COVID-19 physical examination: Difference between revisions

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*[[Patient|Patients]] with mild [[disease]] may appear healthy.
*[[Patient|Patients]] with mild [[disease]] may appear healthy.
*[[Patient|Patients]] will appear [[Illness|sick]], [[lethargic]], and [[Dyspnea|short of breath]] in severe [[disease]].
*[[Patient|Patients]] will appear [[Illness|sick]], [[lethargic]], and [[Dyspnea|short of breath]] in severe [[disease]].
*Patient may appear [[dehydrated]] (dry skin and [[mucosa]]) due to increased [[respiratory rate]], [[nausea]] and [[vomiting]],  
*Patient may appear [[dehydrated]] (decreased [[skin turgor]] and dry [[mucosa]]) due to increased [[respiratory rate]], [[nausea]] and [[vomiting]],  
*[[Confusion]] can be due to severe [[dehydration]], [[electrolyte]] imbalances such as in [[COVID-19-associated acute kidney injury]], [[COVID-19-associated encephalitis]], [[COVID-19-associated meningitis]] or [[COVID-19-associated stroke]]. [[Glasgow coma scale]] can gauge the conscious state of the patient.
*[[Confusion]] can be due to severe [[dehydration]], [[electrolyte]] imbalances such as in [[COVID-19-associated acute kidney injury]], [[COVID-19-associated encephalitis]], [[COVID-19-associated meningitis]] or [[COVID-19-associated stroke]]. [[Glasgow coma scale]] can gauge the conscious state of the patient.
*[[Anxiety]] is an important accompanying factor with most patients visiting hospitals, provided the heterogeneous nature of the disease. A healthy patient may worry about contracting the infection while visiting the hospital or doctor's office.
*[[Anxiety]] is an important accompanying factor with most patients visiting hospitals, provided the heterogeneous nature of the disease. A healthy patient may worry about contracting the infection while visiting the hospital or doctor's office.
*[[Cyanosis]] depicts severe [[hypoxemia]] and the need for supplemental oxygen.


=== Vital Signs ===
=== Vital Signs ===
Line 40: Line 41:
</ref>: The lesion constitutes finger or toe [[cyanosis]], skin [[bullae]] and [[dry gangrene]].
</ref>: The lesion constitutes finger or toe [[cyanosis]], skin [[bullae]] and [[dry gangrene]].
**Chilblain-like<ref name="PiccoloNeri2020">{{cite journal|last1=Piccolo|first1=V.|last2=Neri|first2=I.|last3=Filippeschi|first3=C.|last4=Oranges|first4=T.|last5=Argenziano|first5=G.|last6=Battarra|first6=V.C.|last7=Berti|first7=S.|last8=Manunza|first8=F.|last9=Fortina|first9=A.B.|last10=Di Lernia|first10=V.|last11=Boccaletti|first11=V.|last12=De Bernardis|first12=G.|last13=Brunetti|first13=B.|last14=Mazzatenta|first14=C.|last15=Bassi|first15=A.|title=Chilblain‐like lesions during COVID‐19 epidemic: a preliminary study on 63 patients|journal=Journal of the European Academy of Dermatology and Venereology|year=2020|issn=0926-9959|doi=10.1111/jdv.16526}}</ref>:They constitute [[bilateral]] red-purple [[papules]] on the [[dorsum]] of the fingers and diffuse [[erythema]] in the [[subungual]] area of thumb. Late in the [[COVID-19|SARS CoV2]] disease course, pseudo‐chilblain pattern frequently appear.
**Chilblain-like<ref name="PiccoloNeri2020">{{cite journal|last1=Piccolo|first1=V.|last2=Neri|first2=I.|last3=Filippeschi|first3=C.|last4=Oranges|first4=T.|last5=Argenziano|first5=G.|last6=Battarra|first6=V.C.|last7=Berti|first7=S.|last8=Manunza|first8=F.|last9=Fortina|first9=A.B.|last10=Di Lernia|first10=V.|last11=Boccaletti|first11=V.|last12=De Bernardis|first12=G.|last13=Brunetti|first13=B.|last14=Mazzatenta|first14=C.|last15=Bassi|first15=A.|title=Chilblain‐like lesions during COVID‐19 epidemic: a preliminary study on 63 patients|journal=Journal of the European Academy of Dermatology and Venereology|year=2020|issn=0926-9959|doi=10.1111/jdv.16526}}</ref>:They constitute [[bilateral]] red-purple [[papules]] on the [[dorsum]] of the fingers and diffuse [[erythema]] in the [[subungual]] area of thumb. Late in the [[COVID-19|SARS CoV2]] disease course, pseudo‐chilblain pattern frequently appear.
**[[COVID-19]] Toes: Toes and fingers turn purple or pink as happens during cold. It is mostly seen in younger patients. A patient presented with purple toes should be tested for [[COVID-19]] virus infection.
 


===HEENT===
===HEENT===
*Head examination: Patients with Fluid retention, leading edema and swelling of face and extremities
*Head examination: Patients with [[fluid retention]] due to [[COVID-19-associated acute kidney injury]] may have edema (especially [[periorbital]] and [[swelling]] of face and extremities. Cervical [[lymphadenopathy]] can be present although very few cases have been reported.<ref name="pmid32306118">{{cite journal |vauthors=Krajewska J, Krajewski W, Zub K, Zatoński T |title=COVID-19 in otolaryngologist practice: a review of current knowledge |journal=Eur Arch Otorhinolaryngol |volume=277 |issue=7 |pages=1885–1897 |date=July 2020 |pmid=32306118 |pmc=7166003 |doi=10.1007/s00405-020-05968-y |url=}}</ref>
*[[Eye examination]]:  
*[[Eye examination]]:  
**[[Conjunctivitis]]: has been reported but there is no well established data regarding this manifestation.<ref name="pmid32175797">{{cite journal |vauthors=Seah I, Agrawal R |title=Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Coronaviruses and Ocular Implications in Humans and Animals |journal=Ocul. Immunol. Inflamm. |volume=28 |issue=3 |pages=391–395 |date=April 2020 |pmid=32175797 |pmc=7103678 |doi=10.1080/09273948.2020.1738501 |url=}}</ref>
**[[Conjunctivitis]]: has been reported but there is no well established data regarding this manifestation.<ref name="pmid32175797">{{cite journal |vauthors=Seah I, Agrawal R |title=Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Coronaviruses and Ocular Implications in Humans and Animals |journal=Ocul. Immunol. Inflamm. |volume=28 |issue=3 |pages=391–395 |date=April 2020 |pmid=32175797 |pmc=7103678 |doi=10.1080/09273948.2020.1738501 |url=}}</ref>
**[[Epiphora]]: Patients can have teary eyes due to [[conjunctivitis]] itself or foreign body sensation.<ref name="pmid32232433">{{cite journal |vauthors=Wu P, Duan F, Luo C, Liu Q, Qu X, Liang L, Wu K |title=Characteristics of Ocular Findings of Patients With Coronavirus Disease 2019 (COVID-19) in Hubei Province, China |journal=JAMA Ophthalmol |volume= |issue= |pages= |date=March 2020 |pmid=32232433 |pmc=7110919 |doi=10.1001/jamaophthalmol.2020.1291 |url=}}</ref>
**[[Epiphora]]: Patients can have teary eyes due to [[conjunctivitis]] itself or foreign body sensation.<ref name="pmid32232433">{{cite journal |vauthors=Wu P, Duan F, Luo C, Liu Q, Qu X, Liang L, Wu K |title=Characteristics of Ocular Findings of Patients With Coronavirus Disease 2019 (COVID-19) in Hubei Province, China |journal=JAMA Ophthalmol |volume= |issue= |pages= |date=March 2020 |pmid=32232433 |pmc=7110919 |doi=10.1001/jamaophthalmol.2020.1291 |url=}}</ref>
**Although there are no reports of blurred [[vision]] but [[visual acuity]] should be accessed.
**Although there are no reports of blurred [[vision]] but [[visual acuity]] should be accessed.
*Ear exam:
*Ear exam: A case report of [[COVID-19]] associated [[otitis media]] showed [[hyperemia]] and bulging [[tympanic membrane]] in the patient. [[udiometry]] and [[tympanometry]] can help investigate hearing sequelae.<ref name="Fidan2020">{{cite journal|last1=Fidan|first1=Vural|title=New type of corona virus induced acute otitis media in adult|journal=American Journal of Otolaryngology|volume=41|issue=3|year=2020|pages=102487|issn=01960709|doi=10.1016/j.amjoto.2020.102487}}</ref>
*Nasal exam:
*Nasal exam: [[Runny nose]] and [[nasal congestion]] are relatively common [[physical exam]] findings.
*Throat exam:
*Throat exam: Throat [[congestion]], [[Tonsil]] [[edema]] have been reported.<ref name="pmid32306118">{{cite journal |vauthors=Krajewska J, Krajewski W, Zub K, Zatoński T |title=COVID-19 in otolaryngologist practice: a review of current knowledge |journal=Eur Arch Otorhinolaryngol |volume=277 |issue=7 |pages=1885–1897 |date=July 2020 |pmid=32306118 |pmc=7166003 |doi=10.1007/s00405-020-05968-y |url=}}</ref>


===Neck===
===Neck===
Line 71: Line 72:


===Abdomen===
===Abdomen===
 
*Some [[Patient|patients]] with [[COVID-19]] may report [[abdominal pain]] but abdominal exam findings to be positive is very rare.<ref name="pmid32215956">{{cite journal |vauthors=Wong SH, Lui RN, Sung JJ |title=Covid-19 and the digestive system |journal=J. Gastroenterol. Hepatol. |volume=35 |issue=5 |pages=744–748 |date=May 2020 |pmid=32215956 |doi=10.1111/jgh.15047 |url=}}</ref> Based on three case reports describing patients' atypical [[COVID-19]] presenting complaints the following findings can be seen in patients:<ref name="pmid32309266">{{cite journal |vauthors=Poggiali E, Ramos PM, Bastoni D, Vercelli A, Magnacavallo A |title=Abdominal Pain: A Real Challenge in Novel COVID-19 Infection |journal=Eur J Case Rep Intern Med |volume=7 |issue=4 |pages=001632 |date=2020 |pmid=32309266 |pmc=7162568 |doi=10.12890/2020_001632 |url=}}</ref><ref name="pmid32387082">{{cite journal |vauthors=Hadi A, Werge M, Kristiansen KT, Pedersen UG, Karstensen JG, Novovic S, Gluud LL |title=Coronavirus Disease-19 (COVID-19) associated with severe acute pancreatitis: Case report on three family members |journal=Pancreatology |volume=20 |issue=4 |pages=665–667 |date=June 2020 |pmid=32387082 |pmc=7199002 |doi=10.1016/j.pan.2020.04.021 |url=}}</ref><ref name="pmid32523872">{{cite journal |vauthors=Abdalhadi A, Alkhatib M, Mismar AY, Awouda W, Albarqouni L |title=Can COVID 19 present like appendicitis? |journal=IDCases |volume=21 |issue= |pages=e00860 |date=2020 |pmid=32523872 |pmc=7265835 |doi=10.1016/j.idcr.2020.e00860 |url=}}</ref>
*[[Abdominal examination]] of [[Patient|patients]] infected with COVID-19 is usually normal.
*[[Inspection]]: Slight abdominal distension on day 4 of admission in a single case presenting as [[acute pancreatitis]].
*Some [[Patient|patients]] report [[abdominal pain]].<ref name="pmid32215956">{{cite journal |vauthors=Wong SH, Lui RN, Sung JJ |title=Covid-19 and the digestive system |journal=J. Gastroenterol. Hepatol. |volume=35 |issue=5 |pages=744–748 |date=May 2020 |pmid=32215956 |doi=10.1111/jgh.15047 |url=}}</ref>
*[[Palpation]]: One [[COVID-19]] positive patient had abdominal [[tenderness]] and [[rebound tenderness]] at the [[right iliac fossa]] with no diagnostic proof of [[acute appendicitis]]. Direct [[epigastric]] and [[periumbilical]] [[tenderness]] is reported in only one case. The presence of [[hepatomegaly]] in patients with [[COVID-19-associated hepatic injury]] maybe a forethought of [[organomegaly]].<ref name="pmid32274341">{{cite journal |vauthors=Li J, Fan JG |title=Characteristics and Mechanism of Liver Injury in 2019 Coronavirus Disease |journal=J Clin Transl Hepatol |volume=8 |issue=1 |pages=13–17 |date=March 2020 |pmid=32274341 |pmc=7132021 |doi=10.14218/JCTH.2020.00019 |url=}}</ref>
*[[Percussion]]: No abnormal findings have been reported.
*[[Auscultation]]: [[Decreased bowel sounds|Hypo]]/[[Increased bowel sounds|hyperactive bowel sounds]] have not been reported.


===Back===
===Back===
 
* [[Gait]] can be impaired and the patient will have [[flaccid paralysis]] in [[COVID-19-associated Guillain-Barre syndrome]] and [[COVID-19-associated polyneuritis cranialis]].
* [[Human back|Back]] [[examination]] of [[Patient|patients]] [[Infection|infected]] with coronavirus is usually normal.


===Genitourinary===
===Genitourinary===


* [[Genitourinary system|Genitourinary]] [[Physical examination|examination]] of [[Patient|patients]] [[Infection|infected]] with coronavirus is usually normal.
* There are no reports of [[Genitourinary system|genitourinary]] manifestations of [[COVID-19]] but due to the association of [[SARS]] with [[orchitis]] due to [[autoimmune]] mechanisms, yrologists recommend that [[Genitourinary system|genitourinary]] [[Physical examination|examination]] of [[Patient|patients]] [[Infection|infected]] with coronavirus is usually not be missed.<ref name="WangZhou2020">{{cite journal|last1=Wang|first1=Shangqian|last2=Zhou|first2=Xiang|last3=Zhang|first3=Tongtong|last4=Wang|first4=Zengjun|title=The need for urogenital tract monitoring in COVID-19|journal=Nature Reviews Urology|volume=17|issue=6|year=2020|pages=314–315|issn=1759-4812|doi=10.1038/s41585-020-0319-7}}</ref>


===Neuromuscular===
===Neuromuscular===
 
Dizziness;
* [[Neuromuscular]] [[Physical examination|examination]] of [[Patient|patients]] [[Infection|infected]] with coronavirus shows:
* [[Neuromuscular]] [[Physical examination|examination]] of [[Patient|patients]] [[Infection|infected]] with coronavirus shows:
*[[Cranial nerves|Cranial Nerve 1]] or [[Olfactory nerve]] should be [[Cranial nerve examination|examined]] to evaluate for [[anosmia]]. Studies suggests that anosmia can be an important clue, heping the diagnosis of COVID-19 specially in the early stages.<ref name="pmid32383370">{{cite journal |vauthors=Lee Y, Min P, Lee S, Kim SW |title=Prevalence and Duration of Acute Loss of Smell or Taste in COVID-19 Patients |journal=J. Korean Med. Sci. |volume=35 |issue=18 |pages=e174 |date=May 2020 |pmid=32383370 |pmc=7211515 |doi=10.3346/jkms.2020.35.e174 |url=}}</ref> According to a study published [[anosmia]] and [[aguesia]] to be strong predictors of COVID-1 infection.<ref name="MenniValdes2020">{{cite journal|last1=Menni|first1=Cristina|last2=Valdes|first2=Ana M.|last3=Freidin|first3=Maxim B.|last4=Sudre|first4=Carole H.|last5=Nguyen|first5=Long H.|last6=Drew|first6=David A.|last7=Ganesh|first7=Sajaysurya|last8=Varsavsky|first8=Thomas|last9=Cardoso|first9=M. Jorge|last10=El-Sayed Moustafa|first10=Julia S.|last11=Visconti|first11=Alessia|last12=Hysi|first12=Pirro|last13=Bowyer|first13=Ruth C. E.|last14=Mangino|first14=Massimo|last15=Falchi|first15=Mario|last16=Wolf|first16=Jonathan|last17=Ourselin|first17=Sebastien|last18=Chan|first18=Andrew T.|last19=Steves|first19=Claire J.|last20=Spector|first20=Tim D.|title=Real-time tracking of self-reported symptoms to predict potential COVID-19|journal=Nature Medicine|year=2020|issn=1078-8956|doi=10.1038/s41591-020-0916-2}}</ref>
*[[Cranial nerves|Cranial Nerve 1]] or [[Olfactory nerve]] should be [[Cranial nerve examination|examined]] to evaluate for [[anosmia]]. Studies suggests that anosmia can be an important clue, heping the diagnosis of COVID-19 specially in the early stages.<ref name="pmid32383370">{{cite journal |vauthors=Lee Y, Min P, Lee S, Kim SW |title=Prevalence and Duration of Acute Loss of Smell or Taste in COVID-19 Patients |journal=J. Korean Med. Sci. |volume=35 |issue=18 |pages=e174 |date=May 2020 |pmid=32383370 |pmc=7211515 |doi=10.3346/jkms.2020.35.e174 |url=}}</ref> According to a study published [[anosmia]] and [[aguesia]] to be strong predictors of COVID-1 infection.<ref name="MenniValdes2020">{{cite journal|last1=Menni|first1=Cristina|last2=Valdes|first2=Ana M.|last3=Freidin|first3=Maxim B.|last4=Sudre|first4=Carole H.|last5=Nguyen|first5=Long H.|last6=Drew|first6=David A.|last7=Ganesh|first7=Sajaysurya|last8=Varsavsky|first8=Thomas|last9=Cardoso|first9=M. Jorge|last10=El-Sayed Moustafa|first10=Julia S.|last11=Visconti|first11=Alessia|last12=Hysi|first12=Pirro|last13=Bowyer|first13=Ruth C. E.|last14=Mangino|first14=Massimo|last15=Falchi|first15=Mario|last16=Wolf|first16=Jonathan|last17=Ourselin|first17=Sebastien|last18=Chan|first18=Andrew T.|last19=Steves|first19=Claire J.|last20=Spector|first20=Tim D.|title=Real-time tracking of self-reported symptoms to predict potential COVID-19|journal=Nature Medicine|year=2020|issn=1078-8956|doi=10.1038/s41591-020-0916-2}}</ref>


===Extremities===
===Extremities===
 
*Patients with [[fluid retention]] due to [[COVID-19-associated acute kidney injury]], [[COVID-19-associated heart failure]] or [[COVID-19-associated hepatic injury]] have [[pedal edema]] on examination.
* [[Extremities]] [[Physical examination|examination]] of [[Patient|patients]] [[Infection|infected]] with coronavirus is usually normal.
*[[COVID-19]] toes: Toes and fingers turn purple or pink as happens during cold. It is mostly seen in younger patients. A patient presented with purple toes should be tested for [[COVID-19]] virus infection.
 
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 14:41, 28 June 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]; Syed Hassan A. Kazmi BSc, MD [3]

Overview

COVID-19 is a rapidly evolving situation and a heterogenous disease entity. A suspected or confirmed CVOVID-19 patient can have as common finding as fever and as unique yet significant finding as anosmia. Although, the most common physical examination findings in patients infected with coronavirus include fever, cough, and shortness of breath.[1] The patient may just have abdominal pain and tenderness on examination.[2] The general appearance of the patient infected with coronavirus-19 depends on the severity of the illness. High clinical suspicion and careful physical exam are they key to early diagnosis and treatment of SARS CoV2 infection.

Physical Examination

Physical exam of a suspected or confirmed case of SARS CoV2 patient should be conducted in a private room, preferably a negative pressure one. The examiner should have PPE that includes gloves, gowns or aprons, masks, or respirators covering the mouth and nose, goggles, and face shields.[3] If possible and the patient is in no respiratory distress, patient should wear a surgical mask.[4]

Appearance of the Patient

Vital Signs

Skin


HEENT

Neck

Lungs

may reveal increased work of breathing using accessory muscles, circumoral cyanosis, and/or confusion from hypoxia. Lung sounds initially are unremarkable, but the patient can develop a mild expiratory wheeze

Heart

Abdomen

Back

Genitourinary

Neuromuscular

Dizziness;

Extremities

References

  1. ↑ Zhu, Jieyun; Ji, Pan; Pang, Jielong; Zhong, Zhimei; Li, Hongyuan; He, Cuiying; Zhang, Jianfeng; Zhao, Chunling (2020). "Clinical characteristics of 3062 COVID‐19 patients: A meta‐analysis". Journal of Medical Virology. doi:10.1002/jmv.25884. ISSN 0146-6615.
  2. ↑ 2.0 2.1 Hadi A, Werge M, Kristiansen KT, Pedersen UG, Karstensen JG, Novovic S, Gluud LL (June 2020). "Coronavirus Disease-19 (COVID-19) associated with severe acute pancreatitis: Case report on three family members". Pancreatology. 20 (4): 665–667. doi:10.1016/j.pan.2020.04.021. PMC 7199002 Check |pmc= value (help). PMID 32387082 Check |pmid= value (help).
  3. ↑ "www.cdc.gov" (PDF).
  4. ↑ "Coronavirus (COVID-19) frequently asked questions | CDC".
  5. ↑ Guo T, Fan Y, Chen M, Wu X, Zhang L, He T; et al. (2020). "Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19)". JAMA Cardiol. doi:10.1001/jamacardio.2020.1017. PMC 7101506 Check |pmc= value (help). PMID 32219356 Check |pmid= value (help).
  6. ↑ (PDF) https://www.cdc.gov/sars/about/fs-SARS.pdf. Missing or empty |title= (help)
  7. ↑ Tobin, Martin J. (2020). "Basing Respiratory Management of COVID-19 on Physiological Principles". American Journal of Respiratory and Critical Care Medicine. 201 (11): 1319–1320. doi:10.1164/rccm.202004-1076ED. ISSN 1073-449X.
  8. ↑ Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. PMID 32150360 Check |pmid= value (help). Missing or empty |title= (help)
  9. ↑ "People Who Are at Higher Risk for Severe Illness | Coronavirus | COVID-19 | CDC".
  10. ↑ Jimenez-Cauhe J, Ortega-Quijano D, Carretero-Barrio I, Suarez-Valle A, Saceda-Corralo D, Moreno-Garcia Del Real C, Fernandez-Nieto D (May 2020). "Erythema multiforme-like eruption in patients with COVID-19 infection: clinical and histological findings". Clin. Exp. Dermatol. doi:10.1111/ced.14281. PMID 32385858 Check |pmid= value (help).
  11. ↑ Recalcati, S. (2020). "Cutaneous manifestations in COVID‐19: a first perspective". Journal of the European Academy of Dermatology and Venereology. 34 (5). doi:10.1111/jdv.16387. ISSN 0926-9959.
  12. ↑ 12.0 12.1 Recalcati, S. (2020). "Cutaneous manifestations in COVID‐19: a first perspective". Journal of the European Academy of Dermatology and Venereology. 34 (5). doi:10.1111/jdv.16387. ISSN 0926-9959.
  13. ↑ Fernandez-Nieto, D; Ortega-Quijano, D; Segurado-Miravalles, G; Pindado-Ortega, C; Prieto-Barrios, M; Jimenez-Cauhe, J (2020). "Comment on: Cutaneous manifestations in COVID-19: a first perspective. Safety concerns of clinical images and skin biopsies". Journal of the European Academy of Dermatology and Venereology. doi:10.1111/jdv.16470. ISSN 0926-9959.
  14. ↑ Tammaro, A.; Adebanjo, G.A.R.; Parisella, F.R.; Pezzuto, A.; Rello, J. (2020). "Cutaneous manifestations in COVID‐19: the experiences of Barcelona and Rome". Journal of the European Academy of Dermatology and Venereology. doi:10.1111/jdv.16530. ISSN 0926-9959.
  15. ↑ Jimenez-Cauhe, Juan; Ortega-Quijano, Daniel; Prieto-Barrios, Marta; Moreno-Arrones, Oscar M.; Fernandez-Nieto, Diego (2020). "Reply to "COVID-19 can present with a rash and be mistaken for dengue": Petechial rash in a patient with COVID-19 infection". Journal of the American Academy of Dermatology. doi:10.1016/j.jaad.2020.04.016. ISSN 0190-9622.
  16. ↑ Manalo, Iviensan F.; Smith, Molly K.; Cheeley, Justin; Jacobs, Randy (2020). "A dermatologic manifestation of COVID-19: Transient livedo reticularis". Journal of the American Academy of Dermatology. doi:10.1016/j.jaad.2020.04.018. ISSN 0190-9622.
  17. ↑ Fernandez-Nieto, D.; Jimenez-Cauhe, J.; Suarez-Valle, A.; Moreno-Arrones, O.M.; Saceda-Corralo, D.; Arana-Raja, A.; Ortega-Quijano, D. (2020). "Characterization of acute acro-ischemic lesions in non-hospitalized patients: a case series of 132 patients during the COVID-19 outbreak". Journal of the American Academy of Dermatology. doi:10.1016/j.jaad.2020.04.093. ISSN 0190-9622.
  18. ↑ Piccolo, V.; Neri, I.; Filippeschi, C.; Oranges, T.; Argenziano, G.; Battarra, V.C.; Berti, S.; Manunza, F.; Fortina, A.B.; Di Lernia, V.; Boccaletti, V.; De Bernardis, G.; Brunetti, B.; Mazzatenta, C.; Bassi, A. (2020). "Chilblain‐like lesions during COVID‐19 epidemic: a preliminary study on 63 patients". Journal of the European Academy of Dermatology and Venereology. doi:10.1111/jdv.16526. ISSN 0926-9959.
  19. ↑ 19.0 19.1 Krajewska J, Krajewski W, Zub K, Zatoński T (July 2020). "COVID-19 in otolaryngologist practice: a review of current knowledge". Eur Arch Otorhinolaryngol. 277 (7): 1885–1897. doi:10.1007/s00405-020-05968-y. PMC 7166003 Check |pmc= value (help). PMID 32306118 Check |pmid= value (help).
  20. ↑ Seah I, Agrawal R (April 2020). "Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Coronaviruses and Ocular Implications in Humans and Animals". Ocul. Immunol. Inflamm. 28 (3): 391–395. doi:10.1080/09273948.2020.1738501. PMC 7103678 Check |pmc= value (help). PMID 32175797 Check |pmid= value (help).
  21. ↑ Wu P, Duan F, Luo C, Liu Q, Qu X, Liang L, Wu K (March 2020). "Characteristics of Ocular Findings of Patients With Coronavirus Disease 2019 (COVID-19) in Hubei Province, China". JAMA Ophthalmol. doi:10.1001/jamaophthalmol.2020.1291. PMC 7110919 Check |pmc= value (help). PMID 32232433 Check |pmid= value (help).
  22. ↑ Fidan, Vural (2020). "New type of corona virus induced acute otitis media in adult". American Journal of Otolaryngology. 41 (3): 102487. doi:10.1016/j.amjoto.2020.102487. ISSN 0196-0709.
  23. ↑ Tobin, Martin J. (2019). "Why Physiology Is Critical to the Practice of Medicine". Clinics in Chest Medicine. 40 (2): 243–257. doi:10.1016/j.ccm.2019.02.012. ISSN 0272-5231.
  24. ↑ Semler MW, Wheeler AP, Thompson BT, Bernard GR, Wiedemann HP, Rice TW (April 2016). "Impact of Initial Central Venous Pressure on Outcomes of Conservative Versus Liberal Fluid Management in Acute Respiratory Distress Syndrome". Crit. Care Med. 44 (4): 782–9. doi:10.1097/CCM.0000000000001555. PMC 4792704. PMID 26741580.
  25. ↑ de Jongh TO, Thiadens HA (2011). "[Physical examination of the lungs in suspected pneumonia]". Ned Tijdschr Geneeskd (in Dutch; Flemish). 155: A2656. PMID 21329538.
  26. ↑ Wong SH, Lui RN, Sung JJ (May 2020). "Covid-19 and the digestive system". J. Gastroenterol. Hepatol. 35 (5): 744–748. doi:10.1111/jgh.15047. PMID 32215956 Check |pmid= value (help).
  27. ↑ Poggiali E, Ramos PM, Bastoni D, Vercelli A, Magnacavallo A (2020). "Abdominal Pain: A Real Challenge in Novel COVID-19 Infection". Eur J Case Rep Intern Med. 7 (4): 001632. doi:10.12890/2020_001632. PMC 7162568 Check |pmc= value (help). PMID 32309266 Check |pmid= value (help).
  28. ↑ Abdalhadi A, Alkhatib M, Mismar AY, Awouda W, Albarqouni L (2020). "Can COVID 19 present like appendicitis?". IDCases. 21: e00860. doi:10.1016/j.idcr.2020.e00860. PMC 7265835 Check |pmc= value (help). PMID 32523872 Check |pmid= value (help).
  29. ↑ Li J, Fan JG (March 2020). "Characteristics and Mechanism of Liver Injury in 2019 Coronavirus Disease". J Clin Transl Hepatol. 8 (1): 13–17. doi:10.14218/JCTH.2020.00019. PMC 7132021 Check |pmc= value (help). PMID 32274341 Check |pmid= value (help).
  30. ↑ Wang, Shangqian; Zhou, Xiang; Zhang, Tongtong; Wang, Zengjun (2020). "The need for urogenital tract monitoring in COVID-19". Nature Reviews Urology. 17 (6): 314–315. doi:10.1038/s41585-020-0319-7. ISSN 1759-4812.
  31. ↑ Lee Y, Min P, Lee S, Kim SW (May 2020). "Prevalence and Duration of Acute Loss of Smell or Taste in COVID-19 Patients". J. Korean Med. Sci. 35 (18): e174. doi:10.3346/jkms.2020.35.e174. PMC 7211515 Check |pmc= value (help). PMID 32383370 Check |pmid= value (help).
  32. ↑ Menni, Cristina; Valdes, Ana M.; Freidin, Maxim B.; Sudre, Carole H.; Nguyen, Long H.; Drew, David A.; Ganesh, Sajaysurya; Varsavsky, Thomas; Cardoso, M. Jorge; El-Sayed Moustafa, Julia S.; Visconti, Alessia; Hysi, Pirro; Bowyer, Ruth C. E.; Mangino, Massimo; Falchi, Mario; Wolf, Jonathan; Ourselin, Sebastien; Chan, Andrew T.; Steves, Claire J.; Spector, Tim D. (2020). "Real-time tracking of self-reported symptoms to predict potential COVID-19". Nature Medicine. doi:10.1038/s41591-020-0916-2. ISSN 1078-8956.
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