Bernie Goldblatt didn't think the lingering cough he developed back in March could be COVID-19.

But when it wouldn't go away and his condition took a sudden and desperate turn in early April, the 68-year-old retiree wound up in the ICU for weeks. Nearly two months later, he's still not home.

"I never thought what it's like to fight for your life," said Goldblatt, of Minnetonka. "When it happens, it's like you're living in a nightmare and you can't get out."

Most people sickened by COVID-19 survive, but in serious cases, the experience is harrowing, the effects linger and the long-term health risks aren't clear. Minnesotans need to understand the consequences, survivors say, particularly as many grow restless with restrictions designed to slow the pandemic.

"Please, please, please take it seriously," said Steve Soeffker, a 69-year-old McLeod County resident who spent 43 days in the hospital before returning home this month.

"I nearly lost my life. My wife nearly became a widow. My mother almost lost her son," said Soeffker, who is a retired sheriff's deputy. "You don't know where it's coming from."

More than 19,000 state residents have tested positive for the novel coronavirus. About two-thirds of them no longer require isolation, because 14 days have passed since the onset of symptoms.

Doctors don't know whether COVID-19 survivors will maintain immunity against the virus down the road, said Dr. Jeff Chipman, critical care leader for M Health Fairview.

COVID-19 patients might suffer blood clots after leaving the hospital, doctors say, and there are questions about long-term issues with the lungs, kidneys and liver in serious cases. Like others who need intensive care, some could experience post-ICU syndrome that includes nightmares and panic attacks, said Dr. Jack O'Horo, an infectious disease physician at the Mayo Clinic.

More than 2,500 Minnesotans have been hospitalized thus far with COVID-19; more than 800 of those have required intensive care. In the most serious cases, getting over COVID-19 is just the start of the struggle.

"It's one thing to recover from an acute illness," said Dr. Anne Tita, staff physiatrist at Courage Kenny Rehabilitation Institute in Minneapolis. "It's another thing to transition back into normal life."

Still out of breath

Kelly Bort wasn't too concerned when cold symptoms surfaced in March. Three days later, she woke with a fever and found "the world had completely changed."

Bort, 76, is an artist in St. Louis Park who regularly skis and bicycles despite asthma. During her first night at Methodist Hospital, she couldn't stop gasping for breath.

"I had this moment of total dread that came over me," she said, "as I realized I could possibly die."

Unable to sleep, Bort wrote letters to her children. She described things she treasured in her house and thought about who would take care of Little Girl and Bennie, her pet Corgis.

In time, Bort felt a degree of acceptance — but also a sense that life was ending too suddenly. And then, the next day, Bort started to experience a turnaround.

She returned home after four days. Life moved slowly in April, with Bort surprised by her fatigue walking up stairs. Now, she takes daily walks around Lake of the Isles but doesn't feel completely recovered.

"Two months later, I'm still out of breath — much more out of breath than I normally would be. So, I'm a little worried. … Usually by this time of the year, I'd be riding my bike 10 or 15 miles a day."

When Goldblatt retired this winter as executive director of Adath Jeshurun Congregation, he joked that his next ambition was to take a long nap.

"Little did I know that that meant an induced coma," he said last week while in rehab at Abbott Northwestern Hospital in Minneapolis.

After landing in the hospital, Goldblatt spent about three weeks in the ICU and his memories are the stuff of piercing nightmares and dark visions. The distress is not unique to COVID-19 patients, doctors say, but a function of intensive care that can leave patients disoriented as they try to cope with disrupted sleep, heavy medications and a devastating illness.

Goldblatt's wife has talked to him by phone every day, reading from hundreds of messages left by friends on a CaringBridge site. Caregivers have been "magnificent," he said, even arranging for a brief visit from family during what has seemed like an endless hospitalization.

Now, he's starting to use his arms and legs again and can roll over a bit in bed. The next goal is standing.

"I think I was one of those people who was in complete denial — that that was never going to happen to me," Goldblatt said of COVID-19. "And I have to tell you — it could, and it did."

Soeffker didn't have a cough or fever when he went to bed one night in early April. Around 4 a.m., his wife found him collapsed on the floor and gasping for air. Paramedics drove Soeffker to a hospital in nearby Glencoe and then flew him to Abbott Northwestern.

"Basically, I came in as a corpse," he said. "I'm 6-foot-5 and at that time about 360 pounds. I left most of my weight back at Abbott."

Soeffker doesn't remember the next three weeks as he slowly fought off the infection. His first memory is of being taken by wheelchair from the ICU to a rehabilitation bed.

It took weeks to recover some of his strength and relearn with the help of therapists how to sit up, stand and walk. Before he was discharged in mid-May, Soeffker had to learn again how to eat food and drink liquids.

"This COVID is real. A lot of people are thinking it's not," he said. "Yes, I'm sympathetic for the small businesses, sympathetic for the people who are laid off and are losing wages. But they're in a position where they're still alive, still functioning."

Can turn quickly

Doctors are still learning about COVID-19 and its long-term health impacts. Some of the early lessons have been humbling.

"One of the most shocking parts of this illness is how quickly people can decline — go from just feeling a little short of breath to not able to breathe at all," said Dr. Craig Marshall of Methodist Hospital. "It can happen very quickly, for some patients within six to eight hours."

In late March, Dr. Bevan Yueh was busy helping create Minnesota's only hospital dedicated solely to treating COVID-19.

In April, he became one of Bethesda Hospital's first patients — but only after his wife and colleagues helped him recognize the surprising depths of the disease.

"In 30 years, I've probably missed about six days of work," said Yueh, who is a surgeon, interim chief executive at University of Minnesota Physicians and chairman of the U's department of otolaryngology. "I'm somebody who is healthy."

Yueh has asthma and attributed a cough one day in March to missing a dose of medicine. The next morning, he woke with no sense of smell — an odd hallmark of COVID-19 for some patients. A test confirmed the diagnosis, but Yueh continued calling in for meetings at work.

Colleagues contacted his wife after one phone meeting to say Yueh didn't sound right. One sent a device to his home for checking Yueh's blood-oxygen level, but he downplayed the reading.

"My wife said: 'What does 86 mean?' And I said: 'Oh, it's actually fine. It's scored just like grades — this is actually a B-plus,' " he said. "Something about the way I said it made her know I was not telling the truth."

She got him to the ER and Yueh spent the next 11 days at Bethesda. At one point, his doctor said he might need a ventilator — a frightening prospect, Yueh said, that compelled him to work hard with respiratory therapists.

When he was discharged in mid-April, doctors said recovery would take six to eight weeks. Yueh said he stubbornly tried to push the timeline by joining calls at work within two weeks. But it was so exhausting that he became "almost a little bit despondent."

He talked to his doctor and slowed down. This month, Yueh started feeling better and is gradually returning to work.

"I think everybody who has COVID — there's this narrative that it's just the flu. It's not," he said. "One of my hopes is that we tell people: Hey, this is really serious. And here's a reasonably well-educated doctor … who just didn't understand how serious it was."

Christopher Snowbeck • 612-673-4744

Twitter: @chrissnowbeck