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A novel coronavirus was identified at the end of 2019 primarily centered around the Chinese city of Wuhan in the Hubei Province. The World Health Organization (WHO) has now named this the coronavirus disease 2019 (COVID-19) as of February 2020. It was initially called 2019-nCoV. The COVID-19 virus has now spread to tens of thousands of individuals primary in China, with sporadic cases around the world. This article summarizes what we know about the virus so far.

1) What are the symptoms of COVID-19?

The illness is characterized by fever, cough, and bilateral infiltrates on chest imaging. Pneumonia appears to be the most common manifestation of this infection. However, the majority of those infected are not in serious condition. Mild symptoms have been seen especially in young adults or healthy children. There were few cases of nausea and diarrhea from the virus. However, about 20% of all confirmed cases have had critical illness stemming from respiratory failure, septic shock, or other organ failure. Overall fatality is less than 3 percent, with most cases in those with pre-existing conditions, or have other comorbidities.(1)

2) How is COVID-19 diagnosed?

COVID-19 should be considered in the tri-state area in people who have traveled to or from the Wuhan city within the past 2 weeks. The incubation period is thought to be 14 days following exposure, but in some patients, the incubation period was as little as 5 days. The CDC recommends collection of specimens from the upper respiratory tract, via a nasopharyngeal or oropharyngeal swab, or even the lower respiratory tract if possible. The COVID-19 virus is detected by a polymerase chain reaction, and testing is performed by a CDC-qualified lab in the United States.

3) How is 2019-nCoV treated?

Currently, there is no medicine to treat the virus, which is the case with most viral infections. The initial management should be focused on isolation and the initiation of conservative therapy and infection control. The WHO and CDC do NOT recommend glucocorticoids to treat this virus, as it has been associated with exacerabation of pulmonary disease. Additional therapies are currently being looked at but as of the publication of this article, there is not known vaccine against COVID-19.

4) Is this virus something I need to be concerned about?

Currently, the situation is unfolding with new information daily regarding the virus. In order to determine how serious this outbreak is, consider the variable R0 (R naught), which denotes transmission dynamics. A lower R0 means an outbreak is not readily spreading. An R0 of 1 means an infected person is able to spread the illness to one other person, meaning there is a stable rate of transmission. Anything more than R1 means the rate of spread can be exponentially worse. The R0 for the seasonal flu is about 1.3. The R0 of SARS is about 3. The R0 of measles, a highly contagious virus, is 12 and 14. Scientists are unable to pinpoint the exact number, but state that COVID-19 is between 1.4 to 2.5, with more recent estimates being 2.2-2.5. The mortality rate appears to be 2%. This is much less than with SARS with 10%, and similar to the seasonal flu at 1%.(2) This all means that COVID-19 is not the worst we have seen, and mortality rates are on par with the regular flu. In general, it is better to practice infection control such as routinely washing hands to prevent the spread of germs, staying away from the bodily fluids of people around you who are sick, getting a lot of rest, and getting your regular flu shot.

As always, consult your physician for additional information on this topic, and seek medical attention if you having respiratory related symptoms and have been to China recently.

Check out the Centers for Disease Control and WHO Webpage for further information: https://www.cdc.gov/coronavirus/2019-nCoV/summary.html

https://www.who.int/emergencies/diseases/novel-coronavirus-2019