Clinical Features of COVID-19

👉Incubation period

• The exact incubation period is not known.
• It is presumed to be between 2 to 14 days after exposure, with most cases occurring within 5 days after exposure.

👉The spectrum of illness severity

• Most infections are self limiting.
• COVID-19 tends to cause more severe illness in elderly population or in patients with underlying medical problems.
• As per the report from Chinese center for disease control and prevention that included approximately 44,500 confirmed infections with an estimation of disease severity:
  • Mild illness was reported in 81% patients
  • Severe illness was reported in 14% patients:
    • Definition of severe illness:
      • Hypoxemia
      • Greater than 50% lung involvement on imaging within 24 to 48 hours
  • Critical Disease was reported in 5% patients:
    • Definition of critical disease:
      • Respiratory failure
      • Shock
      • Multi-organ dysfunction syndrome
• Overall case fatality rate was:
  • Between 2.3% to 5%

👉Age affected

• Mostly middle aged (>30 years) and elderly.
• Symptomatic infection in children appears to be uncommon, and when it occurs, it is usually mild

👉Clinical Presentation

• In a study describing 1099 patients with COVID-19 pneumonia in Wuhan, the most common clinical features at the onset of illness were:
  • Fever in 88%
  • Dry cough in 67%
  • Fatigue in 38%
  • Dyspnea in 18.7%
  • Myalgias in 14.9%
• Pneumonia appears to be the most common and severe manifestation of infection:
  • In this group of patients breathing difficulty developed after a median of five days of illness.
  • Acute respiratory distress syndrome:
    • Developed in 3.4% of patients.
• Other symptoms
  • Headache
  • Sore throat
  • Rhinorrhea
  • Gastrointestinal symptoms
• About 80% of confirmed COVID-19 cases:
  • Suffer from only mild to moderate disease
• Nearly 13% have severe disease:
  • Dyspnea
  • Respiratory frequency ≥ 30/minute
  • Blood oxygen saturation ≤ 93%
  • PaO2/FiO2 ratio less than 300
  • Lung infiltrates of greater than 50% of the lung filed within 24 to 48 hours
• Critical illness is seen in approximately 6% of the cases:
  • Respiratory failure
  • Septic shock
  • Mutliple organ dysfunction /failure

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