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
    • SARS-CoV-2 – Suspected to be from pangolins

Specific Coronavirus Sub-Types of Clinical Importance

Clinical Features

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[1]
      • Severity of lymphocytosis and leukopenia shown to be associated with severe of illness[1][2]
    • Thrombocytopenia, elevated lactate dehydrogenase, elevated C-reactive protein, and prolonged prothrombin time have been reported[1][2]

Management

  • There is no specific treatment for Coronavirus, since most infections spontaneously resolve.
  • Supportive care, no specific treatment
  • Hand hygiene to prevent spread

Disposition

Prevention

  • No vaccines have been made thus far to prevent Coronavirus.
  • 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. 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. 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