Good Fully Cited, HIgh Content post here:
(bolded highlights mine)
Compilation of information for health professionals
I've been maintaining a comment with information for health professionals in the r/medicine COVID-19 [megathread](https://www.reddit.com/r/medicine/comments/f9jbqo/megathread_covid19_aka_2019ncov). Figured it might be good to post here as well.
**Basics**:
* **Name of virus:** SARS-CoV-2
* **Name of illness:** COVID-19
* **
R0 SARS-CoV-2**: 2.28 - 3.28 [2](https://www.ijidonline.com/article/S1201-9712\(20\)30091-6/fulltext),[27](https://bit.ly/2I1by2r)
* **
R0 Seasonal Influenza:** 1.28 [19](https://www.ncbi.nlm.nih.gov/m/pubmed/25186370/)
* **COVID-19 Case Fatality Rate:** 2.3% - 4.3% [3](https://jamanetwork.com/journals/jama/fullarticle/2762130?guestAccessKey=bdcca6fa-a48c-4028-8406-7f3d04a3e932&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=022420), [4](https://www.medrxiv.org/content/10.1101/2020.02.18.20024539v2) (Note that CFR is very difficult to estimate accurately in any situation, but especially in an evolving situation like this)
* *
*2019-2020 Influenza Fatality Rate:** 0.039% - 0.14% [5](https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm)
* ***Confirmed* Cases (World):** 82,738 (2/27/20 1700 EST) [13](https://ncov2019.live/data)
* ***Confirmed* Cases (Non-China):** 4,265 (2/27/20 1700 EST) [14](https://ncov2019.live/data)
* ***Confirmed* Cases (US):** 60 (2/27/20 1700 EST) [15](https://ncov2019.live/data)
* **
Case Doubling Time (Non-China):** 6 days [18](https://coronainfo.xyz/)
* **
Transmission Methods:** Respiratory droplet and touch/fomites [6](https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html),
possible fecal-oral [21](https://www.medscape.com/viewarticle/925575),
possible airborne [28](https://www.thailandmedical.news/news/china-officially-announces-that-the-coronavirus-can-be-airborne-and-can-be-conditionally-spread-via-aerosol-transmission-),[29](https://www3.nhk.or.jp/nhkworld/en/news/20200219_43/)
* *
*Incubation Period:** 2-14 days [7](https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html)
* **
Persistence on Inanimate Surfaces:** Up to 9 days. Less at temperatures above 30C [27](https://www.journalofhospitalinfection.com/article/S0195-6701%2820%2930046-3/fulltext)
**
Symptoms:** Fever, cough, SOB [8](https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html). *
It seems to start with a fever, followed by a dry cough.* After a week, it can lead to shortness of breath, with about **20% of patients requiring hospital treatment**. Notably, the COVID-19 infection rarely seems to cause a runny nose, sneezing, or sore throat [9](https://www.worldometers.info/coronavirus/coronavirus-symptoms/). Some atypical patients [may present](https://www.ncbi.nlm.nih.gov/pubmed/32096611) initially with GI symptoms.
**Clinical Features**: Pneumonia appears to be the most frequent serious manifestation of infection, characterized primarily by fever, cough, dyspnea, and bilateral infiltrates on chest imaging. Most infections are not severe, although many patients have had critical illness. In a report from the Chinese Center for Disease Control and Prevention that included approximately 44,500 confirmed infections with an estimation of disease severity,
81 percent were mild (no or mild pneumonia), 14 percent were severe (eg, with dyspnea, hypoxia, or >50 percent lung involvement on imaging within 24 to 48 hours), and 5 percent were critical (eg, with respiratory failure, shock, or multiorgan dysfunction). White count is variable. In a study involving PNA pts, "**lymphopenia** was common, and all patients had parenchymal lung abnormalities on computed tomography of the chest, including bilateral patchy shadows or ground-glass opacities."
Acute respiratory distress syndrome developed in 20 percent, and mechanical ventilation was implemented in 12.3 percent. Among the six patients who died, D-dimer levels were higher and lymphopenia was more severe compared with survivors. [23](https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19?csi=6bb0f4c3-201c-4b34-a17a-e97a91e69d60&source=contentShare#H3392906512)
**Treatment**:
Treatment is primarily supportive. The following medications have either been tentatively shown to be efficacious, or are under investigation as treatment
(Sorry
@chet)
* **Lopinavir/ritonavir**: Protease inhibitor, in [combination with oseltamivir](https://www.bangkokpost.com/thailand/general/1860329/woman-74-recovers-from-virus-after-thai-cocktail) or in combination with [abidol](https://www.ncbi.nlm.nih.gov/pubmed/32096367)
* **Chloroquine Phosphate**: Antimalarial [showing promise](https://www.ncbi.nlm.nih.gov/pubmed/32075365) as a [treatment](https://www.ncbi.nlm.nih.gov/pubmed/32074550)
* **Remdesivir:** Nucleotide analog currently in [clinical trials](https://clinicaltrials.gov/ct2/show/NCT04257656)
* **Hydroxychloroquine**: [In clinical trials](https://clinicaltrials.gov/ct2/show/NCT04261517) as treatment
* **Favipiravir**: [Approved for clinical trial](http://global.chinadaily.com.cn/a/202002/17/WS5e49efc2a310128217277fa3.html) in China
* **Fingolimod**: [In clinical trials](https://clinicaltrials.gov/ct2/show/NCT04280588) in China
* **Methylprednisolone**: Glucocorticoid [in clinical trials](https://clinicaltrials.gov/ct2/show/NCT04273321) in China
* **Bevacizumab**: VEGF inhibitor [in clinical trials](https://clinicaltrials.gov/ct2/show/NCT04275414) in China
**
When to test:** [25](https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html)
*
Fever or signs/symptoms of lower respiratory illness (e.g. cough or shortness of breath) **AND** Any person, including health care workers, who has had close contact) with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset
     OR
* Fever and signs/symptoms of a lower respiratory illness (e.g., cough or shortness of breath) requiring hospitalization **AND** A history of travel from affected geographic areas within 14 days of symptom onset
OR
*
Fever with severe acute lower respiratory illness (e.g., pneumonia, ARDS) requiring hospitalization and without alternative explanatory diagnosis (e.g., influenza) **AND** No source of exposure has been identified
**How to test:** Healthcare providers should immediately notify both infection control personnel at their healthcare facility and their local or state health department in the event of a PUI for COVID-19. State health departments that have identified a PUI should immediately contact CDC’s Emergency Operations Center (EOC) at 770-488-7100 and complete a COVID-19 PUI case investigation form available below. [26](https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html) ([Specimen collection guidelines](https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html))
**Information:**
* [CDC Info for health professionals] (https://www.cdc.gov/coronavirus/2019-ncov/hcp/index.html)
* [WHO Technical Guidance](https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance)
* [AMA resource center for health professionals](https://www.ama-assn.org/delivering-care/public-health/covid-19-2019-novel-coronavirus-resource-center-physicians)
* [ACP Information for Internists](https://www.acponline.org/clinical-information/clinical-resources-products/novel-coronavirus-information-for-internists)
* [CDC Pandemic Preparedness Resources](https://www.cdc.gov/coronavirus/2019-ncov/php/pandemic-preparedness-resources.html)
* [UpToDate COVID-19](https://bit.ly/2Tphyam)
**Trackers and data**
* [Worldometers (lots of disease stats)](https://www.worldometers.info/coronavirus/)
* [ncov2019.live (up to date cases numbers)](https://ncov2019.live/data)
* [coronainfo.xyz (nice case plots)](https://coronainfo.xyz/)
* [BNO News (case tracker with map)](https://bnonews.com/index.php/2020/02/the-latest-coronavirus-cases/)
* [Johns Hopkins Map](https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6)
* [Outbreak Wikipedia](https://bit.ly/3c8pAgu)
**Subreddits to Follow:**
* r/COVID19 - Scientific Discussion
* r/Coronavirus - More casual discussion but moderated for accuracy
* r/China_Flu - Speculation and Conspiracy
**Death Rate Stats:**
> The percentage shown below does NOT represent in any way the share of deaths by age group. Rather, it represents, for a person in a given age group, the risk of dying if infected with COVID-19.
Age | Death Rate
---|----------
80+ years old | 14.8%
70-79 years old | 8.0%
60-69 years old | 3.6%
50-59 years old | 1.3%
40-49 years old | 0.4%
30-39 years old | 0.2%
20-29 years old | 0.2%
10-19 years old | 0.2%
0-9 years old | None
[10](https://bit.ly/2wca1Uy)
Sex | Death Rate
---|----------
Male | 2.8%
Female | 1.7%
[11](https://bit.ly/2wca1Uy)
> The percentage shown below does NOT represent in any way the share of deaths by pre-existing condition. Rather, it represents, for a patient with a given pre-existing condition, the risk of dying if infected by COVID-19.
Pre-existing Condition | Death Rate
---|----------
Cardiovascular disease | 10.5%
Diabetes | 7.3%
Chronic respiratory disease | 6.3%
Hypertension | 6.0%
Cancer | 5.6%
no pre-existing conditions | 0.9%
[12](https://bit.ly/2wca1Uy)
I should mention that I'm a fourth year med student in the US.