1. COVID-19 (coronavirus disease 2019) is
an infectious disease caused by severe
acute respiratory syndrome coronavirus
2 (SARS-CoV-2), previously known
as 2019 novel coronavirus (2019-nCoV),
a strain of Corona Virus

2. The first cases were seen in Wuhan, China
in December 2019 before spreading globally.
The current outbreak was recognized as a
P a n d e m i c o n 1 1 M a r c h 2 0 2 0 .

3. Most people infected with the COVID-19
virus will experience mild to moderate
respiratory illness and recover without
requiring special treatment. Older people,
and those with underlying medical
problems like cardiovascular disease,
diabetes, chronic respiratory disease, and
cancer are more likely to develop serious
illness.

4. The best way to prevent and slow down
transmission is be well informed about the
COVID-19 virus, the disease it causes and
how it spreads. Protect yourself and others
from infection by washing your hands or
using an alcohol based rub frequently and
not touching your face.

5. The COVID-19 virus spreads primarily
through droplets of saliva or discharge
from the nose when an infected person
coughs or sneezes, so it’s important that
you also practice respiratory etiquette
(for example, by coughing into a flexed
elbow).

6. Terminology
The WHO originally called this illness "novel
coronavirus-infected pneumonia (NCIP)" and
the virus itself had been named "2019 novel
coronavirus (2019-nCoV)
On 11 February 2020, the WHO officially
renamed the clinical condition COVID-19 (a
shortening of COronaVIrus Disease-19) .

7. Terminology
day, the
on the same
Study Group (CSG) of the
Coincidentally,
Coronavirus
International Taxonomy of
Viruses renamed
Committee on
the virus "severe acute
respiratory syndrome coronavirus 2" (SARS-
CoV-2) .

8. Terminology
The official virus name is similar to SARS-CoV,
the virus strain that caused epidemic Severe
Acute Respiratory Syndrome(SARS) in 2002-
2004, potentially causing confusion . The WHO
has stated it will use "COVID-19 virus" or the
"virus that causes COVID-19" instead of its
official name, SARS-CoV-2, in dealings with the
public.

9. Epidemiology
As of 31 March 2020, 754.948 cases of
COVID-19 have been confirmed worldwide,
having been diagnosed in 203 countries,
with 36.571 confirmed deaths. There are
nine countries with >10,000 confirmed
cases and 27 countries with between 1000
and 10,000 confirmed cases. On 27 March
2020, the USA surpassed China as the
country with the most confirmed cases

10. Epidemiology
SARS-CoV-2 has been
The R0(basic reproduction number) of
estimated
between 2.2 and 3.28 , that is each infected
individual, on average, causes between 2-3
new infections.

11. Epidemiology
The Incubation period for COVID-19 was initially
calculated to be ~5 days, which was based on 10 patients
only . An American group performed an epidemiological
analysis of 181 cases, for which days of exposure and
symptom onset could be estimated accurately. They
calculated a median incubation period of 5.1 days, that
97.5% became symptomatic within 11.5 days ( 8.2 to 15.6
days) of being infected, and that extending the cohort to
the 99th percentile results in almost all cases developing
symptoms in 14 days after exposure to SARS-CoV-2

12. Epidemiology
The number of deaths from COVID-19 is 36.571 (31
March), with a case fatality rate of 2-3% . It is speculated
that the true case fatality rate is lower than this, because
many mild cases are not being tested which thus skews
the apparent death rate upwards
A paper published by the Chinese Center for Disease
Control and Prevention (CCDC) analyzed all 44,672 cases
diagnosed up to 11 February 2020. Of these, 1.2% were
asymptomatic and 80.9% were classed as "mild"

13. Epidemiology
Another study looked at clinical characteristics in
COVID-19
COVID-19
positively tested closed contacts of
patients . Approximately 30% of those
COVID-19 positive close contacts never developed
any symptoms or changes on chest CT scans. The
remainder showed changes on CT but ~20%
reportedly developed symptoms during their hospital
course, none of them developed severe disease .
This suggests that a high percentage of COVID-19
carriers are asymptomatic.

14. Epidemiology
In the Chinese population, 55-60% of COVID-19
patients were males and the median age has
been reported between 47 and 59 years
Children seem to be relatively unaffected by this
virus, or indeed closely-related
coronaviruses with
other
large cohort studies
reporting that 1-2% of COVID-19 patients are
children.

15. Epidemiology
However, there have been cases of critically-ill
children with infants under 12 months likely to be
more seriously affected . A very low number of
pediatric deaths have been reported . In children,
male gender does not seem to be a risk factor .
The incubation period has been reported to
shorter than adults, at about two days .

16. Clinical presentation
COVID-19 typically presents with systemic
and/or respiratory manifestations . Some
individuals infected with SARS-CoV-2 are
can act as
mild
asymptomatic
carriers . Some
gastrointestinal
and
also experience
or cardiovascular
symptoms, although these are much less
common1

17. Clinical presentation
Common:
Fever (85-90%)
Cough(65-70%)
fatigue (35-40%)
sputum production
(30-35%)
shortness of breath
(15-20%)
Less common:
Mylagia/arthralgia
(10-15%)
headaches (10-
15%)
sore throat (10-
15%)
chills (10-12%)
pleuritic pain

18. Clinical presentation
Rare:
nausea, vomiting, nasal congestion (<10%),
diarrhoea (<5%)
Palpitation and chest tightness

19. Clinical presentation
Pediatric
In the main, the clinical presentation in children
with COVID-19 is milder than in adults.
chest
Symptoms are similar to any acute
infection, encompassing
pyrexia, dry cough, sore
most
throat,
commonly
sneezing,
myalgia and lethargy. Wheezing has also been
noted . Other less common (<10%) symptoms
in children included diarrhea, lethargy,
rhinorrhea and vomiting

20. Diagnosis

22. Diagnosis
The definitive test for SARS-CoV-2 is
reverse
chain
transcriptase-
reaction (RT-
the real-time
polymerase
PCR) test and is believed to be
highly specific but with sensitivity reported as
low as 60-70% and as high as 95-97% .
Thus, false negatives are a real clinical
problem and several negative tests might be
required in a single case to be confident
about excluding the disease.

23. Laboratory tests
The most common ancillary laboratory
findings in a study of 138 hospitalized
patients were the following :
lymphopenia
increased prothrombin time (PT)
increased lactate dehydrogenase
Mild elevations of inflammatory
and D-dimer are
markers (CRP and ESR)
also seen