COVID-19 – Ward (1.0)
Guidance – Covid-19 Ward
Coronavirus (COVID-19), Clinical Overview Synopsis ~
KEY POINTS
- COVID-19 (coronavirus disease 2019) is respiratory tract infection due to a novel coronavirus, SARSCoV-2 (initially called 2019-nCoV); as of March 11, 2020, extent of infection was declared pandemic by the WHO
- Virus is thought to be zoonotic in origin, but the animal reservoir is not yet known, and it is clear that human-to-human transmission is occurring
- Infection ranges from asymptomatic to severe; symptoms include fever, cough, and (in moderate to severe cases) dyspnea; disease may evolve over the course of a week or more from mild to severe. Upper respiratory tract symptoms (eg, rhinorrhea, sore throat) are uncommon
- A significant proportion of clinically evident cases are severe; the mortality rate among diagnosed cases is about 2% to 3%
- Infection should be suspected based on presentation with a clinically compatible history and known or likely exposure (residence in or travel to an affected area within the past 14 days, exposure to a known or suspected case, exposure to a health care setting in which patients with severe respiratory tract infections are managed)
- Chest imaging in symptomatic patients almost always shows abnormal findings, usually including bilateral infiltrates; laboratory findings are variable but typically include lymphopenia and elevated lactate dehydrogenase and transaminase levels
- Diagnosis is confirmed by detection of viral RNA on polymerase chain reaction test of upper or lower respiratory tract specimens or serum specimens
- There is no specific antiviral therapy, although compassionate use and trial protocols for several agents are underway; treatment is largely supportive, consisting of supplemental oxygen and conservative fluid administration
- Most common complications are acute respiratory distress syndrome and septic shock; myocardial, renal, and multiorgan failure have been reported
- There is no vaccine available to prevent this infection; infection control measures are the mainstay of prevention (ie, hand and cough hygiene; standard, contact, and airborne precautions)
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