Coronavirus (COVID-19)

Overview

A novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, a city in the Hubei Province of China late in 2019. This virus is a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and belongs to a family of coronaviruses. The disease caused by SARS-CoV-2 is called COVID-19. Coronaviruses are a family of viruses that are important human and animal pathogens.

WHO has declared COVID-19 as a public health emergency in late January 2020 and characterized it as a pandemic in March 2020.

Person to person spread of SARS-CoV-2 is thought to occur mainly via respiratory droplets, resembling the spread of influenza. The virus is released when the person with infection coughs, sneezes, or talks and can infect another person if the droplets with the virus make direct contact with the mucous membranes. The infection can also occur when the person touches the infected surface and then touches his or her eyes, nose, or mouth. Current evidence suggests that novel coronavirus may remain viable for hours to days on surfaces made from a variety of materials.

The risk factors for COVID-19 include recent travel to and from an area with the ongoing spread of COVID-19 as determined by CDC or WHO, close contact with someone who has COVID-19.

Adults of middle age and older are most commonly affected, although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can infect individuals of any age.

Spectrum of illness severity

  • Mild disease – may or may not have pneumonia
  • Severe disease – shortness of breath, pneumonia, >50 percent lung involvement on imaging within 24 to 48 hours
  • Critical disease – respiratory failure, shock, or multi-organ dysfunction

People who are at higher risk of getting very sick from this illness include – older adults, people who have serious chronic medical conditions like lung disease, heart disease, diabetes. According to the WHO, recovery time appears to be around two weeks for mild infections and three to six weeks for severe disease.

Symptoms

The incubation period (the period between exposure to an infection and the appearance of the first symptoms) of the virus is thought to be within 14 days following exposure.

Asymptomatic people have also been noted.

The most common symptoms include fever, cough, shortness of breath. Other symptoms that have been reported are fatigue, muscle pain, loss of appetite, headache, sore throat, runny nose, nausea, diarrhea.

Emergency warning symptoms and signs include – Difficulty breathing, Persistent pain or pressure in the chest, confusion, bluish discoloration of lips or face.
Older patients and individuals who have underlying medical conditions or are immunocompromised should contact their doctor early in the course of even mild illness.

Laboratory findings and diagnosis

  • Diagnosis is done by collecting samples including a sample of saliva, a nasal swab, and a throat swab, to send for testing.
  • SARS-CoV-2 RNA is detected by the polymerase chain reaction test. In the United States, the testing is performed by the CDC or a CDC-qualified lab.
  • Other laboratory findings include:
  • White blood cell count can vary in people infected with COVID-19:
    1. – Elevated aminotransferase levels have also been noted.
    2. – One study showed high levels of d- dimer and more severe lymphopenia (decrease in the type of white blood cells that fight infections) were associated with mortality.
    3. – A Chest CT scan will show abnormalities in the lungs that are consistent with viral pneumonia.

Prevention

  • Wash your hands diligently or use a hand sanitizer that contains at least 60 percent of alcohol, particularly after touching surfaces in public.
  • Minimizing the spread via droplets by covering the cough or sneeze with the tissue paper and throwing the tissue in the trash after using it.
  • Avoid touching the face.
  • Avoid close contact with anyone who is sick. Droplets typically do not travel more than six feet (about two meters) and do not linger in the air.
  • Avoid crowds particularly poorly ventilated spaces.
  • Stay home as much as possible.
  • Clean and disinfect the objects and surfaces that are frequently touched. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks. The CDC has issued guidelines on disinfection in the home setting.
  • CDC doesn’t recommend that healthy people wear a facemask to protect themselves from respiratory illnesses. However, individuals who are caring for patients with suspected or documented COVID-19 at home should wear a tightly fitting medical mask when in the same room as the infected person. You should also wear a facemask if your doctor tells you to do so.
  • WHO recommends avoiding contact with live animals and surfaces if you’re visiting live markets in areas that have recently had new coronavirus cases.
  • Eating raw or under cooked meat or animal organs should also be avoided as recommended by WHO.
  • If you are planning to travel internationally, first check the CDC and WHO websites for updates and advice.
  • If you think you have been exposed to SARS-CoV-2 infection and develop symptoms call your doctor for advice and tell them that you may have COVID-19. Your doctor will take steps to keep other people from getting infected or exposed. Stay away from other people in your home. Restrict contact with pets and other animals.
  • All these preventive measures are extra important if you or your family members have a higher risk of getting very sick from this illness.

Treatment

  • Currently, there is no antiviral medication to treat COVID-19.
  • Treatment is directed at relieving symptoms and may include rest, fluid intake, pain relievers, cough medication.
  • A mild infection is generally treated at home. People with mild infection should stay home and need to isolate themselves from others including family members.
  • Severe or critical infection is treated at the hospital. Patients with severe disease often need oxygenation support.

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