What Healthcare Officials Need to Know About the Coronavirus COVID-19 (Part 1)
February 17, 2020
From December 31, 2019 through January 3, 2020, a total of 44 case-patients with pneumonia of unknown etiology were reported to the World Health Organization (WHO) by national authorities in China. The Chinese quickly isolated a new coronavirus on January 7, 2020, and by January 20, 2020, there were 282 confirmed infected cases. The new virus was first detected in Wuhan City, Hubei Province, China, and continues to spread throughout the mainland there. Just a little over a month later, this novel coronavirus, named COVID-19, has now infected over 42,000 people in China, causing 1,107 deaths there, and has spread globally to 25 other countries. One person has now died in the Philippines. This coronavirus is a public health emergency of international concern.
2019 Novel Coronavirus Timeline
The first U.S. case was confirmed on January 30, 2020. As of February 10, 2020, there were 13 confirmed cases identified in the states of Washington, California, Arizona, Illinois, and Massachusetts. Additionally, 36 states now have identified additional Persons Under Investigation (PUIs) (WHO, 2020).
A Virus Previously Unknown in Humans
COVID-19 is a new coronavirus that has not been previously recognized in humans. Early cases were thought to have crossed over from an animal, such as a camel, cow, cat, or bat, because many of those that were first infected were exposed in a large seafood and live animal market in Wuhan. The animal source has not yet been identified. COVID-19 is a betacoronavirus like Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV), both of which have their origin in bats. We now know that human-to-human transmission is occurring.
Coronavirus Symptoms and Risks
COVID-19 causes respiratory illness with symptoms of fever, cough, and shortness of breath. Symptoms range from mild, as with the common cold, to deadly. Risk is higher in those individuals over 60 years of age and those with compromised immune systems. The most common laboratory findings among hospitalized patients with pneumonia on admission included leukopenia, leukocytosis, lymphopenia, and elevated levels of alanine aminotransferase and aspartate aminotransferase. Most patients show bilateral involvement on chest CT. Typically there are multiple areas of consolidation and ground glass opacities.
Current Treatment Involves Managing Symptoms
Currently there is no effective vaccine or antiviral agent for this infection, and treatment is supportive to manage symptoms. Clinical management guidelines include information in the following links:
· Surviving Sepsis guidelines for septic shock
· WHO interim guidance on clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected
· Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America
Please Note: Corticosteroids should be avoided unless there is an indication to manage conditions such as chronic obstructive pulmonary disease or septic shock, because there is potential for prolonging viral replication, as has been observed in MERs-CoV patients.
This blog post is an excerpt from a HealthStream white paper, What Healthcare Professionals Need to Know About the Coronavirus, about the global healthcare threat posed by the coronavirus COVID-19. It includes references that will provide you with detailed information that you need should you suspect COVID-19 or must manage confirmed cases. HealthStream put together this basic high-level information as an initial primer for healthcare professionals who want to know more about the coronavirus threat. As with any emerging infection, make sure that you become familiar with the resources available on the CDC website. The CDC updates information there as they learn it, so checking in daily and setting up an email notification for updates is strongly recommended.