When Do You Need to Go to the ER for COVID-19?
Key takeaways:
Most people with COVID-19 infection do not need to go to the hospital and will have a smooth recovery at home.
Severe COVID symptoms that need medical attention include difficulty breathing, confusion or disorientation, and a bluish discoloration in the lips or hands.
In the emergency room, providers can check your vital signs and run some tests to see if it’s safe for you to go home or if you need to stay in the hospital.
Most people with COVID-19 infection never have to see a provider throughout the course of their illness. But, in a world of self-testing and telehealth appointments, it’s totally normal to wonder if you’re OK at home. And it can be scary to know that COVID can still lead to severe problems. We’re here to help you know when it’s time to get help.
What are the symptoms of severe COVID-19?
COVID infection can make you feel very sick, even when you’re OK and not in any real danger. But it can be hard to know when it’s time to get medical attention.
So it’s important to remember that COVID can cause severe symptoms, like difficulty breathing, and cause oxygen levels in your body to be dangerously low. And if this happens, you need medical attention and supplemental oxygen fast.
Your oxygen level might be low if you:
Feel like you’re working very hard to breathe
Feel like you can’t catch your breath
Experience severe chest pain or tightness
Have a bluish or dusky discoloration of your skin, lips, or nail beds
Seem confused or disoriented
Are having difficulty staying awake
If you’re used to feeling shortness of breath from an underlying condition, like asthma or COPD, you’ll want to be extra vigilant if you get COVID infection. Pay attention to any symptoms that seem worse than your baseline.
What if you have risk factors for severe disease?
Certain conditions put you at greater risk for developing severe COVID infection compared to the average population. These include:
Age over 65 years old
Obesity
You’re also at greater risk for severe COVID if you have:
Received an organ transplant
Had any illness requiring steroids or immunosuppressive medications
Not been vaccinated against COVID
If any of the above apply to you, there are a few extra things you can do to look out for signs or symptoms of a more severe disease:
Stay in tune with your body. Take note of how you feel day to day so you can sense if your symptoms are worsening.
When in doubt, see a healthcare provider. Don’t wait until you feel really sick. If you’re wondering if you’re OK, reach out to your healthcare provider to discuss your symptoms. Your healthcare provider can also help you decide if you need to be seen right away in an emergency room (ER).
Consider getting a pulse oximeter. This is a little device that you put on your finger to measure your oxygen levels. If that reading consistently drops under 90%, it’s time to go to the ER.
What happens if you go to the ER for COVID-19?
When you go to the ER, one of the most important parts of your evaluation will be checking your vital signs. These include your:
Oxygen level (sometimes called “pulse ox”)
Breathing rate
Heart rate
Blood pressure
Depending on your vital signs and physical exam, your provider may also run some additional tests to see how the virus is affecting your body. These tests may include:
X-ray of your lungs to look for signs of pneumonia or fluid
CT scan of your chest to look at the lungs in greater detail, or to check for blood clots
EKG of your heart to look for signs of stress or strain on the heart
Blood tests to check your blood counts, kidney function, and electrolytes
After these tests, you and your provider will discuss if you’re safe to continue recovering at home or if you should stay in the hospital for closer monitoring.
What happens when you are admitted to the hospital?
Your provider in the ER will probably recommend you stay in the hospital if:
You are struggling to breathe.
Your oxygen levels are low.
You are struggling to stay hydrated or keep fluids down.
You have any changes in how alert or sleepy you are, or how coherent you seem.
You have a medical condition that makes it more likely that your infection will worsen. In the hospital, a healthcare provider can monitor you and your symptoms more closely.
In addition to close monitoring, you can get helpful COVID treatments in the hospital. Every person is different and has different needs. But some treatment options include:
Oxygen, like through nasal prongs or a mask
Intravenous (IV) fluids to keep you well hydrated
Steroids, if you have underlying lung conditions
Antiviral medications, like remdesivir
Biologic medications, like vilobelimab or tocilizumab
Anti-inflammatory medications, like baricitinib or anakinra
Keep in mind that getting admitted to the hospital doesn’t mean that you will definitely have COVID-related complications. Hospitalization is often to prevent that from happening. And if it does, your provider can treat the issue right away.
The bottom line
If you get COVID-19 infection, it can be scary to think of the potential complications. The good news is that most people have mild to moderate disease and make a full recovery at home. But it’s still important to know the signs and symptoms of a more severe infection — especially so you know if you or a loved one should get checked out in the emergency room. And when in doubt, get medical attention for your symptoms.
References
Centers for Disease Control and Prevention. (2022). COVID-19: Understanding risk.
Centers for Disease Control and Prevention. (2023). People who are immunocompromised.
Centers for Disease Control and Prevention. (2023). Underlying medical conditions associated with higher risk for severe COVID-19: Information for healthcare professionals.