Coronavirus: Difference between revisions
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==Background== | ==Background== | ||
*Enveloped, positive-stranded RNA viruses with nucleocapsid | * 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 | * Very common cause of [[upper respiratory infection]], especially during fall and winter, and some diarrhea in pediatric patients | ||
*[[MERS]]-CoV | * 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== | ==Clinical Features== | ||
*Incubation period: 2-4 days | *Incubation period: 2-4 days | ||
*Upper respiratory symptoms | *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]]) | **Respiratory symptoms may be more severe in elderly/immunocompromised (e.g. [[pneumonia]], secondary bacterial [[pneumonia]]) | ||
*GI symptoms - [[vomiting]], [[diarrhea]], [[Necrotizing enterocolitis]] (in neonates) | *GI symptoms - [[vomiting]], [[diarrhea]], [[Necrotizing enterocolitis]] (in neonates) | ||
| Line 20: | Line 26: | ||
==Evaluation== | ==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== | ==Management== | ||
*There is no specific treatment for Coronavirus, since most infections spontaneously resolve. | *There is no specific treatment for Coronavirus, since most infections spontaneously resolve. | ||
*Supportive care, no specific treatment | *Supportive care, no specific treatment | ||
**Rest, hydration, analgesia, antipyretics | **Rest, hydration, [[analgesia]], antipyretics | ||
*Hand hygiene to prevent spread | *Hand hygiene to prevent spread | ||
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==Prevention== | ==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. | *Measures to reduce risk of transmission: fully wash hands, do not touch face without washing hands, avoid close contact with sick contacts. | ||
==See Also== | ==See Also== | ||
*[[Upper respiratory infection]] | *[[Upper respiratory infection]] | ||
*[[Fever]] | *[[Fever]] | ||
*[[COVID-19]] | |||
==External Links== | ==External Links== | ||
Latest revision as of 23:41, 6 March 2021
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
- SARS-CoV-2 – Suspected to be from pangolins
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
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
External Links
References
- ↑ 1.0 1.1 1.2 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
- ↑ 2.0 2.1 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