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Could Dehydration be a Contributor to the Increase in COVID-19 Hospitalizations?

With the temperature heating up and COVID-19 cases on the rise in the hottest states in the US, one might ask, could there be a correlation?

What do we know about COVID-19 symptoms?

It is common knowledge that COVID-19 symptoms can range from literally none (asymptomatic) to extreme, with extreme cases likely landing individuals in the hospital and/or ICU. The CDC lists the following as possible symptoms for COVID-19:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • Loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

What do we know about recent COVID-19 cases?

In the recent weeks we have seen an increase of age 18 – 35 individuals being diagnosed with COVID-19, as well as being admitted to the hospital. While we know this population appears to be more resilient to the virus and not suffer as badly as older individuals and/or those with pre-existing conditions, the question remains, why is this age group getting sick enough to go to the hospital?

It should also be noted that many of the states with increased cases are in the Sunbelt (specifically Texas, Florida and Arizona), otherwise known as states with very hot temperatures in the months of May through September.

What general things do we know about the 18 – 35 year old age group in the last month?

While this may not be the case for every individual age 18 – 35, governors, states and the media have noted that this population is the group that tends to be more out and about. In the last month (depending on state), many individuals in this age group have spent more time outside at the pool, lake and beach, visited more bars and restaurants, have been outside participating in protests and more.

Why does this matter? Most of those activities put individuals outside, in the heat and humidity, and likely at risk for dehydration.

What do we know about dehydration?

While many people think only athletes can become dehydrated, the reality is, nothing could be further from the truth. Every year hundreds, even thousands, of people experience dehydration during the summer heat. From being at the lake to going to amusement parks to gardening outside to backyard BBQs with beer and more, individuals of all ages can experience dehydration.

We also know that one of the most common recommendations for those with respiratory viruses, like the common cold, flu and COVID-19, is to drink more fluids. It is well-known that people with these illnesses are at a greater risk for dehydration and thus exacerbated symptoms of the illness.

The CDC and other health authorities list the following as symptoms of dehydration:

  • Moderate Dehydration
    • Fatigue
    • Restlessness and irritability
    • Sunken eyes
    • Dry mouth and tongue
    • Decreased urination and/or dark urine
    • Dry skin
    • Dizziness
    • Lightheadedness
    • Headache
    • Nausea
  • Severe Dehydration
    • Lethargy or unconsciousness
    • Muscle cramping
    • Excessive thirst
    • Lack of sweating
    • Very dry mouth and tongue
    • Low blood pressure
    • Rapid heart rate
    • Rapid breathing
    • Sunken eyes
    • Shriveled skin
    • Dark or no urine

Could there be a correlation between the younger age group, COVID-19 hospitalizations and dehydration?

It’s important to note that dehydration will not cause COVID-19, but the question is, could it exacerbate the symptoms of the virus, resulting in individuals going to and being admitted into the hospital? And/or if an individual is asymptomatic, like many age 18-35 are, could dehydration be a reason they are going to the hospital and thus getting tested for COVID-19?

Based on the CDC’s list of COVID-19 symptoms, the following are very similar to dehydration and could be a reason many might seek medical treatment:

  • Fatigue
  • Muscle or body aches
  • Headache
  • Nausea

The average hospital stay for dehydration is 3 – 4 days. The Lieutenant Governor of Texas, where I live, made note that the younger population group going to the hospital is staying approximately 4 days, then getting better and going home.

What does this mean and what can you do?

We know that dehydration can have negative consequences on health and make individuals feel very poorly in many situations. We also know that heat and humidity can accelerate dehydration faster than in cooler, dryer months. In many cases, heat exacerbates sweating by up to 10-20%. But the good news is, hydration is something you can control. Staying well hydrated in the hot summer months (and really all months) can help reduce the risk of suffering from the negative health consequences from dehydration, which could lead to the need for medical treatment.

So how much fluid do you need?

  • Men: 14 – 15 cups of fluid per day
  • Women: 10 – 11 cups of fluid per day
  • Exercise: Add 5-10 oz of fluid for every 20 minutes of exercise or general activity in the heat

What counts as fluid?

  • Water
  • Flavored waters
  • Tea and coffee
  • Milk and chocolate milk
  • Smoothies
  • Fruit
  • Vegetables
  • Soup
  • Other low-calorie fluids

How to manage your hydration?

  • Check your hydration status
    • Use the color of your urine as a guide
      • Pale yellow to clear typically indicates a positive hydration status
      • Apple juice and darker typically indicates dehydration
  • Have a plan
    • Carry a water bottle with you throughout the day
    • Be sure to start drinking first thing in the morning as we all wake up dehydrated
    • Pack fluids if you will be away from home
  • Drink early, drink often
    • In hot months, you are more likely to be dehydrated, so it is important to drink fluids early and often, typically before you feel thirsty
    • During exercise and activity in hot, humid environments, be sure to start drinking fluids immediately and add in electrolytes for longer bouts of activity

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