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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