Symptoms: Numbness, Low Fever, and Heart Issues

Numbness in the cheeks, unexplained fever, and heart rate issues?

Around 1 AM on June 2, my family member received a notification from the "Taiwan Social Distancing" app indicating possible contact with a confirmed COVID-19 case.
They went to work in the morning, but in the afternoon, the company requested them to leave early.
After returning home, they experienced mild nausea and diarrhea, though the symptoms were not severe.
In the evening, they took their temperature, which was around 37.5°C.

On June 3, around noon, in response to the company's request, they went to Zhongxiao Hospital for a rapid test, which returned a negative result.
After returning home around 2 PM, they may have experienced mild heat exhaustion due to waiting under the sun for about two hours.
They reported symptoms such as numbness in the head and limbs, and their hands felt like they were curling up.
After hydrating and resting for half an hour, these symptoms alleviated (they had previously experienced similar symptoms during severe motion sickness).

Around 3 PM to 3:30 PM, they began to have a slight fever (37.5°C to 37.7°C).
Later, around 4:30 PM, their temperature dropped back to around 37.0°C, but the fever continued to fluctuate throughout the evening.
Interestingly, their temperature returned to normal (36.8°C to 36.9°C) while sleeping.
This low-grade fever typically occurs when they are awake.
They have mild Mediterranean anemia, but their blood pressure readings over the past two days have been between 120 and 133 (previously below 110), and their heart rate has been between 80 and 90.
During this time, they also experienced mild fever (around 37.5°C), but it never reached 38°C.
When their temperature is higher, they feel palpitations.
I would like to ask the doctor if it is sufficient to continue monitoring at home, or if they should go to the hospital immediately.
It feels unsafe to go to the hospital right now.
Although the test result was negative, these symptoms are still concerning during this period.

Hsuān, 30~39 year old female. Ask Date: 2021/06/04

Dr. Lin Wufu reply Internal Medicine

Hello! It is common to experience palpitations and other discomforting symptoms during a fever.
A single negative test result does not definitively confirm that you are negative for the virus.
If you still have the same symptoms after 3-4 days (which is now), it is advisable to consider going to the emergency department for a second test.
If that result is also negative, the likelihood of having contracted COVID-19 is low.
It is recommended to consult with a family medicine or infectious disease specialist for further diagnosis and evaluation.

Reply Date: 2021/06/04

More Info

Based on the symptoms and history you've provided, it seems your family member is experiencing a combination of mild gastrointestinal issues, low-grade fever, and some neurological symptoms such as numbness and tingling in the extremities. Let's break down the situation and provide some guidance on how to proceed.

Understanding the Symptoms
1. Low-Grade Fever: A temperature of 37.5°C to 37.7°C (99.5°F to 99.9°F) is considered a low-grade fever. This can be a response to various factors, including infections, inflammation, or even heat exposure. Given that your family member was exposed to heat and possibly dehydrated, this could explain the fluctuating temperature.

2. Gastrointestinal Symptoms: The mild nausea and diarrhea could be attributed to a variety of causes, including stress, dietary changes, or even a mild viral infection. Since the symptoms are not severe, they may resolve on their own with rest and hydration.

3. Neurological Symptoms: The numbness and tingling in the hands and feet, especially after being in a hot environment, could indicate a transient response to heat or dehydration. It's not uncommon for individuals to experience these sensations when they are overheated or anxious. However, if these symptoms persist or worsen, further evaluation may be necessary.

4. Heart Rate and Blood Pressure: The heart rate of 80-90 beats per minute is within a normal range, especially considering the stress and discomfort your family member is experiencing. The blood pressure readings of 120-133 are also generally acceptable, although they are slightly elevated compared to previous readings. This could be a response to stress or discomfort.

Recommendations
Given the current situation, here are some steps to consider:
1. Monitor Symptoms: Continue to observe for any changes in symptoms. If the fever persists or rises above 38°C (100.4°F), or if the gastrointestinal symptoms worsen, it would be prudent to seek medical attention.

2. Stay Hydrated: Ensure that your family member is drinking plenty of fluids, especially if they are experiencing diarrhea. Dehydration can exacerbate feelings of dizziness and numbness.

3. Rest and Recovery: Encourage rest, especially if they are feeling fatigued or unwell. Avoid strenuous activities until they feel better.

4. Seek Medical Attention if Necessary: If symptoms such as severe headache, persistent high fever, difficulty breathing, or significant changes in heart rate or blood pressure occur, it would be wise to seek medical care. While it is understandable to be cautious about visiting hospitals during this time, telehealth options may also be available for initial consultations.

5. Consider Underlying Conditions: Given the history of Mediterranean anemia, it’s important to monitor for any signs of exacerbation of this condition, such as increased fatigue or pallor. If there are concerns about anemia, a blood test may be warranted.

Conclusion
In summary, while the symptoms your family member is experiencing are concerning, they do not appear to be immediately life-threatening based on the information provided. Continuous monitoring, hydration, and rest are key. If symptoms worsen or new concerning symptoms arise, seeking medical attention would be the best course of action. It’s always better to err on the side of caution, especially in the context of potential exposure to infectious diseases.

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