Dr. Chang was at first incredulous that her mild symptoms were COVID-19. Here she shares her survival story.
Editor’s note: This article was updated from an earlier version originally posted on May 20, 2020.
On March 25, emergency medicine physician Dr. Anna Marie Chang posted the following tweet:
Eight Days Before, Symptoms Emerge
Dr. Chang first started to experience symptoms of the coronavirus on March 17, 2020, a date she’ll never forget. She was sitting at her desk and had a dry cough. She remembers joking with her colleagues about the reality of her having the virus, but she was instead met with concern. “They said, you’re a healthcare provider, you should probably get tested,” she recalls.
On some level, Dr. Chang had an intuitive feeling that she would get the virus as an emergency medicine physician at Thomas Jefferson University Hospital. She is a part of the frontline staff directly interfacing with patients, but at this point, they weren’t treating many patients. In fact, the mobile testing site at the hospital had only opened the Friday before. Feeling otherwise fine besides the cough, it was easy for Dr. Chang to shrug off the dry cough. However, by the time she arrived home that afternoon, she felt winded, tired and achy. She took her temperature and it measured 102.7 degrees.
“At that time I was like, oh something is wrong.”
The days following the positive test result were miserable, Dr. Chang recalls. She experienced intense body aches, still had her dry cough and complete fatigue. She barely had enough energy to go to the bathroom and get back into bed. Her boyfriend was able to bring her food.
Results from her test came back that Friday and confirmed what she already knew: she had the coronavirus. “I wasn’t surprised,” she explains. “I had developed GI symptoms. I lost my sense of smell sometime between Thursday and Friday. I couldn’t smell the soap I was using to wash my hands. I also experienced diarrhea. I knew I wasn’t dealing with the flu at that point.”
The next day, a friend’s husband dropped off a pulse oximeter for Dr. Chang. This device measures the saturation of oxygen carried in red blood cells and well as your heart rate. A normal and healthy percentage is above 95% saturation. She noted that on Monday her oxygen levels started dropping to 94%. “I would put on a mask and walk down to my kitchen and need to sit down to recover,” she says. While she felt winded, she remained confident that she was still in a healthy range. She felt like she was still OK.
That changed when she noticed blood after coughing.
She immediately began trying to justify what was going on in her head: “Oh, it’s just a little bit of blood. My airways are just irritated from coughing.”
However, the next day, Dr. Chang was not able to catch her breath after taking a shower and putting on fresh clothes. Her pulse oximeter read 90%, and when she went down to the kitchen, it dropped to a low 88%.
“I felt scared,” she admits. “To go from 94% a day ago to 88%. I called my colleagues and said, ‘I think it’s time.’”
Hospitalization & a Lesson on Loneliness
Dr. Chang was admitted to Thomas Jefferson University Hospital on March 25, less than 10 days after first developing COVID-19 symptoms. She was relieved to see her vital signs were OK. Blood work and chest X-rays were taken. She was put on supplemental oxygen to help her breathe.
“Getting my chest X-ray back was scary,” she explains. “I’ve had chest X-rays done before and this was definitely not normal looking. It looked like I had pretty significant pneumonia.” It also left her with more questions than answers. “Looking at all the Twitter feeds and everything, I had seen chest X-rays that looked better than mine and worse,” she says. “I was like, OK, what does this all mean?”
The experience enhanced my desire to work at breakneck speed to bring more possible treatments to patients.
She was put on antibiotics and monitored. She also felt the isolation of being in the hospital by herself. “The nurses and physicians were so kind, but you’re really alone,” she explains. “And at least for me, I could look up at my monitor and know what my vital signs meant. For people who are alone in their room, wondering what all of it means, and also the sensation of being so unable to breathe. It is so scary.”
Perhaps it was this feeling of isolation that prompted Dr. Chang to pick up her phone and tweet the day she arrived at the hospital. “I’ve never had anything go viral, literally, and I was viral,” she jokes. “I wasn’t able to respond to all of the messages, but I didn’t think about it going viral when I posted it, I just wanted to share that this isn’t just a ‘worse flu.’”
Dr. Chang was treated with antibiotics and hydroxychloroquine, a medication that is widely used to prevent and treat malaria, and at the time, being used as a treatment for COVID-19. “I’m a researcher by background and that’s what I spend most of life doing,” says Dr. Chang. “I knew there was no good data to show whether or not it is an effective treatment [for COVID-19], but when you feel so terrible, you are desperate for anything that could potentially make you feel better. If I could have been a part of a clinical trial, I would have signed up in a heartbeat.”
Now Dr. Chang is leading Jefferson’s participation in a nationwide trial to learn about the long-term health effects of COVID infection.
Luckily, this treatment plan put Dr. Chang on the path of recovery, and she was discharged from the hospital on March 28 to recover at home. For her, that recovery meant using this newfound appreciation and motivation to work with other Jefferson researchers to look at treatment protocols and develop clinical trials to examine other treatment paths.
“If there is a chance that I can feel better, if there is a chance that my mom or dad doesn’t end up in the ICU, of course, I want that for them, for everyone,” she says. “The experience enhanced my desire to work at breakneck speed to bring more possible treatments to patients.”
Dr. Chang set her focus on one treatment in particular—convalescent plasma.
Life After COVID-19
For some, recovery after hospitalization from a novel and deadly virus may look like movie and TV binges and copious napping sessions. For Dr. Chang, recovery meant jumping back into work and helping launch the convalescent plasma donation program and clinical trials (from home, of course).
“There is literature to support the use of plasma,” she explains. “Dr. Julie Karp was already working on a protocol to collect convalescent plasma from donors. We needed to be working on a protocol to then administer the plasma to patients, and that’s where I jumped in to help.”
The first plasma donor at Jefferson donated on April 13. That plasma was administered to a severely sick patient at Thomas Jefferson University Hospital days later.
Things came full-circle for Dr. Chang when she arrived at the Thomas Jefferson University Hospital Blood Donor Center on May 6. At this point, she was considered recovered from COVID-19 and cleared to donate her own plasma, enrolling her in her own clinical trial.
It was her first time ever donating blood products. She felt comfortable in what she describes as a warm and professional setting. She remembers feeling tired during the donation process but used the time to reflect on the whirlwind of events that allowed her to work on this project with so many physicians and researchers at Jefferson.
“I wondered if my plasma would have antibodies and that, hopefully, it would help someone,” she says.
Dr. Chang sees patients via telehealth but with a newfound perspective.
When she had to tell a patient that he needed to go to the hospital due to severe COVID-19 symptoms, he was scared. Dr. Chang understands that fear. She has also seen the scary stories of people who go to the hospital, get put on a ventilator and never go home. “I told him, ‘Hey, I’m a recovered COVID patient,’” she says. “He actually said to me, ‘The fact you’re at home gives me hope.’ That really touched my day.”
Listen to Dr. Chang tell her story in her own words on episode eight of The Health Nexus Podcast: