SARS-CoV-2: Difference between revisions

Revision as of 23:49, 13 September 2020

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%

Incubation period 4 to 5 days (range 2 to 11 days), 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

PCR from NP swab
- Highest sensitivity within 5 days of symptom onset, with decreasing sensitivity as the disease enters the immune-mediated phase
- May be positive long after no longer infectious

For patients no requiring supplemental oxygen, the focus is on supportive care
For patients requiring supplemental oxygen:
- Dexamethasone 6 mg PO/IV daily for 10 days, which has a mortality benefit
- Remdesivir 200 mg PO once on day one followed by 100 mg PO daily for 5-10 days, which has not been shown to have a mortality benefit
Avoid hydroxychloroquine/chloroquine, lopinavir-ritonavir
Other investigational therapeutics include tocilizumab

@@ Line 26: / Line 26: @@
 *Incubation period [[Usual incubation period::4 to 5 days]] (range [[Incubation period::2 to 11 days]]), possibly as long as 14 days in some cases
-*Main presenting symptoms were fever and cough, followed by myalgia, fatigue, headache, dyspnea
+*Main presenting symptoms were [[fever]] and [[cough]], followed by [[myalgia]], [[fatigue]], [[headache]], [[dyspnea]]
-*Other symptoms include dyspnea, rhinorrhea, vomiting, diarrhea, anosmia/hyposmia
+*Other symptoms include [[dyspnea]], [[rhinorrhea]], [[vomiting]], [[diarrhea]], [[anosmia]]/[[hyposmia]]
-*Lymphopenia is common, as is hypoalbuminemia, elevated D-dimer, CRP, LDH, AST/ALT
+*[[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
+=== Pregnancy ===
+* Please refer to [https://doi.org/10.1136/bmj.m3320 a living systematic review on the topic]
 ===Complications===
@@ Line 41: / Line 45: @@
 *PCR from NP swab
+**Highest sensitivity within 5 days of symptom onset, with decreasing sensitivity as the disease enters the immune-mediated phase
 **May be positive long after no longer infectious