes inflammation in different areas of the body and may potentially lead to severe heart damage, requiring special care from a pediatric cardiologist.

Some larger hospital systems have developed special clinics to support people recovering from long-haul COVID.

While complications of COVID-19 are still being investigated, healthcare providers can help to treat long-term COVID effects by examining each specific symptom. Treatments that may be able to help with ongoing care and recovery include breathing exercises, medications to help reduce symptoms, and specialized physical therapy.

Our board-certified primary care physicians can help discuss your long COVID symptoms and discuss potential treatments. Often, in-person evaluation is required to accurately evaluate symptoms, and our doctors can help provide referrals to appropriate specialist care when needed. Our doctors are rarely able to establish a new diagnosis of long COVID or provide disability determination through online evaluation.