COVID-19 (Coronavirus, 2019-nCoV)

Reviewed on 7/23/2021

Facts you should know about COVID-19 (2019 novel coronavirus, 2019-nCoV, Wuhan coronavirus)

Infection with the Wuhan coronavirus causes respiratory problems.
Infection with COVID-19 causes respiratory problems.

What is COVID-19 (2019 novel coronavirus, 2019-nCoV, Wuhan coronavirus)?

SARS-CoV-2 is a single-stranded, positive-sense RNA coronavirus that causes an illness called COVID-19 (note that many people still equate and interchange the disease name COVID-19 with the new official virus named SARS-CoV-2). It is a new strain of coronavirus (means crown) that first caused an outbreak of serious respiratory problems in Wuhan, China. Researchers think it originated from infected animals and jumped over to infecting people in a large open seafood/animal market. Also, the virus is capable of person-to-person transmission, spreading to at least to over 150 countries in about 3 months. It is related to the SARS and MERS coronaviruses. The World Health Organization (WHO) declared COVID-19 a pandemic in March 2020.

What are risk factors for COVID-19 (Wuhan coronavirus) infections?

Initial risk factors for the virus included close contact with someone who has recently visited China, Italy, England, Spain, and many other countries and cities experiencing this outbreak. Close contact with anyone diagnosed with the virus and coming in contact with secretions (for example, those produced by sneeze or cough) or feces from an infected person are risk factors. Some investigators suggested that no wild animals be used for food in China or elsewhere. Since those initial risk factors were presented, many others have been noted and are as follows:

  • Asthma
  • Chronic kidney disease (for example, patients with decreased renal function, patients on dialysis)
  • Not wearing masks when in public
  • Attending gatherings indoors when not wearing a mask
  • Failing to maintain social distancing (at least 6 ft apart)
  • Not performing frequent hand washing/hand sanitizing
  • Chronic liver disease (for example, cirrhosis)
  • Chronic lung disease (for example, COPD, bronchitis, emphysema, idiopathic pulmonary fibrosis, cystic fibrosis, pulmonary hypertension)
  • Gestational diabetes
  • Immunocompromised patients (for example, patients with cancer treatment, bone marrow or organ transplant, immune deficiencies, HIV with a low CD4 cell count)
  • Men have a higher incidence of infections than women
  • Obesity (BMI over 40)
  • Older people (over 60-65 years of age)
  • People in nursing homes
  • Serious heart conditions (for example, heart failure, coronary artery disease, cardiomyopathies, congenital heart disease)
  • Type 1 and type 2 diabetes

What are the signs and symptoms of infection with COVID-19 (Wuhan coronavirus)?

COVID-19 symptoms may begin like the flu but go on to develop

  • fever,
  • severe cough, and
  • shortness of breath (difficulty breathing) that is so serious enough to warrant hospitalization in many patients.

 Occasionally, infected individuals may also experience

COVID toes is a syndrome where young adults and children develop a reddish-purplish discoloration of the toes and may indicate COVID-19 infection even before any other symptoms develop. In addition, doctors have noted an increase of COVID-19 patients with strokes. Mount Sinai Health in New York report a seven-fold increase in young patients (all under 50) with strokes. Doctors found that patients' blood clotted abnormally fast and found many clots in the bodies in about 20%-25% of patients. Although early in this outbreak, Chinese researchers' suggestion that people who are infected but don't show symptoms (incubation period) may be contagious actually proved to be correct. Researchers estimate that about 50% of transferred infections are due to asymptomatic infected people. This allows the virus to spread more effectively from person to person and makes it more difficult to isolate infected patients.

As more experience with COVID-19 occurs, other additional signs and symptoms may emerge (for example, stroke symptoms and multisystem inflammatory syndrome in children).

How does COVID-19 (SARS-CoV-2) spread?

Many coronavirus types infect species of animals that occasionally (or rarely) are able to infect humans. MERS coronavirus is an example where the virus that usually only infected camels became able to infect humans. SARS-CoV-2 is similar as the initially infected people frequented an open-air food market that sold fish and animals, including wild animals. Medical researchers currently do not know the animal species infected, but wild animals are a suspected source. However, the rapid spread of the virus was due to person-to-person contact that has been responsible for the wide outbreak of this infection. Close contact with someone who is infected or with their secretions (for example, cough-generated aerosol droplets) or feces is how the virus spreads.

Unfortunately, at least two highly infectious COVID-19 mutation(s) of SARS-CoV-2 have been detected in several countries worldwide. The new strains appear to spread more easily, but they are not more virulent. Vaccine developers are currently trying to determine if current vaccines are effective against these mutant strains.

What is the incubation period for COVID-19?

Medical researchers estimate that the incubation period for a COVID-19 infection varies from 2 days to about 14 days (average about 5 days).

Is COVID-19 contagious? What is the contagious period for COVID-19?

Although this virus is contagious, the contagious period remains to be determined. Recent findings showed that it is contagious even in the incubation period when the patient shows no symptoms. The virus also survives on surfaces for different time periods adding to the incident of transmission.

How do medical professionals diagnose COVID-19 infections? Are accurate COVID-19 tests available?

In the early phases of the pandemic in the U.S., only the CDC had tests to determine if an individual is infected with the virus, so doctors must safely package blood, swabs, and other specimens and send them to the CDC. It took days to get a result. However, early tests had some accuracy problems that researchers have since resolved. In addition, the FDA has approved about 20 different suppliers of various tests of blood and/or swab samples to quickly diagnose (from about 5-15 minutes) infected or uninfected people. In general, most tests rely on detection of pieces of the viral genes (nasal swab test) or detection of virus surface structure antigens by immunoglobulins (serology blood test). Testing is now available at many sites, hospitals, and doctors' offices around the country, but availability of these tests varies in many parts of the U.S. In addition, the FDA (Pixel Covid-19 test) approved a LabCorp COVID-19 at-home testing kit for emergency use.

What are treatment options for COVID-19 infections?

Fortunately, to date (January 2021), there is now an antiviral drug and vaccines to treat this infection. Symptom relief and supportive care (many requiring hospital care and some need ventilator respiratory support) are also part of the current treatment methods. However, early supportive care may reduce the disease severity. Supportive care may include treatments to reduce symptoms such as fever, cough, and nausea and oxygen by nasal cannula and even mechanical breathing support in severe infections. Other treatments that may be used and determined by your doctors (and availability) may include the following:

When to seek urgent medical care for a COVID-19 infection

If you have been exposed to the virus, put on a mask if one is available and call your doctor for detailed instructions. About 80% of infected individuals do not require hospital treatment. However, you should seek immediate medical care (go to the hospital/ER) if you develop one or more of the following (CDC criteria):

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face (cyanosis)

What are the complications associated with COVID-19 (SARS-CoV-2) infections?

Complications associated with this viral infection include

  • difficulty breathing (may require a breathing machine),
  • high fever,
  • pneumonia,
  • severe cough,
  • organ failure (for example, kidney failure), and
  • death.

How can people prevent a COVID-19 (SARS-CoV-2) infection?

The following are the directions given by the CDC for coronavirus prevention:

  1. Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
  2. Avoid touching your eyes, nose, and mouth with unwashed hands.
  3. Avoid close contact with people who are sick.
  4. Stay home when you are sick.
  5. Cover your cough or sneeze with a tissue, and then throw the tissue in the trash.
  6. Clean and disinfect frequently touched objects and surfaces.
  7. Follow social distancing protocols.

In addition, because of the need of hospitalization for many infected people, many governments have taken steps to limit the chances to spread infections by isolation techniques such as closing down public events and even preventing public transportation, and closing schools and work places. The U.S. and other countries have chartered planes to remove their citizens from outbreak areas in the world. In the U.S., airports are screening people arriving from high-risk areas. Many states issued orders for social distancing (keep 6 feet away from other people), meaning that all people should remain in their homes (except for essential workers) except for emergencies and getting food supplies until the infection level reaches a low percentage.

Vaccines to prevent a COVID-19 (SARS-CoV-2) infection became available in late December and/or early January in the U.S. Availability is currently limited to certain high-risk individuals (like health care workers, elderly). The two now cleared by the FDA are the Pfizer/BioNTech vaccine and the Moderna vaccine. Other vaccines are also being produced and administered in other countries (England, China, Russia). In addition, it is likely that several other vaccines against this disease may be FDA approved in the near future.

What is the mortality rate for COVID-19 (SARS-CoV-2) infections?

This outbreak is about a year old. Determination of the mortality rate may change as the disease outbreak continues. For example, if hospitals become unable to give supportive care to patients because of a lack of hospital beds due to overcrowding, the mortality rate will likely increase. However, if the outbreak is contained quickly and the hospitals have enough beds available to treat patients, the mortality rate may decrease. However, as of July 22, 2021, there were about 192,538,652 infected people worldwide with 4,135,321 deaths, which gives COVID-19 a current world mortality rate of about 2.15%. These rates will change, perhaps drastically, once widespread testing accurately calculates the true infected rates. If worldwide adaptation of mask-wearing and strict hand-washing protocols, along with worldwide vaccinations occur, experts suggest this pandemic can be controlled.

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References
United States. Centers for Disease Control and Prevention (CDC). "2019 Novel Coronavirus, Wuhan, China." Oct. 28, 2020. <https://www.cdc.gov/coronavirus/2019-ncov/about/index.html>.

"Wuhan Coronavirus (2019-nCoV) Global Cases (by Johns Hopkins CSSE)." ReliefWeb.int. Jan. 4, 2021. <https://reliefweb.int/report/world/wuhan-coronavirus-2019-ncov-global-cases-johns-hopkins-csse>.

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