coronavirus (covid-19)

Microbiology and epidemiology

• Person-to-person transmission via respiratory particles; asx & pre-sx transmission can occur
• Incubation period: up to 14 days, median time of 4–5 days from exposure to sx onset

Presentation

• Ranges from asx to severe illness. Of those with sx, 81% mild-to-moderate, 14% severe (hypoxia), 5% critical (ARDS, shock, multiorgan failure) (JAMA 2020:323;13)

• Common sx: fever, chills, cough, dyspnea, myalgias, HA, N/V, diarrhea, loss of smell/taste

• Risk factors for severe illness: age ≥65, CVD, DM, stroke, lung dx, CKD, obesity Diagnosis

• RT-PCR testing of nasopharynx, lower respiratory tract, or anterior nares

• Rapid antigen testing of anterior nares (less Se than PCR)

• CXR: typically bilateral opacities (esp peripheral), can be nl early; consider CT if dx ?

• Treatment of COVID-19 󰒗 (https://www.covid19treatmentguidelines.nih.gov/)

• Prevention

  • Vaccines against spike protein highly effective. Infxn may occur but severity much lower.

• See CDC website for quarantine guidelines (https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html)