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Old 02-01-2020, 12:44 PM
Sailormilan2 Sailormilan2 is offline
Join Date: Dec 2012
Location: Behind the lines in Occupied Central CA
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Clinical Presentation

There are a limited number of reports that describe the clinical presentation of patients with confirmed 2019-nCoV infection, and most are limited to hospitalized patients with pneumonia. The incubation period is estimated at ~5 days (95% confidence interval, 4 to 7 days). Frequently reported signs and symptoms include fever (8398%), cough (76%82%), and myalgia or fatigue (1144%) at illness onset. Sore throat has also been reported in some patients early in the clinical course. Less commonly reported symptoms include sputum production, headache, hemoptysis, and diarrhea. The fever course among patients with 2019-nCoV infection is not fully understood; it may be prolonged and intermittent. Asymptomatic infection has been described in one child with confirmed 2019-nCoV infection and chest computed tomography (CT) abnormalities.

Risk factors for severe illness are not yet clear, although older patients and those with chronic medical conditions may be at higher risk for severe illness. Nearly all reported cases have occurred in adults (median age 59 years). In one study of 425 patients with pneumonia and confirmed 2019-nCoV infection, 57% were male. Approximately one-third to one-half of reported patients had underlying medical comorbidities, including diabetes, hypertension, and cardiovascular disease.

Clinical Course

Clinical presentation among reported cases of 2019-nCoV infection varies in severity from asymptomatic infection or mild illness to severe or fatal illness. Some reports suggest the potential for clinical deterioration during the second week of illness. In one report, among patients with confirmed 2019-nCoV infection and pneumonia, just over half of patients developed dyspnea a median of 8 days after illness onset (range: 513 days).

Acute respiratory distress syndrome (ARDS) developed in 1729% of hospitalized patients, and secondary infection developed in 10%. Between 2332% of hospitalized patients with 2019-nCoV infection required intensive care for respiratory support. Some hospitalized patients have required advanced organ support with invasive mechanical ventilation (410%), and a small proportion have also required extracorporeal membrane oxygenation (ECMO, 35%). Other reported complications include acute cardiac injury (12%) and acute kidney injury (47%). Among hospitalized patients with pneumonia, the case fatality proportion has been reported as high as 1115%. However, as this estimate includes only-hospitalized patients, and therefore is biased upward.
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