2019 Novel Coronavirus Update - Page 2

2019 NOVEL CORONAVIRUS TIMELINE JAN 3, 2020 DEC 31, 2019 Pneumonia of unknown etiology emerges in Wuhan City, Hubei Province, China. Chinese authorities alert WHO that a group of 44 patients are sick with pneumonia. JAN 7, 2020 The Chinese authorities isolate a new coronavirus. JAN 20, 2020 282 cases are confirmed in China. JAN 22, 2020 First confirmed case in the U.S. in a patient who traveled from China. JULY 12, 2020 U.S. confirmed cases: 3,236,130 U.S. deaths: 134,572 GLOBAL: 12,552,765 cases 561,617 deaths This is an ever-evolving disaster due to new findings and data and availability of resources, so refer to the CDC website for detailed information when you need it. BACKGROUND INFORMATION From December 31, 2019 through January 3, 2020, a total of 44 case-patients with pneumonia of unknown etiology were reported to the World Health Organization (WHO) by national authorities in China. Chinese scientists quickly isolated a new coronavirus on January 7, 2020, and by January 20th, there were 282 confirmed infected cases. The new virus named SARs CoV-2, was first detected in Wuhan City, Hubei Province, China, and continued to spread throughout the mainland there. Just a little over a month later, this novel coronavirus, infected over 42,000 people in China, causing 1,017 deaths there, and has since spread globally, causing a pandemic. The first U.S. case was reported on January 22 nd and subsequently confirmed by the Centers for Disease Control and Prevention (CDC). The illness onset was marked as early as January 14th. By February 10, 2020, there were 13 confirmed cases identified in Washington, California, Arizona, Illinois, and Massachusetts. Currently, all states in the U.S., the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands are affected. SARS CoV-2 is a new coronavirus that has not been previously recognized in humans. Early cases were thought to have crossed over to humans from an animal, such as a camel, cow, cat, or bat, because many of those that were first infected were exposed to a large seafood and live animal market in Wuhan. The animal source has not yet been identified. COVID-19 is a betacoronavirus like Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV), both of which have their origin in bats. Human to human transmission is now occurring. The official name for the disease caused by SARS CoV-2 is COVID-19. ‘CO’ stands for ‘corona’, ‘VI’ for ‘virus,’ and ‘D’ for ‘disease’. Signs and Symptoms COVID-19 causes respiratory illness with symptoms of fever or chills, cough, and shortness of breath. Symptoms range from mild, as with the common cold, to deadly. Other symptoms include fatigue, muscle or body aches, headache, new losses of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea. The incubation period is thought to extend to 14 days with most developing symptoms within 11.5 days. Signs and symptoms are similar in children, but they are usually milder. Clinicians should be aware that some patients deteriorate rapidly one week after symptom onset. The most common laboratory findings among hospitalized patients with pneumonia on admission included lymphopenia, neutrophilia, and elevated alanine aminotransferase and LDH levels. Elevated D-dimer and lymphopenia have been associated with increased mortality. Most patients show bilateral involvement on chest CT. Typically there are multiple areas of consolidation and ground glass opacities; however, these findings are not specific to COVID-19, and chest radiograph or CT alone should not be used to diagnose the disease. Hypoxia and systemic inflammation may result in increased cytokines and activation of the coagulation pathway, causing hypercoagulability. More information on hypercoagulability and COVID-19 is available from: • American Society of Hematology • National Institutes of Health: Coronavirus Disease 2019 (COVID-19) Treatment Guidelines – Antithrombotic Therapy in Patients with COVID-19 TREATMENT GUIDELINES Currently there is no effective vaccine or antiviral agent for this infection, and treatment is supportive to manage symptoms. Clinical management guidelines include information in the following links: • American Society of Hematology – “COVID-19 Resources” • National Institutes of Health (NIH) - “COVID-19 Treatment Guidelines” • NIH - COVID-19 Treatment Guidelines Panel Provides Recommendations for Dexamethasone in Patients with COVID-19 • Surviving Sepsis Campaign – “COVID-19 Guidelines” • World Health Organization (WHO) - "Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected" • American Thoracic Society–"Diagnosis and Treatment of Adults with Communityacquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America" HealthStream.com/contact • 800.521.0574 •