infectious diseases
COVID 19
Symptoms and Signs of COVID 19
The severity and constellation of symptoms vary in people with COVID-19. Some have few to no symptoms, and some become severely ill and die. Symptoms may include Fever Cough Sore throat Congestion or runny nose Shortness of breath or difficulty breathing Chills or repeated shaking with chills New loss of smell or taste Fatigue Muscle pain Headache Nausea or vomiting Diarrhea The incubation period (ie, time from exposure to symptom onset) ranges from 2 to 10 days, with a median estimated to be only 2 to 4 days for the Omicron variant ( Symptoms and signs references ). Many infected people have no symptoms or mild disease; the likelihood of this varies depending on the SARS-CoV-2 variant and person's risk for severe disease, including COVID immunization status. Severe disease is characterized by dyspnea, hypoxia, and extensive lung involvement on imaging. This can progress to Overview of Respiratory Failure requiring mechanical ventilation, shock, multiorgan failure, and death. The risk of serious disease and death in COVID-19 cases increases in people over age 65, in people who smoke or previously smoked, and in people with other serious medical disorders, such as Cancer Chronic heart, lung, kidney, or liver disease Diabetes Stroke or cerebrovascular disease Immunocompromising conditions HIV infection Tuberculosis Sickle cell disease Thalassemia Dementia Obesity Pregnancy (up to 42 days after pregnancy) Some types of disabilities Substance use disorders Physical inactivity Some mental health disorders such as depression and schizophrenia (Also seeCDC: COVID-19 Understanding Risk.) COVID-19 Vaccine dramatically lowers the risk of severe illness for all age groups—lower vaccination rates in younger age groups has shifted the age demographic of hospitalized patients (see In addition to respiratory disease that can progress to acute respiratory distress syndrome ( Acute Hypoxemic Respiratory Failure (AHRF, ARDS) ) and death, other serious complications include the following: Heart disorders including Overview of Arrhythmias , Coagulation disorders including thromboembolism and Pulmonary Embolism (PE) , Guillain-Barré Syndrome (GBS) (rare) Sepsis and Septic Shock , has been observed as a rare complication of SARS-CoV-2 infection. It has features similar to Kawasaki Disease or In most patients, symptoms resolve within about a week. However, some patients begin with mild symptoms, then clinically deteriorate after a week, progressing to severe disease, including Acute Hypoxemic Respiratory Failure (AHRF, ARDS) . Prolonged illness appears to be more common in those with severe disease, but even patients with mild illness may have persistent symptoms, including dyspnea, cough, and malaise that last for weeks or even months. Viral PCR tests in patients may remain positive for at least 3 months regardless of symptoms. However, even patients with lingering symptoms are generally not considered infectious, as virus is rarely able to be cultured from the upper respiratory tract of patients after 10 days of illness. COVID-19 may also be associated with long-term sequelae following acute illness ( Symptoms and signs references ), and symptoms from post–COVID-19 conditions can linger for months. This has been referred to by many names, including long COVID, long-haul COVID, and post-acute COVID-19 syndrome or condition, and is estimated to impact 25 to 50% of all patients in some United States surveys. Fatigue, weakness, pain, myalgias, dyspnea, and cognitive dysfunction are commonly reported and can be associated with a poorer quality of life ( 1.Jansen L, Tegomoh B, Lange K, et al: Investigation of a SARS-CoV-2 B.1.1.529 (Omicron) variant cluster - Nebraska, November-December 2021.MMWR Morb Mortal Wkly Rep70(5152):1782-2784, 2021. doi: 10.15585/mmwr.mm705152e3 2.Miller AD, Yousaf AR, Bornstein E, et al: Multisystem inflammatory syndrome in children (MIS-C) during SARS-CoV-2 Delta and Omicron variant circulation - United States, July 2021-January 2022.Clin Infect DisJun 10;ciac471, 2022. doi: 10.1093/cid/ciac471 3.Morris SB, Schwartz NG, Patel P, et al: Case series of multisystem inflammatory syndrome in adults associated with SARS-CoV-2 infection — United Kingdom and United States, March–August 2020.MMWR69:1450–1456, 2020. doi: 10.15585/mmwr.mm6940e1 4.Nalbandian A, Sehgal K, Gupta A, et al: Post-acute COVID-19 syndrome.Nat Med27(4):601-615, 2021. doi: 10.1038/s41591-021-01283-z 5.Han JH, Womack KN, Tenforde MW, et al: Associations between persistent symptoms after mild COVID-19 and long-term health status, quality of life, and psychological distress.Influenza Other Respir Viruses16(4):680-689, 2022. doi:10.1111/irv.12980 6.Soriano JB, Murthy S, Marshall JC, et al: A clinical case definition of post-COVID-19 condition by a Delphi consensus.Lancet Infect Dis22(4):e102-e107, 2022. doi: 10.1016/S1473-3099(21)00703-9 