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COVID-19 CLINICAL PREENTATION

COVID-19 CLINICAL PREENTATION

 

COVID-19 CLINICAL PREENTATION

 

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It was the late of year 2019, when a novel coronavirus, now designing a severe form of acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was recognized as a causative for an outbreak of acute respiratory illness in Wuhan, a city in China. In Feb 2020, the WHO designated this disease (COVID-19) that stands for coronavirus infection 2019. The reported “incubation period” for COVID-19 can be reached as long as 14 d, with many cases mostly observed 4-5 days post-exposure. Pneumonia is the most frequent serious complication of this type of infection, with nearly 15 % of ptns may develop severe disease with hypoxia, dyspnea, or intense pulmonary affection. Moreover, fever, cough, and/or SOB, other features, may include upper respiratory tract Sms, myalgias, Drr & lost smell/taste sensation, can be also observed.

There’re no specific clinical manifestation that can yet reliably distinguish COVID-19 from other viral respiratory diseases, although the rapid evolution of SOB several days after disease onset is highly suggestive of COVID-19 diagnosis. However, the evolution of ARDS is the most serious sequela in ptns with intense infection that can be manifested shortly after the onset of SOB. In addition, a variety of other complications have been also observed, including thrombo-embolic events, acute cardiac injury, AKI, and other inflammatory sequelae.  

 

 

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Whatever the age of the ptn, he/she can acquire SARS-CoV-2 disease, despite middle aged adults and elderly are mostly affected, moreover, elderly ptns are more vulnerable to a severe form for the disease. However, severe illness can be also seen with medical co-morbidity and other specific lab alterations.The possibility of COVID-19 should be considered primarily in ptns with compatible Sms, particularly fever and/or respiratory Sms, who has residence in or hv traveled to areas with possible community transmission or hv had a recent close exposure with a confirmed/suspected case of COVID-19.

Treating clinician should be aware of the possibility of COVID-19 in ptns with severe respiratory disease when no other possible etiology can be recognized. Whenever possible, all symptomatizing ptns with suspected SARS-CoV-2 disease should proceed to a confirmatory testing. COVID-19 testing is now widely available. With suspicion of COVID-19, infection measures control should be rapidly implemented.  

Interim guidance has been provided by the WHO and by the US Center for Disease Control and Prevention (CDC), in addition to other expert organizations.     

 

REFERENCES


v  World Health Organization. Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. http://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020 (Accessed on February 12, 2020).

v  Centers for Disease Control and Prevention. 2019 Novel coronavirus, Wuhan, China. Information for Healthcare Professionals. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html (Accessed on February 14, 2020).

v  World Health Organization. Novel Coronavirus (2019-nCoV) technical guidance. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance (Accessed on February 14, 2020).

v  Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020; 395:514.

v  Liu YC, Liao CH, Chang CF, et al. A Locally Transmitted Case of SARS-CoV-2 Infection in Taiwan. N Engl J Med 2020; 382:1070.

v  World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report – 28. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200217-sitrep-28-covid-19.pdf?sfvrsn=a19cf2ad_2 (Accessed on February 18, 2020).

v  Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill 2020; 25.

v  Kimball A, Hatfield KM, Arons M, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep 2020; 69:377.

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