CDC: Summary of Recent Updates to Research of COVID-19

Revisions were made on March 30, 2020, to reflect the following:

• New information about asymptomatic and pre-symptomatic infections
• Non-steroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers and risk of infection or infection severity
• Information about COVID-19 and potential for SARS-CoV-2 reinfection
• Possibility of infection with both SARS-CoV-2 and other respiratory viruses
• Additional laboratory and imaging findings in COVID-19
• Updated guidelines from the World Health Organization and the Surviving Sepsis Campaign
• Inclusion of new resource: Information for Clinicians on Therapeutic Options for COVID-19 Patients

Incubation period

The incubation period for COVID-19 is thought to extend to 14 days, with a median time of 4-5 days from exposure to symptoms onset.^1-3 One study reported that 97.5% of persons with COVID-19 who develop symptoms will do so within 11.5 days of SARS-CoV-2 infection.³ MORE

Presentation

The signs and symptoms of COVID-19 present at illness onset vary, but over the course of the disease, most persons with COVID-19 will experience the following^1,4-9:

• Fever (83–99%)
• Cough (59–82%)
• Fatigue (44–70%)
• Anorexia (40–84%)
• Shortness of breath (31–40%)
• Sputum production (28–33%)
• Myalgias (11–35%)

In one study of 1,099 hospitalized patients, fever was present in only 44% at hospital admission but later developed in 89% during hospitalization.¹ 

Headache, confusion, rhinorrhea, sore throat, hemoptysis, vomiting, and diarrhea have been reported but are less common (<10%).^1,4-6 

Some persons with COVID-19 have experienced gastrointestinal symptoms such as diarrhea and nausea prior to developing fever and lower respiratory tract signs and symptoms.⁹ 

Anosmia or ageusia preceeding the onset of respiratory symptoms has been anecdotally reported, but more information is needed to understand its role in identifying COVID-19. MORE

Illness Severity

The largest cohort of >44,000 persons with COVID-19 from China showed that illness severity can range from mild to critical²⁸:

• Mild to moderate (mild symptoms up to mild pneumonia): 81%
• Severe (dyspnea, hypoxia, or >50% lung involvement on imaging): 14%
• Critical (respiratory failure, shock, or multiorgan system dysfunction): 5% MORE

Clinical Progression

Among patients who developed severe disease, the medium time to dyspnea ranged from 5 to 8 days, the median time to acute respiratory distress syndrome (ARDS) ranged from 8 to 12 days, and the median time to ICU admission ranged from 10 to 12 days.^5,6,10,11 MORE

Mild to Moderate Disease

Patients with a mild clinical presentation (absence of viral pneumonia and hypoxia) may not initially require hospitalization, and many patients will be able to manage their illness at home. MORE

Severe Disease

Some patients with COVID-19 will have severe disease requiring hospitalization for management. Complications of severe COVID-19 include pneumonia, hypoxemic respiratory failure/ARDS, sepsis and septic shock, cardiomyopathy and arrhythmia, acute kidney injury, and complications from prolonged hospitalization including secondary bacterial infections.^{1,4-6,10,11,28} MORE

Continued updated information based on current research Here:

Footnotes can be accessed through the link to the original article, linked above.