Coronavirus (patient information)

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Coronavirus
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for Coronavirus?
Prevention
What to expect (Outlook/Prognosis)?
Possible complications
Coronavirus On the Web
Ongoing Trials at Clinical Trials.gov
Images of Coronavirus
Videos on Coronavirus
FDA on Coronavirus
CDC on Coronavirus
Coronavirus in the news
Blogs on Coronavirus
Directions to Hospitals Treating Coronavirus
Risk calculators and risk factors for Coronavirus

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

Coronavirus is a genus of animal virus belonging to the family Coronaviridae. Coronavirus, named due to the "crown" like appearance of its surface projections, was first isolated from chickens in 1937. In 1965, Tyrrell and Bynoe used cultures of human ciliated embryonal trachea to propagate the first human coronavirus (HCoV) in vitro. There are now approximately 15 species in this family, which infect not only humans but cattle, pigs, rodents, cats, dogs and birds (some are serious veterinary pathogens, especially chickens). Coronavirus gained international popularity after the deadly SARS epidemic caused by SARS-CoV in 2002 - 2003. A novel coronavirus known as the MERS-CoV was the highlight of the year 2012 when it caused the Middle East respiratory syndrome (MERS) epidemic. 2019 Novel Coronavirus (2019-nCoV) is a virus identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China. Based on the grouping, coronavirus can be classified into three groups. It can also be classified into families based on the genome and the method of replication. The virus can also be classified based on human infectivity.

What are the Symptoms of Coronavirus?

2019-nCoV

For confirmed 2019-nCoV infections, reported illnesses have ranged from people with little to no symptoms to people being severely ill and dying. Symptoms can include:

• Fever
• Cough
• Shortness of breath

Common Human Coronaviruses

Common human coronaviruses, including types 229E, NL63, OC43, and HKU1, usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. Most people get infected with these viruses at some point in their lives. These illnesses usually only last for a short amount of time. Symptoms may include

• Runny nose
• Headache
• Cough
• Sore throat
• Fever
• A general feeling of being unwell

Human coronaviruses can sometimes cause lower-respiratory tract illnesses, such as pneumonia or bronchitis. This is more common in people with cardiopulmonary disease, people with weakened immune systems, infants, and older adults.

Other Human Coronaviruses

Two other human coronaviruses, MERS-CoV and SARS-CoV have been known to frequently cause severe symptoms. MERS symptoms usually include fever, cough, and shortness of breath which often progress to pneumonia. About 3 or 4 out of every 10 patients reported with MERS have died. MERS cases continue to occur, primarily in the Arabian Peninsula. SARS symptoms often included fever, chills, and body aches which usually progressed to pneumonia. No human cases of SARS have been reported anywhere in the world since 2004.

Transmission

2019-nCoV

• Much is unknown about how 2019-nCoV, a new coronavirus, spreads. Current knowledge is largely based on what is known about similar coronaviruses. Coronaviruses are a large family of viruses that are common in many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS, SARS, and now with 2019-nCoV.
• Most often, spread from person-to-person happens among close contacts (about 6 feet). Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory pathogens spread. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. It’s currently unclear if a person can get 2019-nCoV by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes

Who is at the Highest Risk?

The following individuals may be at high risk for contacting coronavirus infection:

• Close contacts of infected humans or animals
• Healthcare workers
• Immunocompromised individiuals
• Patients on immunosupressive therapy
• Patients with compromised respiratory system

Diagnosis

• Your healthcare provider may order laboratory tests on respiratory specimens and serum (part of your blood) to detect human coronaviruses. Laboratory testing is more likely to be used if you have severe disease or are suspected of having MERS.
• If you are experiencing symptoms, you should tell your healthcare provider about any recent travel or contact with animals. Most MERS-CoV infections have been reported from countries in the Arabian Peninsula. Therefore reporting a travel history or contact with camels or camel products is very important when trying to diagnose MERS.

Treatment Options

Treatment of coronavirus infection is limited to supportive measures and prevention of development of acute respiratory distress syndrome and quarantine.

Where to Find Medical Care for Coronavirus?

Directions to Hospitals Treating Coronavirus

Prevention

2019-nCoV

There is currently no vaccine to prevent 2019-nCoV infection. The best way to prevent infection is to avoid being exposed to this virus. However, as a reminder, CDC always recommends everyday preventive actions to help prevent the spread of respiratory viruses, including:

• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
• If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

What to Expect (Outlook/Prognosis)?

• The prognosis of the coronovirus infection is highly dependent on the type of the virus involved and the disease presentation.
• It has been noted that young children, elderly, immunocompromised, and individuals with comorbid conditions are at the highest risk for worse prognosis.
• A higher chest radiographic score coupled with a high number of medical comorbidities translated into poor prognosis and higher mortality in patients infected with MERS-CoV.

Possible Complications

• Coronavirus infection is most commonly complicated by respiratory distress indicating mechanical ventilation and ICU care.
• Other complications include:
  • Pneumonia
  • Kidney failure
  • Acute respiratory injury
  • Septic shock
  • Acute myocarditis

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