Friday, March 13, 2020

Coronavirus Covid-19 clinical information!

Coronavirus clinical:

  • COVID-19 is the disease, SARS-2-CoV is the virus
  • Transmission
    • Respiratory and likely by fomite (contact with hard surfaces). Virus found in respiratory secretions and saliva.
    • Stool shedding also described, but uncertain what role, if any, that plays.
  • Incubation period
    • Mean of 6.4 days, range 2-12. For people quarantined, 14d observation recommended to exclude infection, though 24d asymptomatic time from exposure described.
    • Viral shedding occurs following recovery, but unclear what role this plays in transmission.
    • Children and intrafamilial (family) spread appear to be a growing means of transmission.
  • Cause of upper respiratory tract disease and pneumonia.
    • The most common symptoms include fever, fatigue, and dry cough.
      • Fever (83-98%)
      • Cough (46-82%, usually dry)
      • Myalgia (muscle pain) or fatigue (11-44%)
      • Shortness of breath at onset (31%)
      • Less common symptoms:
        • Pharyngitis (inflammation of the pharynx )
        • Headache
        • Productive cough
        • GI symptoms
        • Hemoptysis (coughing up of blood )
  • Estimates are ~80% of infections non-severe, including asymptomatic infection likely.
    • The mortality rate is thought to be ≤2%, but precise numbers uncertain due to a lack of available serological testing.
    • Most deaths in patients with comorbidities (the simultaneous presence of two chronic diseases or conditions in a patient) and often elderly (> 60 considered a "risk factor"), although healthy younger patients also described.
  • Epidemiology
    • China remains with most reported cases, but as of March 2020, upswing in many countries including especially S Korea, Italy, US (California, Washington state).

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