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This article is about the disease. For the virus, see 2019 novel coronavirus. For the outbreak, see 2019–20 Wuhan coronavirus outbreak.

COVID-19
Other namesNovel coronavirus pneumonia[1]
Symptoms
SpecialtyInfectious diseases, pulmonology, virology, epidemiology, emergency medicine Edit this on Wikidata
SymptomsFever, cough, shortness of breath
ComplicationsPneumonia, ARDS, kidney failure
CausesSARS-CoV-2
Diagnostic methodPCR testing
TreatmentSymptomatic and supportive

COVID-19 (COrona VIrus Disease 2019),[2] also known as 2019-nCoV acute respiratory disease, and novel coronavirus pneumonia ('NCP),[1] is an infectious disease caused by the 2019 novel coronavirus (SARS-CoV-2).[3][4] It was first detected during the 2019–20 Wuhan coronavirus outbreak.[5][6] It results in flu-like symptoms,[7][8] including fever, coughing, shortness of breath, pain in the muscles and tiredness. It may result in pneumonia, acute respiratory distress syndrome, sepsis and septic shock, and possible death. There is no specific treatment, with efforts typically to manage symptoms and support functioning.[7]

The most common method of spread is between people, generally airborne by respiratory droplets that people sneeze, cough, or exhale.[7] Symptoms generally begin 2 to 14 days after exposure.[9] Transmission can be limited by washing hands regularly, wearing surgical masks, and prompt diagnosis.[10][11][8]

The disease was first identified by health authorities in the city of Wuhan, capital of Hubei province in China, among patients who had developed pneumonia of no clear cause.[12] Amid rapid spread of the disease, the World Health Organization has since declared the 2019-20 Wuhan coronavirus outbreak to be a Public Health Emergency of International Concern (PHEIC), based on the impact the virus could have on poorer countries with weaker healthcare infrastructures.[13] Infections have been reported throughout the Western world and the Asia-Pacific, mostly of travelers originating in Mainland China, with local transmission also reported in Germany,[14] France,[15] Hong Kong,[16] Vietnam,[17] Thailand,[18] Singapore,[19] Japan,[18] South Korea,[20] and Australia.[21] The deaths have been reported in Mainland China, the Philippines,[22] and Hong Kong.[23] As of 11 February 2020, only Mainland China is listed as an area with known ongoing community transmission of SARS-CoV-2.[24]

Signs and symptoms

Those infected may either be asymptomatic or have mild to severe symptoms, like fever, cough, shortness of breath.[25][26][27] Diarrhea or upper respiratory symptoms (e.g. sneezing, runny nose, sore throat) are less frequent.[28] Cases can progress to severe pneumonia, multi-organ failure, and death.[5][29]

The incubation period is estimated at 2 to 10 days by the World Health Organization,[30] and 2 to 14 days by the US Centers for Disease Control and Prevention (CDC).[31] A study published in February by several dozen researchers in China, including the doctor responsible for discovering SARS, found evidence of the incubation period stretching to 24 days.[32]

Cause

Main article: 2019 novel coronavirus

The cause is the virus named SARS-CoV-2, [3] which is thought to have a zoonotic origin.[33]

The primary mode of transmission is human-to-human transmission via respiratory droplets that people sneeze, cough or exhale.[7]

Diagnosis

The WHO has published several testing protocols for the disease.[34][35] Testing uses real time reverse transcription-polymerase chain reaction (rRT-PCR).[36] The test can be done on respiratory or blood samples.[37] Results are generally available within a few hours to days.[38][39] Chinese scientists were able to isolate a strain of the coronavirus and publish the genetic sequence so that laboratories across the world could independently develop PCR tests to detect infection by the virus.[5][40][41][42][43]

Diagnostic guidelines released by Zhongnan Hospital of Wuhan University suggested methods for detecting infections based upon clinical features and epidemiological risk. These involved identifying patients who had at least two of the following symptoms in addition to a history of travel to Wuhan or contact with other infected patients: fever, imaging features of pneumonia, normal or reduced white blood cell count, or reduced lymphocyte count.[44]

Prevention

Global health organisations have published preventive measures to reduce the chances of infection. Recommendations are similar to those published for other coronaviruses and include: frequent washing of hands with soap and water; not touching the eyes, nose, or mouth with unwashed hands; and practicing good respiratory hygiene.[45][46]

Management

There are no known treatments for the disease. The WHO recommended volunteers take part in randomized controlled trials for testing the effectiveness and safety of potential treatments.[47]

Research into potential treatments for the disease were initiated in January 2020, and new therapies may take until 2021 to develop.[48] The Chinese Center for Disease Control and Prevention started testing existing pneumonia treatments in coronavirus-related pneumonia in late January.[49] There has also been examination of the RNA polymerase inhibitor remdesivir,[50][51][52][53] and interferon beta.[53]

In late January 2020, Chinese medical researchers expressed an intent to start clinical testing on remdesivir, chloroquine, and lopinavir/ritonavir, all of which seemed to have "fairly good inhibitory effects" on the virus at the cellular level in exploratory research.[54] On 5 February 2020, China started patenting use of remdesivir for the disease.[55][56][57]

The Russian Ministry of Health identified 3 medicines for adults that may help treat the disease, in late January 2020. Ribavirin, lopinavir/ritonavir and interferon beta-1b can be used to fight the coronavirus, according to them. These drugs are typically used to treat hepatitis C, HIV and multiple sclerosis respectively. The Russian Health Ministry offered descriptions and guidelines in how the treatments works, and in what quantities these recommendations should be prescribed for doctors in hospitals throughout Russia.[58] In February it was reported that China started testing Triazavirin, a 2014 Russian anti-viral drug, in the hope that it might be helpful in controlling the new coronavirus. Triazavirin was developed at Ural Federal University in Yekaterinburg, originally to combat H5N1. Due to similarities between the two infections, the researchers feel that it may be worth testing according to the reports. The drug is claimed to be effective against Rift Valley fever and the West Nile virus, as well as other viral infections.[59][60]

Epidemiology

Main article: 2019–20 Wuhan coronavirus outbreak

Overall mortality and morbidity rates due to infection are not well established; while the case fatality rate changes over time in the current outbreak, the proportion of infections that progress to diagnosable disease remains unclear.[61][62] However, preliminary research has yielded case fatality rate numbers between 2% and 3%,[63] and in January 2020 the WHO suggested that the case fatality rate was approximately 3%.[64] An unreviewed Imperial College preprint study among 55 fatal cases noted that early estimates of mortality may be too high as asymptomatic infections are missed. They estimated a mean infection fatality ratio (the mortality among infected) ranging from 0.8% when including asymptomatic carriers to 18% when including only symptomatic cases from Hubei province.[65]

As of 12 February 2020, 45,207 cases have been confirmed, 7,345 are severe (16%)[66] with 4,805 having recovered.[67]

Prognosis

Early data indicates that among the first 41 confirmed cases that were admitted to hospitals in Wuhan, 13 (32%) individuals required intensive care, and 6 (15%) individuals died.[28] Of those who died, many were in unsound health to begin with, exhibiting conditions like hypertension, diabetes, or cardiovascular disease that impaired their immune systems.[68]

In early cases that resulted in death, the median time of disease was found to be 14 days, with a total range from six to 41 days.[69]

Psychological

Psychological effects may be caused by feeling trapped under quarantine, travel restrictions and isolation.[70] At the end of January 2020, the National Health Commission of China published a national guideline of psychological crisis intervention for the disease, endorsing mental health care for people affected, close contacts, those isolated at home, families and friends of affected people, health care workers and the general public who need it.[71][72]

Naming

The World Health Organization on 11 February 2020 announced that "COVID-19" will be the official name of the disease. World Health Organization chief Tedros Adhanom Ghebreyesus said "co" stands for "corona", "vi" for "virus" and "d" for "disease", while "19" was for the year, as the outbreak was first identified on December 31. Tedros said the name had been chosen to avoid references to a specific geographical location, animal species or group of people in line with international recommendations for naming aimed at preventing stigmatisation.[73]

See also

References

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