The novel illness in people infected with the new Coronvirus range from running with mild symptoms to severe illness and death.
Typical symptoms are:
Fever (high temperature)
The disease COVID-19 usually proceeds with flu-like symptoms, including fever and coughing. In some patients — especially in the elderly and with other chronic diseases — symptoms may develop into pneumonia, with tightness and chest pains and shortness of breath (shortness of breath).
Usually, the infection first begins with a fever followed by a dry cough. After about an average week in some patients, shortness of breath occurs, for which 20% of patients will seek hospital treatment.
COVID-19 rarely causes a runny nose, sneezing or sore throat (these symptoms are observed only in about 5% of patients). Sore throat, sneezing, and stuffy nose are the most common signs of common cold due to the viral, respiratory-syncytial and other viruses.
Based on all 72 314 confirmed cases of COVID-19, the following data are derived:
- 80.9% of infections were mild (with flu-like symptoms) and patients could recover at home without complications.
- 13.8% were severe with the development of pneumonia and shortness of breath.
- 4.7% of the infected were critical with a picture of respiratory failure, septic shock, and multi-organ failure.
- In about 2% of reported cases, the virus caused a fatal outcome.
The risk of death increases in the elderly.
Relatively few cases are observed among children.
Existing diseases that expose patients to a higher risk are:
- Heart disease
- Chronic respiratory disease
However, some otherwise healthy people develop a severe form of pneumonia after being infected by the virus. The reason for this is to be investigated, and an overreaction of the immune system is possible to be responsible for the severe course and the fatal end.
How long do the symptoms last?
Using available preliminary data based on 55 924 laboratory-confirmed cases, the meantime from the onset of symptoms to the clinical recovery was:
Mild cases: approximately 2 weeks
Severe or Critical illness: 3–6 weeks
Time from the onset of the development of severe disease (including hypoxia): 1 week
Among patients who have died, the time from the onset of symptoms to the fatal end ranged from 2 to 8 weeks.
Symptoms observed in hospitalized patients with COVID-19
These complaints refer to hospitalized patients, who usually pose serious or critical cases. The majority of COVID-19 cases (about 80%) are mild.
Common symptoms include:
- Fever (at 98.6%)
- Fatigue (at 69.6%)
- Dry cough (59.4%)
From the first symptom to → dyspnoea (shortness of breath) = 5 days
From the first symptom to → hospital reception = 7 days
From the first symptom to → ARDS (acute respiratory distress syndrome) = 8.0 days.
In patients Wuhan, China, the following clinical characteristics were observed:
- Fever (98%)
- Cough (76%)
- Myalgia (muscle pain) or fatigue (44%)
- Productive cough with phlegm (28%)
- Headache (8%)
- Haemoptysis (Coughing Blood) (5%)
- Diarrhea (3%)
- Sore throat (5%)
- Rhinorrhea (runny nose) (4%)
- Chest pain (2%)
- Nausea and vomiting (1%)
More than one attribute was present in more than 90% of patients. The combination of fever, coughing, and shortness of breath is observed only in 15% of cases.
It is important to know you may not have any symptoms or they may be small. In addition, you may not know that you have symptoms of COVID-19 as they are similar to a cold or flu. Symptoms may debut within 14 days after exposure to the virus. This is the longest known infectious period for a family representative of Coronaviruses.
In comparison, it is believed that other coronaviruses passed from animals to humans, infect humans to increase their spread, but do not aim to kill them. The previous two outbreaks of coronavirus, flowing like SARS (Severe acute respiratory syndrome) and MERS (Middle Eastern Respiratory Syndrome, so-called the site of the first outbreak), were extremely fatal to humans with very rare asymptomatic cases. If there were more than the latter, the disease would spread more widely. In the end, each of the SARS and MERS killed less than 1000 people.
The data currently shows that COVID-19 has killed twice as many people. It is deadly, but not too. By making people sick not severely difficult, it allows the virus to move freely all over the world. An example of this is the cruise ship in Japan, in which 14 Americans were positive for coronavirus without having any symptoms.
Fourteen percent of confirmed cases are “severe”, including pneumonia and shortness of breath. In another 5% of patients, the disease has evolved as respiratory failure, septic shock and/or multi-organ failure — these are “critical cases” that potentially lead to death.
It is not yet clear why some people suffer more from the virus than others. It is also unclear why the new Coronvirus — like his cousins, SARS and MERS — seems more deadly than other coronaviruses that regularly circulate among people every winter and usually cause cold symptoms. It will probably take a long time to understand the biological behavior of the virus and the immunological and clinical changes to which the infection leads to it.
Risk factors for the severe course of COVID-19
Recent data from China after analysis of nearly 45 000 confirmed cases suggest that people who most likely develop severe forms of COVID-19 are those with chronic diseases and elderly people.
Less than 1% of people who were otherwise healthy had died from the disease, mortality in people with cardiovascular disease was 10.5%. This figure is 7.3% for patients with diabetes and about 6% in patients with chronic respiratory disease, hypertension or cancer.
Average estimated mortality of 2.3% is estimated to be overestimated, given that very mild cases may remain undiagnosed. The overall rate was high at the expense of 14.8% mortality in adults above 80. Deaths were reported in each age group, except for children under nine years of age. In addition, relatively few cases have been observed among children.
Scientists do not know exactly what is happening in the body when infection with the new Coronavirus. How the infection will proceed depends on the immune response of a person. Moreover, the virus directs the course of infection, but the outcome and recovery depend on the immune system and other factors in the host. For the moment, it is known that nCov-19 enters and multiplies in the epithelium of the respiratory tract. In most people, a local inflammatory reaction is observed as a response to the immune system.
However, in adults and injured people, the immune system may not be able to cope with the virus when the virus multiplication is faster than it can control. Another scenario is to induce an uncontrolled immune response, with the involvement of a huge number of immune cells and the overproduction of cytokines, the so-called. “Cytocyinic Storm”. Clinically, it is manifested with severe inflammatory conditions, pneumonia, shortness of breath, inflammation of the respiratory tract, up to Polyorgan failure.
The second mechanism is probably responsible for the rare but still existing cases of deceased young and healthy people, such as the 34-year-old Chinese doctor Li Wenliang, who first flagged the virus. He died a few weeks after infecting the pathogen.
Genetic factors and those of the environment may also influence the severity of infection flow. While genetic factors are still being researched at the mice level, smoking and contaminated air are clearly harmful factors in the course of infection with Corononvirus.
Men have a more severe course and higher mortality than COVID-19 than women (2.8% versus 1.7%) of preliminary data. This is probably related to the gene for the receptor, through which the virus enters the cells and which is located in the X chromosome. But, it may also be due to the greater incidence of smokers among males. Estrogens act defensively in the course of infection.
WHO recommendations to stop the spread of the epidemic
If you are not in an area where COVID-19 is actively spreading, or if you have not traveled to any of these areas or have not been in close contact with someone who has symptoms, feels unwell or has been in a risk region, your chances of being ill now are Very low.
It is understandable, however, that you may feel stressed and stressed by the situation. It is good to know the details of ways of spreading the virus (see Questions and answers). It is important to be informed to take appropriate measures and protect yourself.
Measures to prevent infection with the new coronavirus and those restricting the spread of the virus should be taken by all, especially the sick, whether diagnosed with this virus or have clinical manifestations characteristic of It.
- Avoidance of public transport;
- Avoid coughing and sneezing in the hands, it is recommended to do this in the bend of the elbow and, if not possible, immediately perform hand hygiene without touching surfaces;
- The use of a handkerchief for sneezing does not exclude the washing of the hands after discharge into the trash;
- Avoid contact with people who show signs of infection;
- Avoid close contacts with persons who show signs of disease;
- Proper ventilation of enclosed spaces (waiting rooms, classrooms, public transport, conference halls, etc.);
- Avoid traveling to affected areas;
- Proper ventilation of office buildings, which have an open or shared working space;
- Properly wear a protective mask and change in short time intervals.
- The mask should be placed tightly, covering the mouth and nose, and covering the chin;
- The metal edge at the top should be fixed as high as possible on the nose, without interfering with breathing;
- The mask should be removed without touching the front part. As soon as it is removed, hand hygiene should be carried out, using water and soap.
Currently, there is no specific treatment of infection with the new Coronavirus, as recommended treatment is only symptomatic. For this reason, prophylaxis is the only way to protect against the spread of the new Coronavirus.
Has there already been a vaccine against Coronedvirus?
The world responds to the epidemic with unprecedented speed and mobilization of resources. The global scientific community is working on creating a vaccine, the Chinese government has introduced dramatic containment measures, and the World Health Organization has declared a state of emergency of international importance. However, the infection continues to spread. 100 million people were covered and confined to the area around Wuhan city, but the infection spread to 24 countries. Despite the apparent ineffectiveness of such measures — at least unacceptable social and economic harm — the repression continues to escalate.
Under political pressure to “stop” the virus last Thursday the Chinese government announced that the officers in Hubei province will walk from door to door, will test people for high fever and will look for other symptoms of the disease, they will send all Potential cases in quarantine camps. But even with the ideal restriction and quarantine measures, the spread of the virus may have been inevitable. Testing people who are already extremely ill is a poor strategy if people can spread the virus, and when they feel good.
Italy, Iran and South Korea are now among the countries reporting the rapidly growing number of detected COVID-19 infections. These countries also try to implement measures of repression proven ineffective. Ultimately, dealing with the pandemic will require the opening of borders rather than closure.
Doomsday forecasts of experts include the possibility within the next year around 40 to 70% of people around the world to be infected with the virus that causes COVID-19. But that does not mean that all will experience severe illnesses. In the majority of people, a slight disease or asymptomatic course will be observed. As with influenza, which is often life-threatening for people with chronic diseases, immunodeficiencies, and older age, most cases of COVID-19 will pass without medical help. For comparison, about 14% of people with influenza have no symptoms.
Initial testing recommendations for nCoV-19 is the people who visited China or other affected regions in the world or had contact with someone who was diagnosed with the disease. However, diagnostic tests are not routine and are not in sufficient quantities.
The disturbance of the Coroninvirus comes from the fact that it is not clear how long the virus will be active and will spread. At the moment, the global race against time is the creation of an effective vaccine — one of the clearest strategies for saving lives in the coming years. At present, the company Inovio has developed a product that uses small parts of the virus RNA in order to be presented to the immune system and to develop immunity against the entire virus. This is the first promising step, but technically it’s nowhere close to a vaccine. Like other drugs, vaccines require a long testing process to check whether they really protect people from disease and make it safe.
Although genetic sequencing is now extremely fast, the creation of vaccines is as much an art as a science. It is necessary to find exactly this viral sequence, which will lead to the creation of an effective and permanent immunological memory. At the same time, it does not provoke an acute inflammatory response, for example, “flu-like symptoms.” Before it is widely applied, such a vaccine should be tested in a laboratory, in animals, and finally in humans. A few more biotech companies are working at the same time in carrying out this project — Moderna, CureVac and Novavax, as well as academic institutes. The timeline for creating a vaccine can be compressed, but nevertheless, it takes at least 12–18 months to create an effective and safe vaccine. Next, the challenges will include other problems such as production and logistics, which can also be difficult to limit the workforce (especially in lead China) and the closed international borders.