Coronavirus disease 19

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Revision as of 16:51, April 1, 2020 by Loopy (talk | contribs) (→‎Disinfecting your home if someone is sick: A little cleanup with bullets and some clarification)

Coronavirus disease 19, commonly known as COVID-19, is the airborne infectious respiratory illness caused by the novel (new) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), previously known as n-2019-nCoV.[1][2][3][4]

Computer-aided identification of lesions on the lungs of COVID-19 patients.
COVID-19 can cause lesions on lungs, and pneumonia.
Author: Shen et al. 2020. Journal of Pharmaceutical Analysis. Copyright: CC-BY-NC-ND-4.0

COVID-19 was first identified in Wuhan, China, in December 2019,[1] and can infect babies, children, and adults of any age.[5] It spread globally, resulting in the 2019-2020 coronavirus pandemic.[6][7]

Symptoms[edit | edit source]

Symptoms are usually mild and begin gradually, although around 1 in 6 people with COVID-19 need medical help.[1] Some people become infected but don't develop any symptoms and don't feel unwell.[8] These symptoms may appear 1-14 days after exposure; most commonly around five days.[8][9]

Common Symptoms[edit | edit source]

Most patients only have one or two of the common symptoms.[8][11][12]

Other Symptoms[edit | edit source]

Emergency Warning Signs*[edit | edit source]

*This list is not all inclusive. Consult your medical provider for any other symptoms that are severe or concerning.[9]

Additionally, there are reports that patients have lost or have a reduced sense of smell, or lost or distorted of taste, but are otherwise asymptomatic.[13]

The American Academy of Otolaryngology on Sunday posted information on its website[14] saying that mounting anecdotal evidence indicates that lost or reduced sense of smell and loss of taste are significant symptoms associated with Covid-19, and that they have been seen in patients who ultimately tested positive with no other symptoms.[13]

The symptoms, in the absence of allergies or sinusitis, should alert doctors to screen patients for the virus and “warrant serious consideration for self isolation and testing of these individuals,” the academy said.[13]

Asymptomatic carriers[edit | edit source]

The SARS-CoV-2 virus causes COVID-19.
Author: CDC

A number of studies have found that some people who test positive for COVID-19 do not have any symptoms of illness or a raised temperature, and have normal blood test results, but are able to infect others, some of whom developed severe COVID-19 pneumonia as a result of COVID-19.[15][16][17] Some asymptomatic carriers have abnormal chest CT scans, and some do not. False negative tests have also been reported.[15][16]

Estimates of the number of asymptomatic carriers vary wildly. Mizumoto et al. (2020) estimated that asymptomatic carriers accounted for 17.9% of the COVID-19 positive people on the Diamond Princess cruise ship, which was quarantined for 14 day after a previous passenger developed the illness.[11]

Recovered patients testing positive[edit | edit source]

Lan et al (2020) identified a group of 4 recovered patients who continued to test positive for COVID-19 after recovery; suggesting that they may still be infectious.[12] It is not known whether patients who have recovered may be reinfected later, or whether those who later needed treatment actually relapsed, or if recovered patients who later test positive do so because of issues with the diagnostic test's accuracy.[18] Another study found group of 5 recovered patients were found to have reactivated COVID-19.[19]

ME/CFS[edit | edit source]

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Risk of COVID-19 in patients with ME/CFS[edit | edit source]

There is a lack of evidence about ME/CFS patients developing COVID-19 illness; but a number of medical advisors have given their expert opinions on this. Immunologist and ME researcher Dr Nancy Klimas has said she believes people with ME/CFS are at a little higher risk of developing COVID-19 after exposure to the virus;[20] Dr Nigel Speight, Dr William Weir and Dr Charles Shepherd have said they do not think there is an increased risk.[21][22][23] Klimas, Speight, Weir and Shepherd have all advised ME/CFS patients to take additional precautions, and highlighted that there is a risk of ME/CFS becoming significantly worse after viral infections.[20][21][22][23]

ME/CFS includes immune symptoms including a sore throat, swollen lymph nodes, and flu-like symptoms, but patients are generally not considered to be severely immunocompromised, and immunosuppressant medications are unlikely to be used by most ME/CFS patients. [20] [24][25] This means most ME/CFS patients would not be considered to be at very high risk of COVID-19 illness.[20]

  • Ibuprofen - Ibuprofen drugs (Nurofen, Bruprofen, Advil, Midol, Motrin, Motrin) are anti-inflammatories commonly used for cold/flu symptoms and for ME/CFS. There have been some reports that ibuprofen taken for COVID-19 may prolong the illness and increase it's severity. Several countries including the UK and France now recommend that people with suspected or confirmed COVID-19 avoid ibuprofen and use paracetamol / acetaminophen (e.g., Tylenol) instead, although the evidence for this is relatively limited.[23][26][27] There is no suggestion that ibuprofen affects the risk of catching COVID-19.
  • Rituximab - The MS Society has stated that taking rituximab, which has been used in clinical trials for ME/CFS, may affect the risk of catching COVID-19.[28][29]
  • Ampligen - Ampligen or rintatolimod is sometimes used by ME/CFS patients, it is an antiviral immunostimulant rather than immunosuppressing drug, and is being tested for the treatment of COVID-19 illness in Japan.[30] There is no information about whether it may help prevent COVID-19 in ME/CFS patients.
  • The unproven autoimmune hypothesis states that a subtype of ME involves autoimmunity, which is an overactive immune system rather than a weakened immune response.[31]
Advice from the UK's ME Association

I have now reached the conclusion that people with pre-existing health conditions that make them more vulnerable to lung complications (which may or may not be the case with ME/CFS – at this stage we just don’t know), or have a condition like ME/CFS where an infection such as this will almost certainly cause a relapse, or significant exacerbation of symptoms, need to be doing far more to protect themselves, and to socially distance themselves from other people, than official NHS guidance indicates.

In particular, for those who are not housebound, this applies to social mobility and what you can do (and cannot do) if you decide to leave your home.[23]

Charles Shepherd, ME Association


Risk of death or serious complications in ME/CFS patients[edit | edit source]

25% ME Group for Severe ME

Although ME is a "chronic condition" my gut feeling is that they are not actually at greater risk of dying from the virus itself than healthy people. The conditions which put people at extra risk would be things like severe asthma or COPD, or immunosuppressed people eg those on chemotherapy for cancer.

The biggest worry therefore for ME sufferers is that catching the virus will make their ME much worse, and of course people in the 25% group do not have much leeway.

It might even be that worsening of their already severe ME could be a bigger threat to life than the virus itself.[22]


Risk of developing ME/CFS after COVID-19[edit | edit source]

ME/CFS has been linked to many different viruses, but it is not known what the likelihood is of developing ME/CFS after COVID-19 illness.

ME/CFS charity medical advisors' COVID-19 statements[edit | edit source]

Prevention[edit | edit source]

image of Coronavirus Disease 2019 (COVID-19)
Image author: CDC


The SARS-CoV-2 coronavirus is an enveloped virus, which means it is easier to kill outside the body than non-enveloped viruses like Coxsackievirus, or Poliovirus.[33][34]

CDC advice[edit | edit source]

  • Know How it Spreads
  • Clean your hands often
  • Avoid close contact
  • Stay home if you're sick (may have the virus)
  • Cover coughs and sneezes
  • Wear a face mask if you are sick (may have the virus)
  • Clean and disinfect

High touch surfaces: disinfect daily[edit | edit source]

High-touch surfaces: disinfect daily. Tables, doorknobs, light switches, countertops, handles, desks, phones keyboards, remote controls, toilets, faucets, sinks, hard-backed chairs. Source: Coronavirus disease 19 Prevention - CDC, March 2020. Public domain image.


The CDC currently recommends people clean AND disinfect frequently touched surfaces daily:

  • tables
  • doorknobs
  • light switches
  • countertops
  • handles
  • desks
  • phones
  • keyboards
  • remote controls
  • toilets
  • faucets
  • sinks
  • hard-backed chairs[35][36]


To clean use:
  • Detergent or soap and water prior to disinfection. [35]
To disinfect use:
  • Disinfectants used against SARS-CoV-2 (list)
  • Most common EPA-registered household disinfectants will work, or
  • Diluted household bleach (mix: 5 tablespoons bleach per gallon of water, OR 4 teaspoons bleach per quart of water), or
  • Alcohol solutions with at least 70% alcohol
Follow manufacturer’s instructions for application and proper ventilation. Check the product is not past its expiration date. (Updated Mar 18, 2020)[35]
Check for updates:

Suspected or confirmed COVID-19 cases:
If possible the sick person should also clean:

  • soiled items and surfaces (as needed)
  • if a separate bathroom is not available, the bathroom should be cleaned and disinfected after each use by an ill person
  • provide personal cleaning and disinfectant supplies in ill person's room (unless unsafe, e.g. they are a young child) - include tissues, paper towels, cleaners and EPA-registered disinfectants[35][36]

Coronavirus transmission from surfaces[edit | edit source]

The new coronavirus can survive on different surfaces for hours or days:

  • small airborne virus particles (aerosols) - 3 hours
  • copper - 4 hours
  • cardboard - 24 hours
  • stainless steel - 2 to 3 days
  • plastic - 2 to 3 days[37][38]

This means direct contact with an infected person is not needed to contact the illness.[37] Surgical face masks have not been effective against aerosols in previous influenza outbreaks like swine flu, but N95 respirators have been effective.[38]

Disinfecting your home if someone is sick[edit | edit source]

The following abbreviated bullet-point information is provided by the Centers for Disease Control and Prevention in their article "Everyday Steps and Extra Steps When Someone Is Sick"


Suspected or confirmed COVID-19 cases:


If possible the sick person should also clean:

  • soiled items and surfaces (as needed)
  • if a separate bathroom is not available, the bathroom should be cleaned and disinfected after each use by an ill person
  • provide personal cleaning and disinfectant supplies in ill person's room (unless unsafe, e.g. they are a young child) - include tissues, paper towels, cleaners and EPA-registered disinfectants[35][36][39]


Additional Steps

  • Take additional steps covering soft surfaces, food, laundry, and trash

COVID-19 pneumonia[edit | edit source]

Severe Acute Respiratory Infection (SARI) is the name for the type of pneumonia caused by COVID-19.[40] A clinical trial is in progress to determine if intravenous vitamin C is an effective treatment for SARI.[40]

Myth, Hoaxes, Scams and Fake News[edit | edit source]

Many myths, hoaxes and fake news have been spreading, particularly on social media, some of which claim to be from doctors or health professionals.[41][42] Scam include seeking fake cures or ineffective protective equipment like masks, scammers pretending to be from the World Health Organization asking for donations, or a stranger asking for money on behalf of a relative's medical bills.[43][44]

Posters for those self-isolating to avoid infection[edit | edit source]

Mental health[edit | edit source]

Anxiety around COVID-19 illness may cause anxiety or affect mental health.

News articles[edit | edit source]

Learn more[edit | edit source]

Government Health Organizations

ME/CFS Organizations

Media

Johns Hopkins University Global Cases Map

See also[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 1.2 World Health Organization. "Q&A on coronaviruses (COVID-19)". www.who.int. Retrieved March 16, 2020. Cite has empty unknown parameter: |dead-url= (help)
  2. Centers for Disease Control and Prevention (February 27, 2020). "Human Coronavirus Types". www.cdc.gov. Retrieved March 16, 2020. Cite has empty unknown parameter: |dead-url= (help)
  3. Li, Guangdi; Clercq, Erik De (March 2020). "Therapeutic options for the 2019 novel coronavirus (2019-nCoV)". Nature Reviews Drug Discovery. 19 (3): 149–150. doi:10.1038/d41573-020-00016-0.
  4. "Naming the coronavirus disease (COVID-19) and the virus that causes it". www.who.int. Retrieved March 28, 2020.
  5. Wei, Min; Yuan, Jingping; Liu, Yu; Fu, Tao; Yu, Xue; Zhang, Zhi-Jiang (February 14, 2020). "Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in China". JAMA. doi:10.1001/jama.2020.2131.
  6. Hui, David S.; Azhar, Esam I.; Madani, Tariq A.; Ntoumi, Francine; Kock, Richard; Dar, Osman; Ippolito, Giuseppe; Mchugh, Timothy D.; Memish, Ziad A. (February 1, 2020). "The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health — The latest 2019 novel coronavirus outbreak in Wuhan, China". International Journal of Infectious Diseases. 91: 264–266. doi:10.1016/j.ijid.2020.01.009. ISSN 1201-9712. PMID 31953166.
  7. "WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020". www.who.int. Retrieved March 28, 2020.
  8. 8.0 8.1 8.2 8.3 8.4 World Health Organization. "Q&A on coronaviruses (COVID-19)". www.who.int. Retrieved March 24, 2020. Cite has empty unknown parameter: |1= (help)
  9. 9.0 9.1 9.2 9.3 CDC (March 20, 2020). "Coronavirus Disease 2019 (COVID-19) – Symptoms". Centers for Disease Control and Prevention. Retrieved March 24, 2020. Cite has empty unknown parameter: |1= (help)
  10. National Health Service (March 24, 2020). "Symptoms and what to do - Coronavirus (COVID-19)". nhs.uk. Retrieved March 26, 2020. Cite has empty unknown parameter: |dead-url= (help)
  11. 11.0 11.1 Mizumoto, Kenji; Kagaya, Katsushi; Zarebski, Alexander; Chowell, Gerardo (March 12, 2020). "Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020". Eurosurveillance. 25 (10): 2000180. doi:10.2807/1560-7917.ES.2020.25.10.2000180. ISSN 1560-7917. PMC 7078829. PMID 32183930.
  12. 12.0 12.1 Lan, Lan; Xu, Dan; Ye, Guangming; Xia, Chen; Wang, Shaokang; Li, Yirong; Xu, Haibo (February 27, 2020). "Positive RT-PCR Test Results in Patients Recovered From COVID-19". JAMA. doi:10.1001/jama.2020.2783.
  13. 13.0 13.1 13.2 Rabin, Roni Caryn (March 22, 2020). "Lost Sense of Smell May Be Peculiar Clue to Coronavirus Infection". The New York Times. ISSN 0362-4331. Retrieved March 24, 2020.
  14. American Academy of Otolaryngology (March 15, 2020). "Coronavirus Disease 2019: Resources". American Academy of Otolaryngology-Head and Neck Surgery. Retrieved March 24, 2020.
  15. 15.0 15.1 Bai, Yan; Yao, Lingsheng; Wei, Tao; Tian, Fei; Jin, Dong-Yan; Chen, Lijuan; Wang, Meiyun (February 21, 2020). "Presumed Asymptomatic Carrier Transmission of COVID-19". JAMA. doi:10.1001/jama.2020.2565.
  16. 16.0 16.1 Chan, Jasper Fuk-Woo; Yuan, Shuofeng; Kok, Kin-Hang; To, Kelvin Kai-Wang; Chu, Hin; Yang, Jin; Xing, Fanfan; Liu, Jieling; Yip, Cyril Chik-Yan (February 15, 2020). "A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster". The Lancet. 395 (10223): 514–523. doi:10.1016/S0140-6736(20)30154-9. ISSN 0140-6736. PMID 31986261.
  17. del Rio, Carlos; Malani, Preeti N. (February 28, 2020). "COVID-19—New Insights on a Rapidly Changing Epidemic". JAMA. doi:10.1001/jama.2020.3072.
  18. "Can People Who Recover from COVID-19 Become Reinfected?". Snopes.com. Retrieved March 26, 2020.
  19. Ye, Guangming; Pan, Zhenyu; Pan, Yunbao; Deng, Qiaoling; Chen, Liangjun; Li, Jin; Li, Yirong; Wang, Xinghuan (March 11, 2020). "Clinical characteristics of severe acute respiratory syndrome coronavirus 2 reactivation". Journal of Infection. 0 (0). doi:10.1016/j.jinf.2020.03.001. ISSN 0163-4453. PMID 32171867.
  20. 20.0 20.1 20.2 20.3 Klimas, Nancy (March 13, 2020). "COVID-19 and ME/CFS - Dr Nancy Klimas, Mar 13, 2020". Retrieved March 24, 2020. Cite has empty unknown parameter: |dead-url= (help)
  21. 21.0 21.1 21.2 Speight, Nigel; Weir, William (March 2020). "re Coronavirus and members of the 25% ME Group, Severe ME charity | Message from Dr Willy Weir and Dr Nigel Speight, Medical Advisor to 25% ME Group | Update to the advice given on 29 February 2020". 25megroup.org. Cite has empty unknown parameter: |1= (help)
  22. 22.0 22.1 22.2 22.3 Speight, Nigel (March 2020). "re Coronavirus and members of the 25% ME Group, Severe ME charity Types | Message from Dr Nigel Speight, Medical Advisor to 25% ME Group". 25megroup.org. William Weir.
  23. 23.0 23.1 23.2 23.3 23.4 Shepherd, Charles (March 16, 2020). "ME Association Guidance: Coronavirus and ME/CFS by Dr Charles Shepherd | 16 March 2020". ME Association. Retrieved March 23, 2020. Cite has empty unknown parameter: |dead-url= (help)
  24. Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, A C Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003), "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols" (PDF), Journal of Chronic Fatigue Syndrome, 11 (2): 7-115, doi:10.1300/J092v11n01_02
  25. Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6
  26. Day, Michael (March 17, 2020). "Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists". BMJ. 368. doi:10.1136/bmj.m1086. ISSN 1756-1833. PMID 32184201.
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