Q. I have chills, breathing problems and cough with white phlegm. Could it be Coronavirus infection?

Answered by
Dr. Shyam Kalyan N
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Mar 22, 2020

Hello doctor,

Last night I was getting chills, feeling more cold than usual and lightheaded and a lot of burping. Maybe like every 30 minutes or less or so feel more chills running down my body and chest feeling bit weird like I am starting having trouble breathing then goes back to normal and repeats, with weird feeling like chills down my left and right lungs or left and right upper chest. Also, my heart was pumping fast. Also, some minor coughs were there since seven days ago, still here. I have white mucus and have not gotten yellow yet.

I took medicines yesterday but today I got severe cold and flu medicine with a pain reliever, the chills did not go away. Then today, I called the doctor on the phone and told him what happen last night and the same thing happened this morning too. I had minor coughs, feeling lightheaded, feel like maybe cannot breathe or something, and a lot of burping. I told him the burping issue was going on for at least two years, but somehow this time I am feeling lightheaded. He just gives Pepcid, a try maybe GERD. I ate that today still feeling chills now and still burping a lot.

Right now, still some chills on arms, with breathing issue or something makes my chest feel weird and arm sometimes. So, should I be worried? I do not think I have a fever now but do not feel hot on the forehead? Was it GERD or flu, it is Coronavirus or something else? I hope it is not Coronavirus.

I am 21 years old and weigh around 110-115 kg.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
#

Hello,

Welcome to icliniq.com.

Please answer the following:

Any travel history in the last one month? Any use of airports? Any fever, have you checked the temperature? Any cough? Any mucus or phlegm? How is your sleep? Is there any malaise or body aches or weakness?


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Thank you doctor,

I travel to school, nearby grocery stores in the bus. No airport exposure. I have not checked the temperature. I do not feel hot or anything. I have minor coughs and sore throat. Yes, I have mucus which seems white or clear for now.

During sleep, I do not have much aches. Last night I have not got much sleep, probably because I was thinking about stuff being worried, but got some sleep though.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
#

Hi,

Welcome back to icliniq.com.

Most probably with the history it does not appear like a severe problem or Coronavirus infection. Is sore throat severe and does the pain last the whole day? Do you smoke or drink?

Can you try taking Sudafed, Tylenol, and Zyrtec and try getting sleep for a few days? I am sure that will make you feel better.

Avoid exposure to smoke dust and cold winds. Keep the AC to a minimum or use ceiling fan instead. Drink plenty of water and warm fluids. Avoid eating out, partying. Avoid unnecessary travel.

You need not quarantine yourself in the strictest manner but some amount of restrictions in interacting and meeting with the community is advised.

Lastly, where are you currently? Your place of residence and country? Is it a Corona endemic country? Did you talk to or interact with any known or suspected flu patient?

Can you please take a picture of the back of the throat with open mouth showing details of the tonsils and pharyngeal wall and send it to me?


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Thank you doctor,

I woke up this morning, I had trouble sleeping being worried, but I got some sleep then nearby phone ringing woke me up.

So far, seems no one got any severe coughs or pain so far. I only hear minor coughs the past week or so. Thanks for those medicine recommendations for sleep. I fall asleep quicker, usually, it takes me around one hour to fall asleep on most days.

I will try to avoid smoking as much as possible. Yes, I will be staying inside since many places are on lockdown. And school is online. I recently turned on the air purifier to clean up some air for allergies possible viruses but makes me cold. I might not need AC unless really hot.

I will be staying home for the next month at least. My chills right now are feeling a bit better, but a little sick only because maybe I did not get enough sleep.

I stay in San Francisco CA, United States, and there are close to 40 confirmed cases around here. No severe reports near my district, and have not heard anyone in serious condition.

So, last week I have a sore throat and tonsil pain while swallowing for a few days, then one day drank a lot of honey and water and some tea, then it got better. Not sure if it got smaller, but the pain was less now though. Between my tonsils in the middle (behind the tongue) looks like my throat, got some red stuff, maybe looks like inflamed or rashes. Any recommendations? Any foods or drinks that can help?

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
#

Hi,

Welcome back to icliniq.com.

You have got it right. Follow all the precautions. You will be alright soon. Try getting a good sleep tonight.

I heard about the cases in SF. My brother was supposed to fly there from India for work but his meeting got canceled in the wake of the virus.

Yes, your camera has not done a decent job this time around. It has not focussed on our area of interest. (attachment removed to protect patient identity). But yours has picked up the two big bumps in the back of the throat (enlarged tonsils).

The tonsils could be enlarged due to the current infection and sore throat problem you are having. Once the problem is resolved they should get back to their normal size, which I guess, in you, must be slightly big. The pharyngeal wall between the tonsils could be having some granular bumps which are quite common during an infection.

Now you do not worry, for most such infections are due to viruses (not Corona). They usually get better with time and supportive treatment. Traditional Indian forms of medicine advise honey and hot water. Tea makes a good addition I guess. Sudafed and Zyrtec appropriate for your weight will help additionally. Tylenol every time you got pain will help you tide over this period wonderfully.

Now watch for some warning symptoms fever, increased pain, thick mucus, thick postnasal drip, severe malaise, swelling in the neck, etc. In such cases promptly revert to me. You may need a Z pack then.


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Thank you doctor,

As of now 12:40 PM I am breathing harder than usual since 30 minutes ago. I only ate some breakfast and drank water.

Here is my story: Before Feb 28th - no issues at all, besides always burping a lot, sometimes bloating, no coughs, tonsil was enlarged for a while, no lightheadedness, no breathing problems, not sick.

Friday February 28th - I woke up feeling unwell, drank water went back to bed, came back out super lightheaded about to faint, lied on bed for an hour, came out stomach feeling weird, even more lightheaded about to faint, can barely even eat a little noodles and two small pieces of spam, vomited it, then four more times which as water or acid. Hours later was better.

Saturday February 29th - diarrhea

Sunday March 1st - diarrhea

Monday March 2 - diarrhea

Tuesday March 3 - diarrhea

Wednesday March 4 - No stool

Thursday March 3 - No more diarrhea

Friday March 4th - Monday March 9th - no issues

Monday March 9th - feeling better, no problems, enlarged tonsil, no coughs really.

Sunday march 15 - no problems besides burping, minor coughs, some sore throat

Afternoon I ate chicken, burping a lot, stomach uncomfortable, felt like breathing problems, chills on hands, chest and left and right side, felt like could not breathe. 20 minutes later, still chills breathing a bit better, lightheaded kind of feel like fainting, then went to bed for 15 minutes (the breathing problem and weird chest feeling comes back randomly), ate tums, then later I drank cough and flu medicine.

On Monday march 16 - woke up around 11:30 AM, feeling breathing problems, chills around body, lightheaded again, chest feeling weird, burping a lot, and I described my story to doctor he said it sounds like you ate something bad, does sound like GERD, of course we do not know for sure unless lab tests maybe on stool. He asked have you tried stronger antacids like Pepcid or Zantac?

I said no. Then doctor asked me to try Pepcid and tell me how it goes.

Tuesday and Wednesday March 16/17 - feeling better, no lightheadedness, no more chills, minor coughs, sore throat, burping a lot, no breathing problems so far. Pepcid no problems so far besides making me burp almost all day.

Wednesday night still coughing a lot and drank severe cold and flu medicine.

Thursday march 21 I woke up fine, then once ate Pepcid and drank some water, heart rate was going really fast, started to make worried, called doctor office they said can you count your beats per minute, then I counted, my phone was showing my heart rating going to 120 bpm, when I counted to them was not 120 bpm, then they told me to call back if it gets worse. Then shortly after, I drank some water and ate a little bit of breakfast. My heart rate started to drop slowly and was getting better after that.

Friday march 20- 10 AM I woke up with some chest pains (chest area above the stomach), then some coughing and feeling a little sick, little lightheaded, heart beating fast, breathing harder, felt of shortness of breath. Drank some water and breathe harder, a little bit of mucus.

15-20 minutes later no more chest pains, still breathing harder.

11 AM - still breathing a little bit harder than usual, coughing would make me breathe even harder. Better now, but still breathing a little harder than usual.

11:30 AM moving makes me breathe harder, sat in bed.

11:58 AM - feeling a bit better

12:10 - feeling like breathing a harder than usual.

After an hour later, feeling better now which is strange. Not sure if its heart problems, acid reflux, chest issues, or esophagus.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
#

Hello,

Welcome back to icliniq.com.

Always Protonix is better than Zantac. Try using Protonix (Pantoprazole). Do not lie down immediately after consuming meals. Do not drink a lot of water after a meal. Avoid spicy and oily foods.


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Thank you doctor,

I went to the store to look for Zantac they did not have it, so I talked to the pharmacy they said sounds like could be some weird chest tightening and the doctor said since Pepcid and Zantac are the same. He said to try Ranitidine.

Right now I tried Pepcid again like now, for the first five to ten minutes I think it means me feel more nervous or anxiety or something, I tried to calm myself by putting fingers on teeth. Then I think now it did not cause my heart to beat super fast this time which was strange. Even water makes my heart beat a little faster. Should I stick with Pepcid? Finish the entire bottle? I think it has 20-30 pieces.

I used to lie down after a meal a few years ago like I get hungry before I go to bed then I started eating snacks and lying down. Sometimes I starve myself. Sometimes I wake up with acid feeling in my mouth.

I don't know why I woke up this morning with chest pain, like the middle area right above the stomach and felt like I had breathing problems, breathing harder than usual, drank water and barely could eat breakfast (lasted for at least 30 minutes+). I then waited a bit after 10 minutes, drank hot water and ate breakfast, I started to breathe better again.

Could it be shortness or breath? May be blood pressure? Esophagus issue? Chest issue? Heart issue? I am having weird breathing. Should I be worried?

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
#

Hi,

Welcome back to icliniq.com.

You need to take Pantoprazole or any other proton pump inhibitor. Avoid heavy meals. The issue appears like a heartburn problem due to acidity only. It does not appear sinister.


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Thank you doctor,

I was trying to finish the bowl of food in one hour. I was eating veggies and rice, halfway through felt something like acid may be some pain in chest and throat. Feeling lightheaded so ate some meat to then coughed after.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
#

Hi,

Welcome back to icliniq.com.

Do not worry about it. Drink plenty of water but not immediately after a meal. Eat well cooked meats.


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Thank you doctor,

I really appreciate your help so much. I appreciate your time and effort to help me and give advice. Only thing I am worried is just the chest pains, breathing issues and esophagus and throat stuff. I will try to wait two to three hours after eating or drinking before bed now. I hope to get less chest issues when I wake up.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
#

Hi,

Welcome back to icliniq.com.

Do not worry so much. You will be absolutely alright. Give it some time. If you are not getting better we can do laryngoscopy and check if there is anything wrong with the larynx. Do you eat healthy food and do exercises?


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Yeah if it doesn't get better Laryngoscopy would be perfect. Okay, I'll give it some time Thank you!

I try to eat vegetables and fruits. I don't eat much junk food that much. I used to eat more junk years ago, but now mostly vegetables, fruits, meat (pork, chicken, beef, fish) usually not fried, and tried to eat whole wheat bread with fried chicken patty from the super market (for school lunch) since its cheap and its chicken (stopped now after acid problems), don't really eat french fries, pizza or drink soda etc...

Exercise, haven't been exercising these few months. I have been telling myself that, but then i haven't really been doing it. Used to a lot years ago, now barely.

Since high school, when i exercise running when i try to get air feels like throat is tight or chest is tight and air is trying to squeeze its way through. After this point High school until college feels like i'm not breathing enough air. When i was younger (Elementary/middle school) felt like i gotten a lot more air then now through my throat and air doesn't squeezes through.
One doctor just used stethoscope for heart and lungs, told me to breathe hasn't said much about it. Then another doctor said, sounds you are not breathing that much, feels like not getting another air (in high school, like 4-6 years ago maybe), they didn't do much about it.

So, when i try to breath regularly, seems like not much air comes out through mouth even before acid reflux,.That's why recent breathing problems kinda worry me, but anyways yeah like that.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
# I guess you are in the right track. With regards to food diet and exercise.

Restart doing your exercise. Keep yourself active. Try having more than three meals a day but keep the quantity of each meal less than the usual. That way you eat more frequently but without putting weight or adding unnecessary calories.

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Sorry, that I ask alot of questions. Thank you for your help though.

I didn't drink a lot of water yesterday. I usually drink at least 1100 ML a day my urine is usually yellow. Don't eat alot.

I woke up with no. chest pain this morning somehow... strange? Not too much breathing problems, but a slight breathing problem with coughing and a feel bit sick, Heart was beating fast without medicine, but that was not as fast as Wednesday morning once I woke up. I tried to get up slowly then drink a bit of water, wasn't really that light headed, a little cold.

Last night, I ate bigger meal around 9 PM - 12 PM around that time, Then around 3AM started to feel bit hungry and really cold. Maybe was about to feel bit lightheaded, Maybe because I was hungry or didn't get enough calories or protein idk? I tried not to eat since I have to wait another few hours before bed, then drank a little water, few sips.

Last night, I tried to sleep on my left side instead of my normal sleep, I usually sleep on my back. Woke up feel slight acid, sick kind of coughing, little sick, stomach minor pain. No chest pain today. (few days before slept on back, there wasn't much chest pain, strange that happened Wednesday...).

So avoid drinking too much water after a meal, maybe a tiny bit sip? 2-3 hours eating before bed, maybe 3 hours to be safe, but 3 hours sometimes might make me hungry if wait that long. Drink some honey for sore throat maybe, honey and something else, ill check again, what you said earlier for sore throat and coughing (Not sure If dried cough, but sick kind of coughing, with mucus coming out later).
Which side should I sleep, is there a difference on left side vs back vs right?

How much water? based on my calorie needs? I don't eat that much right now, should I I still drink at least 2000 ML a day, that is 8 cups of water even if I eat around 1000 calories? Not sure though.

You said exercise, like a time that im not eating right? 1 hour after meal? I think I just go walk around the house, can't outside really, due to the corona virus situation outside. Yeah I been losing weight this week, like 5 pounds probably... I usually just eat 1 bowl of food within an hour i'm slow before this breathing/acid situation, so slightly less than that and more meals, got it.

If I feel hungry during that night after waiting 3 hours before sleep, should I just hold the hunger and just sleep? If I can't sleep due to hunger, not sleepy or something, I should get up and wait until im sleepy? that might make me more hungry? Is it okay to drink tiny sips of water before bed, roughly 1 hour before bed?

What else should I do?

So drink water 1 hour after meal?

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
# Sorry, that I ask alot of questions. Thank you for your help though.

I didn't drink a lot of water yesterday. I usually drink at least 1100 ML a day my urine is usually yellow. Don't eat alot.

YOU MUST DRINK AT LEAST 5 LITERS OF WATER DAILY. 4 LITERS MINIMUM. YELLOW URINE IS A SIGN OF DEHYDRATION AND INSUFFICIENT WATER INTAKE.

I woke up with no. chest pain this morning somehow... strange? Not too much breathing problems, but a slight breathing problem with coughing and a feel bit sick, Heart was beating fast without medicine, but that was not as fast as Wednesday morning once I woke up. I tried to get up slowly then drink a bit of water, wasn't really that light headed, a little cold.

Last night, I ate bigger meal around 9 PM - 12 PM around that time, Then around 3AM started to feel bit hungry and really cold. Maybe was about to feel bit lightheaded, Maybe because I was hungry or didn't get enough calories or protein idk? I tried not to eat since I have to wait another few hours before bed, then drank a little water, few sips.

DO NOT EAT SO LATE AND GO TO BED IMMEDIATELY. EAT A LIGHT DINNER WITH LESS CALORIES, LESS PROTEINS, MORE GREENS AND FIBER AND MORE OF FRUITS AND VEGGIES. BECAUSE YOU ARE ANYWAYS GONNA SLEEP THERE AINT ANY NEED FOR EXCESS CALORIES AND PROTEINS. ON THE CONTRARY TRY HAVING A GOOD WHOLESOME PROTEIN AND CALORIES RICH MEAL FOR BREAKFAST.

Last night, I tried to sleep on my left side instead of my normal sleep, I usually sleep on my back. Woke up feel slight acid, sick kind of coughing, little sick, stomach minor pain. No chest pain today. (few days before slept on back, there wasn't much chest pain, strange that happened Wednesday...).

SLEEP AT A COMFORTABLE POSTURE AS DETERMINED BY YOU IN THE LONG RUN.

So avoid drinking too much water after a meal, maybe a tiny bit sip? YES
2-3 hours eating before bed, maybe 3 hours to be safe, but 3 hours sometimes might make me hungry if wait that long.
CAN HAVE A FRUIT THEN, SAY AN ORANGE OR AN APPLE BEFORE SLEEP
Drink some honey for sore throat maybe, honey and something else, ill check again, what you said earlier for sore throat and coughing (Not sure If dried cough, but sick kind of coughing, with mucus coming out later).
HONEY IN WARM WATER WITH A TINGE OF LEMON IS GOOD FOR SORE THROAT. CAN ADD A SMALL BIT OF GINGER ALSO.
Which side should I sleep, is there a difference on left side vs back vs right?
SLEEPING SIDEWAYS REDUCES SNORING AND MOUTH BREATHING. SOME FEEL BETTER THAT WAY AND SOME PREFER SLEEPING ON THEIR BACK. YOU SHOULD DECIDE. SLEEPING ON THE LEFT SIDE IS BETTER THAN RIGHT GENERALLY.

How much water? based on my calorie needs? I don't eat that much right now, should I I still drink at least 2000 ML a day, that is 8 cups of water even if I eat around 1000 calories? Not sure though.

DONT MIX UP CALORIES AND WATER INTAKE. TAKE 4 LITERS OF WATER DAILY. THIS IS INCLUSIVE OF PROTEIN SHAKES, MILK, COFEE ETC.

You said exercise, like a time that im not eating right? 1 hour after meal? I think I just go walk around the house, can't outside really, due to the corona virus situation outside. Yeah I been losing weight this week, like 5 pounds probably... I usually just eat 1 bowl of food within an hour i'm slow before this breathing/acid situation, so slightly less than that and more meals, got it. EXERCISE WHENEVER YOU FEEL CONVENIENT. IDEALLY FOR WEIGHT LOSS DO CARDIO IN EMPTY STOMACH. FOR BODY BUILDING USE PROTEIN SUPPLEMENTS AND EXERCISE AFTER A PRE-WORKOUT MEAL OF PROTEINS.

If I feel hungry during that night after waiting 3 hours before sleep, should I just hold the hunger and just sleep? HAVE A FRUIT. DRINK SOME CURD OR BUTTERMILK.

If I can't sleep due to hunger, not sleepy or something, I should get up and wait until im sleepy? DO NOT EVER WAIT FOR SLEEP TO COME. GO TO SLEEP AND CLOSE YOUR EYES. THINK OF SOME POSITIVE THOUGHTS. PLAY SOME MILD SOOTHING MUSIC. AND SLEEP WILL COME. that might make me more hungry? Is it okay to drink tiny sips of water before bed, roughly 1 hour before bed? ABSOLUTELY ALRIGHT TO DRINK SOME WATER BEFORE SLEEP. BUT NOT LIKE 500 ML AND IMMEDIATELY LIE DOWN. TAKE PLENTY OF SIPS OF WATER AS MUCH AS YOU FEEL BEFORE SLEEP.

What else should I do?

So drink water 1 hour after meal? SAY HALF HOUR TO 40 MINUTES AFTER A MEAL YOU CAN HAVE SOME WATER.

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Sounds good! Awesome! Appreciate your time and effort to help, this means a lot. Very patient and kind!

What does foamy urine mean? It has been like this for the past 2 years... And don't urinate as much as before. Could it mean I don't drink enough water, Kidney disease? liver? UTI? or something else?

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
# foamy urine is mostly due to the speed of urination and concentrated urine. drink plenty of water and do not rush while peeing. just let it out normally without putting pressure. then it wont form foam.

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I don't rush it, i don't urinate that much also very little comes out. Even if i drink more 1000 something ML. It's kind of like the ones on google, foamy urine images. If it happens again that is very foamy I'll let you know.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
# alright. but start drinking more water and let's see

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Feel like its harder to breath now, weird chest feeling. bit lightheartedness.

Feel a little better now.

Maybe some random panick attacks, also due to chest issues or blood pressure or idk?

Okay im guessing these random panick attacks are happening randomly so much now... I'm guessing its panick attack, weird feeling chest, breathing issues, lightheadedness, making it hard to breathe. seems like im more vulnerable to it, but the other two times for lightheadedness after eating and burping wasn't panick attack last week.

But now its better.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
# yeah

these are random attacks

you must sleep well every night

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Yeah It could be, not sure why its happen more often now, just more vulnerable to it now, probably blood pressure, heart chest, etc.
Cold and shivering now, in bed was warm cold after i got out. I'm trying to drink a mug of water in the morning.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
# you may drink water in the middle of night if you become awake also.

try having some tender coconut water once every few days to replenish the minerals in your body.

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Coconut, that's a good idea, i have a few bottles, haven't drank any. Barely eating much right now. Losing energy.

Yeah i need some vitamins, minerals and protein.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
# absolutely.

coconut and sometimes aloe Vera juice

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When swallow food left and right side chests kinda hurts, slight coughing. Maybe the heart? The throat?

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
# This looks like esophagus issue.
Are you chewing the food well ? Drink a few sips of water between swallows.

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I'm trying to chew it smaller peices, i drink tiny sip of water if it hurts, I'll try to drink sips between swallows. Is 1 hour to finish normal, should i do 2 hours instead? it could be acid, and heart too?

What's the reason when i eat sometimes start to get lightheaded a bit? Maybe changes to blood pressure? Eating more food for dinner than lunch? Or irritation in stomach or esophagus?

Google: Postprandial hypotension is a condition that occurs after eating. It's caused by increased blood flow to the stomach and intestines, which takes blood flow away from other parts of the body. ... The blood vessels also tighten. Both factors can cause a person to feel dizzy after eating

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
# Postprandial hypo-tension will not be felt the way you are describing but. Do not worry about it. Its a normal phenomenon that after a meal the blood circulation increases to the intestines.

Meanwhile have a light dinner and better lunch. As the day progresses the amount of food that goes inside should be less and less.

You can eat slowly if you have enough time for the same.

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This lightheadedness reminds me of a week ago, that's why it scares me, because I don't want it happened again. Not happening now.

I'm trying to eat slowly.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
# It won't again. Just follow all the instructions we have been discussing. you should be fine

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Alright, pray I get better thanks! Is it okay for to eat more and more over time? If i don't feel too full?

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
# yeah but smaller meals. can have more frequent meals though. don't over eat.

I'm praying for you. take care.

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Feel like I'm losing more and more weight.

How you spending your time during the corona virus outbreak? I'm just staying at home, waiting for acid re flux to get better, doing HW. Watching Youtube, going on Facebook.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
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