SARS-CoV-2: Difference between revisions

Revision as of 23:16, 30 July 2020

Background

Microbiology

Coronavirus related to SARS-CoV
Virion consists of:
- Spike glycoprotein (S)
- Membrane protein (M)
- Nucleocapsid protein (N)
- Hemagglutinin esterase (He)
- Envelope protein (E)

Epidemiology

First cases detected Dec 2019 related to likely exposure in wet market in Wuhan, Hubei, China, and declared a pandemic in 2020
Secondary household attack rate of 12-17%

Risk Factors for Mortality

Greater age
Male sex
COPD
Dyslipidemia
Diabetes

Clinical Manifestations

Incubation period 4-5 days (range 2 to 11), possibly as long as 14 days in some cases
Main presenting symptoms were fever and cough, followed by myalgia, fatigue, headache, dyspnea
Other symptoms include dyspnea, rhinorrhea, vomiting, diarrhea, anosmia/hyposmia
Lymphopenia is common, as is hypoalbuminemia, elevated D-dimer, CRP, LDH, AST/ALT
Viral load detectable before symptom onset and peaks around the time of symptom onset

Complications

In critically ill patients:
- ARDS (75%)
- AKI (40%)
- Thrombosis (10%)

Diagnosis

PCR from NP swab
- May be positive long after no longer infectious

Management

Dexamethasone for patients requiring supplemental oxygen
Investigational therapeutics include tocilizumab, lopinavir/ritonavir, and chloroquine

References

^ Louise Lansbury, Benjamin Lim, Vadsala Baskaran, Wei Shen Lim. Co-infections in people with COVID-19: a systematic review and meta-analysis. Journal of Infection. 2020;81(2):266-275. doi:10.1016/j.jinf.2020.05.046.

@@ Line 1: / Line 1: @@
-== Background ==
+==Background==
-=== Microbiology ===
+===Microbiology===
-* Coronavirus related to [[SARS-CoV]]
+*Coronavirus related to [[SARS-CoV]]
-=== Epidemiology ===
+*Virion consists of:
-* First cases detected Dec 2019 related to likely exposure in wet market in Wuhan, Hubei, China
+**Spike glycoprotein (S)
-* Declared pandemic by WHO in 2020
+**Membrane protein (M)
+**Nucleocapsid protein (N)
+**Hemagglutinin esterase (He)
+**Envelope protein (E)
+===Epidemiology===
-== Clinical Manifestations ==
-* Incubation period 4-5 days on average, possibly as long as 14 days in some cases
-* Main presenting symptoms were fever and cough
-* Other symptoms include dyspnea, rhinorrhea, vomiting, diarrhea
+*First cases detected Dec 2019 related to likely exposure in wet market in Wuhan, Hubei, China, and declared a pandemic in 2020
-== Management ==
+*Secondary household attack rate of 12-17%
-* Primarily supportive
-* Investigational therapeutics include [[tocilizumab]], [[lopinavir/ritonavir]], and [[chloroquine]]
+=== Risk Factors for Mortality ===
+* Greater age
+* Male sex
+* [[COPD]]
+* [[Dyslipidemia]]
+* [[Diabetes]]
+==Clinical Manifestations==
+*Incubation period 4-5 days (range 2 to 11), possibly as long as 14 days in some cases
+*Main presenting symptoms were fever and cough, followed by myalgia, fatigue, headache, dyspnea
+*Other symptoms include dyspnea, rhinorrhea, vomiting, diarrhea, anosmia/hyposmia
+*Lymphopenia is common, as is hypoalbuminemia, elevated D-dimer, CRP, LDH, AST/ALT
+*Viral load detectable before symptom onset and peaks around the time of symptom onset
+=== Complications ===
+* In critically ill patients:
+** [[ARDS]] (75%)
+** [[AKI]] (40%)
+** [[Thrombosis]] (10%)
+== Diagnosis ==
+* PCR from NP swab
+** May be positive long after no longer infectious
+==Management==
+*Dexamethasone for patients requiring supplemental oxygen
+*Investigational therapeutics include [[tocilizumab]], [[lopinavir/ritonavir]], and [[chloroquine]]
+== Further Reading ==
+* 10.1001/jama.2020.12839
 [[Category:Viruses]]