Coronavirus | Complete report & tracker (National and Global).



Here you will find expert, curated information for the research and health community on SARS-CoV-2 (the novel coronavirus) and COVID-19 (the disease).



COVID - 19 Tracker: NationalGlobal

In December, China notified the World Health Organization of several cases of human respiratory illness, which appeared to be linked to open seafood and livestock market in the city of Wuhan. The infecting agent has since been identified as a novel coronavirus, now called SARS-CoV-2 (initially called 2019-nCoV). Novel Coronavirus associated infection is now designated as COVID-19. Although the virus is presumed zoonotic in origin, person-to-person spread is evident. Cases have now been reported in many parts of mainland China and in other countries throughout the world. Outbreaks involving large numbers of people are ongoing in South Korea, Iran and Italy, and local transmission is occurring on a smaller scale in other countries. Travel restrictions and quarantine measures have been placed in some affected areas. Screening of travellers is being implemented in other countries and quarantine measures have been enacted under some circumstances. While the number of new cases in China is declining, the scope and trajectory of infection elsewhere remain to be seen.
Novel coronaviruses have emerged as human pathogens in the past, notably associated with outbreaks of SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome). Current investigative methods and recommendations derive in some part from the experience of those epidemics.


Clinical presentation: 

The incubation period is thought to be 2 to 14 days. Symptoms include fever (which may be absent in persons at extremes of age or with immunocompromised), cough and dyspnea. Chest radiographs may show bilateral infiltrates. Clinical illness varies from mild to severe; about 25 per cent of confirmed cases have been classified as severe, with up to 32 per cent requiring intensive care for respiratory support. Some reports suggest worsening during the second week of illness. In early cases, mortality was associated with advanced age or comorbidities. An asymptomatic infection has also been described.


Diagnosis: 


Although respiratory infections (including influenza) are prevalent in the northern hemisphere during the winter, clinicians should inquire about travel history and exposure to possible or known COVID-19 in persons presenting with respiratory illness. The possibility of COVID-19 should be suspected in persons who present with compatible clinical illness and exposure history. The US Centers for Disease Control (CDC) and World Health Organization (WHO) developed criteria for whom to test, and these have been modified continually. With significant outbreaks in several countries and community transmission in others, as well as wider availability of diagnostic test kits, both organizations have broadened recommendations for testing. CDC now recommends that clinicians use their judgment, informed by knowledge of local COVID-19 activity as well as travel history and other risk factors, to determine the need for testing in patients with a compatible clinical illness. WHO   defines a suspect case (for whom testing is recommended) as follows:
  • A patient with acute respiratory illness (fever and at least one sign/symptom of respiratory disease) AND no other aetiology that fully explains the condition AND a history of travel to or residence in an area reporting local transmission of COVID-19 during the 14 days prior to symptom onset
  • A patient with any acute respiratory illness AND contact with a confirmed or probable COVID-19 case in the last 14 days prior to symptom onset
  • A patient with a severe acute respiratory infection (as defined above) AND requiring hospitalization AND without other explanatory aetiology
In the United States, suspected cases should be reported immediately to local or state health departments, which will determine whether the patient meets clinical and epidemiologic criteria for disease and can aid in coordinating diagnostic testing, as well as monitoring and contact tracing. The FDA has provided guidance permitting the use of validated diagnostic tests developed by other qualified laboratories that have submitted a request for emergency use authorization, in order to increase testing capacity. The WHO Prequalification Team has also opened an Emergency Use Listing for manufacturers to submit newly developed diagnostic tests. Collection of specimens from the upper respiratory tract, lower respiratory tract and serum is recommended as a priority; other specimens, such as stool or urine may be collected and stored to be tested at the discretion of the CDC. The CDC provides detailed information on the collection and shipping of specimens for cases approved by local or state authorities for processing by the CDC. The CDC advises that testing for other respiratory pathogens by the provider should be done as part of the initial evaluation and should not delay specimen shipping to CDC.
If a patient with suspected COVID-2019 infection tests positive for another respiratory pathogen, after clinical evaluation and consultation with public health authorities, they may no longer be considered a person under investigation.

[Red colour indicates the infected people: shade variation indicates the infection severity]


Management: 


Patients with a mild clinical presentation may not require hospitalization but should be monitored for worsening, especially in the second week of illness. No specific antiviral agent is available for the treatment of this infection, although clinical trials are in progress and some antiviral agents (e.g., remdesivir) may be available for compassionate use (see clinicaltrials.gov). Treatment is supportive and includes supplemental oxygen, conservative fluid management and when needed, critical care measures (mechanical ventilation, hemodynamic support), as indicated by clinical condition. WHO provides detailed guidance on such supportive measures and cautions that severely ill patients should be treated empirically for other possible causes while diagnostic test results are pending.
Infection control measures are an integral part of management:
  • Provide the patient with a face mask and place the patient in a closed room (preferably with structural safeguards against airborne transmission).
  • Persons entering the room should follow the standard, contact, and airborne precautions.
  • Patients managed at home are encouraged to self-isolate to a single area of the house (preferably with a separate bathroom) and to wear a face mask during any contact with household members.
  • The patient and all household members should follow diligent hand and cough hygiene.

Complications

Respiratory failure and septic shock occur in some patients. The case fatality rate is about 3 per cent.



Words from NividBook: 

"Dear people, take care of your loved ones and especially the senior citizen as now we are not only humans but warriors defending ourselves."


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