SARS-CoV-2 and COVID-19
Update to Chapter 155: Coronaviruses, Including Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS)
Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, Ninth Edition (Elsevier, 2020)
Writers: Raphael Dolin, MD
Date: April 16, 2020
Document Released: May 15, 2020 © 2020 Elsevier Inc.
Infection with a novel coronavirus, now designated as SARS-CoV-2, and the disease which it causes, COVID-19, has resulted in a pandemic which has involved 184 countries. As of April 16, 2020, 1,991,562 cases of COVID-19 and 130,885 deaths were reported world-wide.(1) The greatest number of cases were reported in the United States, 605,390, along with 24,582 deaths.(2) Person to person transmission appeared to be rapid, and disease spread from a single city in China (Wuhan) to the entire country within 30 days.(3)
COVID-19 presents with a spectrum of severity of illness, ranging most frequently from fever with mild to moderate respiratory illness, to a severe hypoxic, pneumonic form, which may require mechanical ventilation.(4) Characteristics of patients with severe disease, including those admitted to the ICU, were that they were older in age, and had underlying comorbidities, such as diabetes, cardiovascular diseases, chronic lung diseases and malignancies.(5)
Multiple antiviral and anti-inflammatory therapies have been utilized in treatment of COVID-19, but none have as yet been established as efficacious with rigorously controlled studies. Among the most widely utilized are hydroxychloroquine (with or without azithromycin and zinc)(6) and remdesivir(7). Placebo controlled trials of these are currently underway.
References
1. https://covid19.who.int/. Accessed on April 16, 2020.
2. https://www.cdc.gov/coronavirus/2019-ncov/index.html. Accessed on April 16, 2020.
3. Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72,314 Cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020 Feb 24; DOI: 10.1001/jama.2020.2648.
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092819/
5. https://www.ncbi.nlm.nih.gov/pubmed/32031570
6. https://www.ncbi.nlm.nih.gov/pmc/?term=PMC7102549
7. https://www.ncbi.nlm.nih.gov/pubmed/32275812
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