View source for Coronavirus

==Background==
* Enveloped, positive-sense single-stranded RNA viruses with nucleocapsid
* Very common cause of [[upper respiratory infection]], especially during fall and winter, and some diarrhea in pediatric patients
* Emerging pathogen for respiratory disease outbreaks
* Probably originated from bats, then spread to other mammalian hosts
** [[SARS]]-CoV – Himalayan palm civets
** [[MERS]]-CoV – Dromedary camels
** [[COVID-19|SARS-CoV-2]] – Suspected to be from pangolins

{{Specific Coronavirus Sub-Types of Clinical Importance}}

==Clinical Features==
*Incubation period: 2-4 days 
*Upper respiratory symptoms
**[[Rhinorrhea]], [[cough]], [[sore throat]], earache, [[fever]], malaise
**Respiratory symptoms may be more severe in elderly/immunocompromised (e.g. [[pneumonia]], secondary bacterial [[pneumonia]])
*GI symptoms - [[vomiting]], [[diarrhea]], [[Necrotizing enterocolitis]] (in neonates)

==Differential Diagnosis==
*[[Rhinovirus]]: most common cold virus.  Causes around 40% colds. 
**as opposed to Coronavirus, this causes cold in other seasons besides winter. 
**Rhinovirus is NOT encapsulated as opposed to Coronavirus. 
*[[respiratory syncytial virus]] (RSV)
*[[influenza]]
*parainfluenza

==Evaluation==
*PCR Testing
**Should be obtained on nasopharyngeal swab preferably one with synthetic fibers and plastic tip and under isolation
**Criteria for who to test is constantly evolving at this time. The CDC currently recommends clinicians to refer to local and/or institutional guidelines and test availability when deciding who should be tested.
*Laboratory Abnormalities
**Lymphocytosis
***Present in 70-80% of patients<ref name="clinical characteristics">Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China [published online ahead of print, 2020 Feb 7]. JAMA. 2020;10.1001/jama.2020.1585. doi:10.1001/jama.2020.1585</ref>
***Severity of lymphocytosis and leukopenia shown to be associated with severe of illness<ref name="clinical characteristics"></ref><ref name="disease 2019">Wei-jie Guan, Ph.D., Zheng-yi Ni, M.D., Yu Hu, M.D., et al. Clinical Characteristics of Coronavirus Disease 2019 in China. China Medical Treatment Expert Group for Covid-19. The New England Journal Of Medicine website. https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 Published February 28, 2020. Accessed March 31, 2020</ref>
**Thrombocytopenia, elevated lactate dehydrogenase, elevated C-reactive protein, and prolonged prothrombin time have been reported<ref name="clinical characteristics"></ref><ref name="disease 2019"></ref>

==Management==
*There is no specific treatment for Coronavirus, since most infections spontaneously resolve.  
*Supportive care, no specific treatment
**Rest, hydration, [[analgesia]], antipyretics
*Hand hygiene to prevent spread

==Disposition==

==Prevention==
*The first vaccines produced against a coronavirus were developed during the [[COVID-19]] pandemic
*Measures to reduce risk of transmission: fully wash hands, do not touch face without washing hands, avoid close contact with sick contacts.

==See Also==
*[[Upper respiratory infection]]
*[[Fever]]
*[[COVID-19]]

==External Links==
*http://www.cdc.gov/coronavirus/about/
*https://en.wikipedia.org/wiki/Coronavirus

==References==
<references/>

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