Recent updates. References: Uptodate

1. COVID-19
EPIDEMIOLOGY
Globally, more than four million
confirmed cases of COVID-19
have been reported. The
number is increasing daily
TRANSMISSION
1. Person to person:Via
respiratory droplets typically
within the distance of 6 feet
while coughing, sneezing or
talking.
2. Airborne: Through the
particles smaller than droplet
that remain in air over time and
distance.
3. Virus has been found in non
respiratory droplets such as
stool, blood, occular secretions
and semen, but the role of these
sites in transmission is uncertain
TAXONOMY
Category: Coronaviruses
Kingdom: Riboviria
Order: Nidovirales
Sub-Order: Cornidovirineae
Family: Coronaviridae
Sub- Family: Orthocoronaviridae
Genus: Betacoronavirus
Sub-Genus: Sarbecovirus
Species: SARS-r Coronavirus
Individuum: SARS-CoV2
CLINICAL FEATURES
Incubation period: 14 days
following exposure
Spectrum of Illness severity
1. Mild: No or mild Pneumonia
2. Severe: With dyspnea,
hypoxia or >50% Lung
involvement on imaging within
24-48 hours
3. Critical: With respiratory
failure, shock or multi-organ
dysfunction
Overall case fatality rate: 2.3%
RISK FACTORS FOR SEVERE
ILLNESS
Cardiovascular disease
Diabetes mellitus
Hypertension
Chronic lung disease
Cancer (in particular
hematologic malignancies, lung
cancer, and metastatic disease)
Chronic kidney disease
Obesity
Smoking
LAB FEATURES with worse
outcomes
Lymphopenia
Elevated liver enzymes
Elevated lactate
dehydrogenase (LDH)
Elevated inflammatory markers (
eg, C-reactive protein [CRP],
ferritin)
Elevated D-dimer (>1 mcg/mL)
Elevated prothrombin time (PT)
Elevated troponin
Elevated creatine
phosphokinase (CPK)
Acute kidney injury
Fever in 99 percent (note that fever on
presentation is not this common in all
studies
Fatigue in 70 percent
Dry cough in 59 percent
Anorexia in 40 percent
Myalgias in 35 percent
Dyspnea in 31 percent
Sputum production in 27 percent
DIAGNOSIS
NAAT (RT-PCR) to diagnose
current infection
SPECIMEN COLLECTION
One of the following
Nasopharyngeal swab
specimen, collected by a health
care professional
Oropharyngeal swab specimen,
collected by a health care
professional
Nasal swab specimen from the
anterior nares, collected by a
health care professional or by
the patient on-site or at home
Nasal or nasopharyngeal wash/
aspirate, collected by a health
care professional
MANAGEMENT
Symptomatic and Supportive
Antiviral drugs are under study
to reduce the course of the
disease such as Fapilavir,
Remdesivir. Furthe studies are
required
PREVENTION
Infection control in health care
setting
Personal Preventive measures:
Social distancing
Diligent hand washing,
particularly after touching
surfaces in public.
Use of hand sanitizer that
contains at least 60 percent
alcohol is a reasonable
alternative if the hands are not
visibly dirty.
Respiratory hygiene (eg,
covering the cough or sneeze).
Avoiding touching the face (in
particular eyes, nose, and
mouth).
Cleaning and disinfecting
objects and surfaces that are
frequently touched.