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What Is Expected In Recovering From A Traumatic Brain Injury?

The prognosis for mild TBI is usually better than for a moderate TBI, and the prognosis for moderate TBI is usually better than for a severe TBI.

With a concussion (mild TBI), most people recover most or all of their brain function within 3 months following injury, with most recovering sooner.

With moderate TBI, most people recover most or all of their brain function, although neurosurgery, occupational/physical therapy, speech/language therapy, psychological services, and/or social services may be needed.

With severe TBI, it is hard to predict recovery because it depends on location of trauma, severity of the damage, length of time in coma, and many other factors.  However, long-term effects of the injury typically increase with the increased need for length of recovery.

See ResourcesUnderstanding TBI Part 2: Brain injury impact on individuals' functioningThis information sheets is written for consumers through a collaboration between the Model Systems Knowledge Translation Center (MSKTC) and the TBI Model Systems of Care. (en español)

Understanding TBI Part 3: The Recovery ProcessThis information sheets is written for consumers through a collaboration between the Model Systems Knowledge Translation Center (MSKTC) and the TBI Model Systems of Care. (en español)

MEDLINEplus: Head and Brain InjuriesThis easy to use website of the National Library of Medicine provides links to articles, research reports, and organizations covering various aspects of head and brain injuries. Some information is available in Spanish.

Stages of Brain InjuryOne of a series of videos from the Brain Injury Toolbox and developed by the Brain Injury Association of Illinois to disseminate educational materials and other materials that may be useful tools to those whose lives have been impacted by brain injury, for professionals working with individuals who have sustained a TBI, and to the community at large.

Long-Term OutcomesFrom the Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.

Understanding Brain Injury: What you should know about brain injury and recoveryThis video uses simple language and images of real people who have sustained a brain injury, as well as medical experts and advocates. Produced by Shepherd Center and KPKinteractive in collaboration with the American Trauma Society, the Brain Injury Association of America and the Christopher & Dana Reeve Foundation.

COVID-19 Symptoms

COVID-19 is a respiratory condition caused by a coronavirus. Some people are infected but don't notice any COVID-19 symptoms (doctors call that being asymptomatic). Most people have mild symptoms and get better on their own. But some have severe problems, such as trouble breathing. The odds of more serious COVID-19 symptoms are higher if you're older or have another health condition such as diabetes or heart disease.

Here's what to look for if you think you might have the virus.

COVID-19 symptoms can range from mild to serious. Anyone can have symptoms at any intensity level. You don't have to have an underlying condition to develop severe symptoms.

Common COVID-19 symptoms

The most common symptoms of COVID-19 include:

Fever or chills

A dry cough and shortness of breath

Feeling very tired

Muscle or body aches

Headache

A loss of taste or smell

Sore throat

Congestion

Runny nose

Nausea

Vomiting

Diarrhea

These symptoms can start anywhere from 2 to 14 days after you're in contact with the virus.

Emergency COVID-19 symptoms

You need immediate medical help if you have any of these issues:

Trouble breathing

Constant pain or pressure in your chest

Bluish lips or face

Sudden confusion

Having trouble staying awake

Having a hard time waking up

Pale, gray, or bluish skin, lips, or nail beds

If you have any of these symptoms, call your doctor's office or hospital before you go in. This will help them prepare to treat you and protect medical staff and other people.

Strokes have also been reported in some people who have COVID-19. To identify signs of stroke, remember FAST:

Face. Is one side of the person's face numb or drooping? Is their smile lopsided?

Arms. Is one arm weak or numb? If they try to raise both arms, does one arm sag?

Speech. Can they speak clearly? Ask them to repeat a sentence.

Time. Every minute counts when someone shows signs of a stroke. Call 911 right away.

The FDA has approved the antiviral drug remdesivir (Veklury) and nirmatrelvir with ritonavir (Paxlovid) to treat COVID-19 in some people. Molnupiravir (Lagevrio) has been given emergency use authorization for treating the virus. If you have serious COVID-19 symptoms, you should get one of these treatments as soon as possible.

COVID-19 SYMPTOM CHECKER

Find Out if You Have Symptoms of Coronavirus (COVID-19)

Other COVID-19 symptoms

Less common problems that the virus can cause include:

Some doctors have reported rashes tied to this virus, including on children's toes and feet. These rashes may show up as purple or blue lesions on lighter skin or pale or gray on darker skin. Researchers are looking into these reports so they can understand the effect on people who have it.

COVID-19 symptoms in children

Kids have many of the same COVID-19 symptoms as adults, but they tend to be milder. Some children may not have any symptoms, but can still spread the virus.

Common coronavirus symptoms in children include:

Fever

Cough

Shortness of breath

Some children and teens who are hospitalized with COVID-19 have an inflammatory syndrome that may be linked to the coronavirus. Doctors call it pediatric multisystem inflammatory syndrome (PMIS). Symptoms include fever, rash, belly pain, vomiting, diarrhea, and heart problems. It's similar to toxic shock and Kawasaki disease, a condition in children that causes inflammation in blood vessels.

In some cases, certain symptoms show up before the more obvious signs of the coronavirus. Warning signs to look out for include:

Digestive issues. Nausea, vomiting, and diarrhea may show up with other symptoms or before them.

New loss of smell or taste. This symptom, without a stuffy nose, is a common early warning sign of COVID-19. It may go away within 30 days. But in some cases, it can last 60 days or more.

Most variants of the virus have similar symptoms. But a few strains may have slightly different signs.

COVID-19 symptoms of Omicron variant

COVID-19 Omicron symptoms are usually mild. They tend to include sore throat, runny nose, and other symptoms similar to a cold. They may not include lower respiratory tract symptoms such as wheezing, severe cough, or fever.

COVID-19 symptoms of Delta variant

With this variant, symptoms usually include runny nose, fever, sore throat, and headache. You're less likely to have coughing or loss of taste or smell.

Get tested if:

You've had symptoms of the virus.

You've come into close contact with a person who has the virus (take a test at least 5 days after you last saw the person).

You've been asked to get tested by your school, health care provider, workplace, state, local, tribal, or territorial health department (regardless of your vaccination status).

Your regular body temperature may be higher or lower than someone else's. It also changes throughout the day. Doctors generally consider a fever in an adult to be anything over 100.4 F on an oral thermometer and over 100.8 F on a rectal thermometer.

If you think you've come into contact with the virus, or if you have symptoms, isolate yourself and check your temperature every morning and evening for at least 10 days. Keep track of the readings. A fever is the most common COVID-19 symptom, but it's sometimes below 100 F. In a child, a fever is a temperature above 100 F on an oral thermometer or 100.4 F on a rectal one.

Most people with this virus have a dry cough that they can feel in their chest.

If you have milder COVID-19 symptoms like a fever, shortness of breath, or coughing:

Stay home unless you need medical care. If you do need to go in, call your doctor or hospital first for guidance.

Tell your doctor about your illness. If you're at high risk of complications because of your age or other health conditions, they might have more instructions.

Isolate yourself. This means staying away from other people as much as possible, including members of your family. Stay in a specific "sick room," and use a separate bathroom if you can.

Wear a face mask if you have to be around anyone else. This includes people you live with. If a mask makes it hard for you to breathe, keep a distance of at least 6 feet from others and cover your mouth and nose when you cough or sneeze. After that happens, wash your hands with soap for at least 20 seconds. The CDC states that well-fitting respirator masks (like N95s and KN95s) give better protection than cloth masks.

Rest up, and drink plenty of fluids. Over-the-counter medicines might help you feel better.

Keep track of your symptoms. If they get worse, get medical help right away.

Dyspnea is the word doctors use for shortness of breath. It can feel like you:

Have tightness in your chest

Can't catch your breath

Can't get enough air into your lungs

Can't breathe deeply

Are smothering, drowning, or suffocating

Have to work harder than usual to breathe in or out

Need to breathe in before you're done breathing out

You should monitor your oxygen levels, and if they drop to the 80s, contact your doctor. If your face and/or lips get a bluish tint, call 911 right away.

Cold vs. Flu vs. Allergies vs. COVID-19

Symptoms Cold Flu Allergies

COVID-19

(can range from moderate to severe)

Fever Rare High (100-102 F), can last 3-4 days Never Common Headache Rare Intense Uncommon Common General aches, pains Slight Usual, often severe Never Common Fatigue, weakness Mild Intense, can last up to 2-3 weeks Sometimes Common Extreme exhaustion Never Usual (starts early) Never Can be present Stuffy/runny nose Common Sometimes Common Has been reported Sneezing Usual Sometimes Usual Has been reported Sore throat Common Common Sometimes Has been reported Cough Mild to moderate Common, can become severe Sometimes Common Shortness of breath Rare Rare Rare, except for those with allergic asthma In more serious infections

The CDC recommends that everyone aged 5 and above get an updated COVID-19 vaccine to keep them from getting seriously ill from the coronavirus. Three updated vaccines are available in the U.S.:

Pfizer-BioNTech

Moderna

Novavax

Recommendations by age group are:

People aged 12 and above who haven't been vaccinated before: 1 dose of either Pfizer-BioNTech or Moderna, or 2 doses of Novavax

People aged 12 and above who got coronavirus vaccines before September 12, 2022: 1 dose of any of the 3 newer vaccines

Children aged 5-11, regardless of previous vaccine status: 1 dose of Pfizer-BioNTech or Moderna

Children aged 6 months-4 years who haven't had a coronavirus vaccine before: 2-3 doses of one of the updated vaccines, depending on type

Children aged 6 months–4 years who were vaccinated before September 12, 2023: 1 or 2 doses of one of the updated vaccines, depending on which type and how many doses they've had

Talk with your doctor before getting the vaccine if you have immune system issues.

Until you're fully vaccinated, be sure to take these steps to prevent illness:

Wash your hands often, for at least 20 seconds each time, with soap and water.

Use an alcohol-based sanitizer with at least 60% alcohol if you don't have soap and water handy.

Limit your contact with other people. Stay at least 6 feet away from others if you have to go out.

Wear a well-fitted protective face mask in public places.

Avoid people who are sick.

Don't touch your eyes, nose, or mouth unless you've just washed your hands.

Regularly clean and disinfect surfaces that you touch a lot.

NEWSLETTER

Stay Up-to-Date on COVID-19

If you're taking care of someone with COVID-19 symptoms, follow these steps to protect yourself:

Limit your contact as much as you can. Stay in separate rooms. If you have to be in the same room, use a fan or an open window to improve airflow.

Ask the person who's sick to wear a well-fitted protective face mask when you're around each other. You should wear one, too.

Don't share items such as electronics, bedding, or dishes.

Use gloves when handling the other person's dishes, laundry, or trash. When you're done, throw away the gloves and wash your hands.

Regularly clean and disinfect common surfaces such as doorknobs, light switches, faucets, and countertops.

Take care of yourself. Get enough rest and nutrition. Watch for COVID-19 symptoms.

Severe COVID-19 symptoms tend to affect older people or those with underlying conditions. But they can develop in anyone, so it's important to take a test if you think you have signs of the virus. If you have serious symptoms, see your doctor right away. To protect yourself and others from COVID-19, get vaccinated and limit contact with those who are infected.

What day do severe COVID-19 symptoms start?

Symptoms, whether they're mild or severe, usually show up 2-14 days after you're exposed to the virus.

When does COVID-19 peak in your body?

You'll have the most active illness in your body anywhere from 1 to 2 weeks after symptoms show up. But in very serious cases, this phase could last for months.

What are the symptoms of the newest COVID-19?

Newer versions of COVID-19, like the Omicron strain EG.5, tend to infect the upper respiratory tract. Common symptoms of the new COVID-19 variants include a runny nose, sore throat, and other symptoms similar to a cold. But people aged 65 and older and those with weak immune systems are more likely to have more serious symptoms affecting their lower respiratory tract.

Patients With Mild Psoriasis Face Less Favorable Status At Diagnosis, First Line Of Treatment, Study Finds

ConferenceAMCP Nexus: The Academy of Managed Care Pharmacy Nexus

Psoriasis status from time of diagnosis to initiation of current treatment was less favorable for patients with mild psoriasis compared with moderate psoriasis, according to one study.

A recent poster at the Academy of Managed Care Pharmacy (AMCP) Nexus 2023 conference presented a real-world analysis published in the Journal of the American Academy of Dermatology, which found patients with mild psoriasis experience worse disease status than patients with moderate psoriasis at the time of diagnosis to initiation of current treatment.

A dermatologist wearing gloves examines the skin of a sick patient. Examination and diagnosis of skin diseases-allergies, psoriasis, eczema, dermatitisImage credit: fusssergei - stock.Adobe.Com

The study aimed to characterize the disease profile and treatment patterns among patients with mild and moderate psoriasis. While the current management of mild to moderate psoriasis often entails topicals, phototherapies, and conventional systemic agents, most advanced therapies that exists are meant for moderate to severe psoriasis. This leaves a significant gap for patients not responding to current standard of care for milder forms of the disease.

Data included in the study was collected from a cross-sectional survey of physicians and their adult patients with psoriasis in the United States between December 2021 to March 2022. The data included information pertaining to the consulting patient's demographics, disease profile such as body surface area (BSA) percentage affected by psoriasis symptoms, symptoms suffered, areas of the body affected, and prescribed treatment received.

The analysis included a total of 389 patients, including 72 patients with mild disease at diagnosis, and 317 patients with moderate disease. Both groups of patients had a similar mean age and sex distribution. However, patients with moderate psoriasis had a higher mean [SD] body mass index (BMI) of 27 [4.0](P = .0022) and a higher rate of concomitant psoriatic arthritis (PsA) of 7.6 [2.4](P = .4416) than patients with mild psoriasis.

Additionally, both groups reported similar affected body areas, but patients with moderate psoriasis reported more areas being affected (3.4 [1.8]; P < .0001) compared with patients with mild psoriasis (1.9 [1.2]; P < .0001). Furthermore, patients with mild psoriasis had a smaller average number of symptoms present at diagnosis (2.8 [1.5]; P < .0001) compared with patients with moderate psoriasis (3.8 [1.7]; P < .0001).

Patients with moderate psoriasis also experienced a greater reduction in mean percentage of BSA affected after diagnosis than patients with mild psoriasis. These patients were also treated more aggressively at diagnosis with conventional agents and biologic therapies used more commonly as the initial treatment at diagnosis compared with patients with mild psoriasis (P = .0173 vs P = .4391, respectively). Meanwhile, most patients received topicals as the initial treatment at diagnosis in both mild (87.3%) and moderate (86%) groups. The factors associated with receiving advanced therapies as the first line of treatment after diagnosis included older age, higher BMI, higher BSA percentage affected, symptoms at diagnosis (bleeding, cracked skin, burning), and affected body areas (neck and palm of hands).

Overall, patients with mild and moderate psoriasis reported similar symptoms at the time of diagnosis, but mild patients had fewer affected body areas. However, patients with mild psoriasis were observed to have a mean BSA affected at diagnosis of 6.2%, which indicates having moderate skin coverage. Furthermore, a higher proportion of patients with mild psoriasis experienced a flare at the time if survey completion.

These findings suggest a less favorable disease status for patients with mild psoriasis at the time of diagnosis to initiation of current treatment, highlighting potential unmet needs in the treatment of mild psoriasis. Moreover, the researchers suggest the possible negative impact of delaying initiation of more affective treatment in patients with mild psoriasis.

Reference

Wu D, Teneralli R, Fitzgerald T, et al. Patient characteristics, disease profile and treatment patterns in mild and moderate psoriasis patients in real world practices (prospect study). Poster presented at: AMCP Nexus; October 16-19, 2023; Orlando FL. Poster U13.

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