COVID-19 natural history, complications and prognosis: Difference between revisions
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===Infectious Disease Complications=== | ===Infectious Disease Complications=== |
Revision as of 13:23, 10 July 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
In symptomatic patients, the clinical features of the disease usually start within a week, consisting of fever, cough, nasal congestion, fatigue, and other signs of upper respiratory tract infections. Disease progression and severity is manifested by dyspnea and severe chest symptoms corresponding to pneumonia in approximately 75% of the patients.
Natural History
- The clinical course of the disease consists of three major patterns:[1]
- Mild illness with upper respiratory tract presenting symptoms
- Non-life-threatening pneumonia
- Severe pneumonia with acute respiratory distress syndrome (ARDS) that begins with mild symptoms for 7 - 8 days and progressing to rapid deterioration and ARDS requiring advanced life support
- In a study of 44,672 confirmed cases in Mainland China:[2]
- 80.9% were reported to have a mild disease
- 13.8% were reported to have severe disease with the indication for hospitalization
- 4.7% were reported to have critical disease with the indication for intensive care
- In symptomatic patients, the clinical features of the disease usually start within a week, consisting of fever, cough, nasal congestion, fatigue, and other signs of upper respiratory tract infections.[3]
- Disease progression and severity is manifested by dyspnea and severe chest symptoms corresponding to pneumonia in approximately 75% of the patients.[4]
- Pneumonia mostly occurs in the second or third week of a symptomatic disease.
- Signs of the above mentioned pneumonia (viral pneumonia) include decreased oxygen saturation, blood gas deviations, and changes on chest X‐ray and other imaging techniques.
Global Course
Currently, 952,100 cases of COVID-19 have been reported worldwide to date (April 2, 2020) with 48,100 confirmed deaths. This pandemic can have three possible scenarios in relation to its global course:
- If all countries work together to contain the virus, due to its similarity with the SARS virus which caused an outbreak in 2003, the pandemic may be contained by July-August, 2020 but it should be taken into account that in the 2003 outbreak, international travel was not as frequent as it is today which may worsen the situation due to imported cases.
- The second scenario may occur if the virus stays until the summer of 2020 in the northern hemisphere subsequent to which it may turn up in the southern hemisphere and reappear in the northern hemisphere during the months of November-December. This would be the case if the virus behaves as seasonal flu.
- The third scenario is where we develop vaccination and vaccinate the human race against this fatal virus and eradicate it similar to other viruses such as smallpox, polio and others.
Complications
Cardiovascular Complications
- COVID-19-associated myocardial injury
- COVID-19-associated myocarditis
- COVID-19-associated myocardial infarction
- COVID-19-associated heart failure
- COVID-19-associated arrhythmia and conduction system disease
- COVID-19-associated cardiogenic shock
- COVID-19-associated cardiac arrest
- COVID-19-associated pericarditis
- COVID-19-associated spontaneous coronary artery dissection
Dermatologic Complications
Gastrointestinal and Hepatic Complications
- COVID-19-associated digestive symptoms
Hematologic Complications
- COVID-19-associated anemia
- COVID-19-associated lymphopenia
- COVID-19-associated neutrophilia
- COVID-19-associated thrombocytopenia
- COVID-19-associated cytokine storm
Infectious Disease Complications
Nephrologic Complications
Neurologic Complications
- COVID-19-associated CNS manifestations
- COVID-19-associated PNS manifestations
Pulmonary Complications
- COVID-19-associated acute respiratory distress syndrome
- COVID-19-associated hypoxemia
- COVID-19-associated pneumonia
- COVID-19-associated pulmonary embolism
- COVID-19-associated pulmonary hypertension
- COVID-19-associated respiratory failure
Endocrine Complications
Pediatric Complications
References
- ↑ Heymann, David L; Shindo, Nahoko (2020). "COVID-19: what is next for public health?". The Lancet. 395 (10224): 542–545. doi:10.1016/S0140-6736(20)30374-3. ISSN 0140-6736.
- ↑ http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51. Missing or empty
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(help) - ↑ Velavan, Thirumalaisamy P.; Meyer, Christian G. (2020). "The COVID‐19 epidemic". Tropical Medicine & International Health. 25 (3): 278–280. doi:10.1111/tmi.13383. ISSN 1360-2276.
- ↑ Guan, Wei-jie; Ni, Zheng-yi; Hu, Yu; Liang, Wen-hua; Ou, Chun-quan; He, Jian-xing; Liu, Lei; Shan, Hong; Lei, Chun-liang; Hui, David SC; Du, Bin; Li, Lan-juan; Zeng, Guang; Yuen, Kowk-Yung; Chen, Ru-chong; Tang, Chun-li; Wang, Tao; Chen, Ping-yan; Xiang, Jie; Li, Shi-yue; Wang, Jin-lin; Liang, Zi-jing; Peng, Yi-xiang; Wei, Li; Liu, Yong; Hu, Ya-hua; Peng, Peng; Wang, Jian-ming; Liu, Ji-yang; Chen, Zhong; Li, Gang; Zheng, Zhi-jian; Qiu, Shao-qin; Luo, Jie; Ye, Chang-jiang; Zhu, Shao-yong; Zhong, Nan-shan (2020). doi:10.1101/2020.02.06.20020974. Missing or empty
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(help)