COVID-19 (coronavirus disease 2019) is respiratory tract infection due to a novel coronavirus, SARS-CoV-2 (initially called 2019-nCoV); as of March 11, 2020, extent of infection was declared pandemic by the WHO
Virus is thought to be zoonotic in origin, but the animal reservoir is not yet known, and it is clear that human-to-human transmission is occurring
Infection ranges from asymptomatic to severe; symptoms include fever, cough, and (in moderate to severe cases) dyspnea; disease may evolve over the course of a week or more from mild to severe. Upper respiratory tract symptoms (eg, rhinorrhea, sore throat) are uncommon
A significant proportion of clinically evident cases are severe; the mortality rate among diagnosed cases is about 2% to 3%
Infection should be suspected based on presentation with a clinically compatible history and known or likely exposure (residence in or travel to an affected area within the past 14 days, exposure to a known or suspected case, exposure to a health care setting in which patients with severe respiratory tract infections are managed)
Chest imaging in symptomatic patients almost always shows abnormal findings, usually including bilateral infiltrates; laboratory findings are variable but typically include lymphopenia and elevated lactate dehydrogenase and transaminase levels
Diagnosis is confirmed by detection of viral RNA on polymerase chain reaction test of upper or lower respiratory tract specimens or serum specimens
There is no specific antiviral therapy, although compassionate use and trial protocols for several agents are underway; treatment is largely supportive, consisting of supplemental oxygen and conservative fluid administration
Most common complications are acute respiratory distress syndrome and septic shock; myocardial, renal, and multiorgan failure have been reported
There is no vaccine available to prevent this infection; infection control measures are the mainstay of prevention (ie, hand and cough hygiene; standard, contact, and airborne precautions; social distancing)