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Anatomy or system affected:Gastrointestinal system, lungs, respiratory system

Also known as: Common cold, coronavirus 2019 (COVID-19), Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS), viral bronchitis, viral pneumonia

Definition

Exposure to the coronavirus results in a variety of infections, including approximately one-third of all cases of the common cold. The virus also may be responsible for viral bronchitis, pneumonia, and SARS, especially in persons with weakened immune systems. The coronavirus is the largest positive-strand ribonucleic acid (RNA) virus; it is part of the Coronaviridae family. A new coronavirus disease, Coronavirus 2019 (COVID-19), was first reported in Wuhan, China, in December 2019. By March 2020, COVID-19 had become a pandemic.

Causes

Coronavirus is the underlying cause of a variety of illnesses that affect the respiratory system, the gastrointestinal system, and, in rare cases, the neurological system. Infections with the virus are often seasonal in nature, with more occurring in winter. Contact with contaminated droplets from sneezing and coughing and direct contact by touching contaminated objects, such as surfaces and tissues, may transmit the virus from person to person. With COVID-19, contaminated droplets may remain airborne even after a person who is infected with the virus has left the area.

The virus may live six to nine hours, and the live virus has been found in the stool of people diagnosed with SARS. It is highly contagious, and reinfection may occur. The virus can affect humans, cattle, pigs, rodents, cats, dogs, and birds, but instances of animal-to-human coronavirus infections, such as SARS and MERS, are rare. While COVID-19 is suspected to have started as an animal coronavirus that spread to humans, its exact origins are as yet unknown.

Risk Factors

Risk factors for coronavirus infection are exposure to an infected person through kissing and sharing living spaces and contact with droplets or contaminated surfaces containing the virus. The severity of the infection increases if a person is immunocompromised (less able to fight infections because of a weakened immune system). With COVID-19, older people and those with serious chronic medical conditions including heart disease, diabetes, and lung disease are at greater risk of becoming very ill if they are infected with the virus.

Symptoms

Coronavirus infection that leads to the common cold comes with symptoms of fatigue, a scratchy throat, sneezing, nasal congestion, and a runny nose. Fever rarely occurs with a cold, except in children. A more serious infection, such as pneumonia or SARS, may be occurring if symptoms include fever, chills, muscle aches, an acute cough, a headache, dizziness, or diarrhea. COVID-19 symptoms may develop within fourteen days of exposure and may include cough, fever, and shortness of breath. Some people with COVID-19 may have mild symptoms or be asymptomatic.

Screening and Diagnosis

A physical examination including listening to lung sounds, reviewing symptoms, chest X rays, and blood work may be used to determine if a person has a cold or has developed pneumonia or SARS. Blood work may include blood chemistries and a complete blood count to determine if white blood cell counts, lymphocytes, and platelets are low. Specific tests for SARS may be ordered too. COVID-19 can only be diagnosed with a laboratory test.

Treatment and Therapy

In the absence of fever, symptoms may be treated with over-the-counter medications, plenty of fluids, and rest. If symptoms worsen or if a fever develops, one should seek medical care. Antibiotics, antiviral medications, and high doses of steroids to decrease lung inflammation may be prescribed. In severe cases, the patient may need oxygen, breathing support with a respirator, and hospitalization.

For cases of suspected COVID-19 exposure and infection, the Centers for Disease Control and Prevention (CDC) recommends calling one’s healthcare provider ahead of seeking care, noting that those with mild cases of the illness are able to recover at home and that staying home except to get medical care will prevent the spread of the virus. For those with worsening symptoms, such as difficulty breathing, it is essential to get care and to call one’s doctor or emergency room ahead of arrival. In such cases, the CDC also advises staying at least six feet (about two meters) away from others, wearing a facemask, and avoiding public transportation, taxis, or ride-sharing services.

Prevention and Outcomes

The best prevention against coronavirus infection is to limit contact with infected persons. Hand hygiene, including frequent handwashing with soap and water or cleaning hands with an alcohol-based hand sanitizer with at least 60 percent alcohol, is an important part of prevention. The CDC recommends washing with soap and water for at least twenty seconds after blowing one’s nose, coughing, or sneezing; after going to the bathroom; and before preparing food or eating. Avoid touching the eyes, nose, and mouth with unwashed hands. Cough or sneeze into tissue or into the arm to minimize droplets and airborne particles. Used tissues should be disposed of in a lined trash can. Because coronavirus is contagious, those who are sick should not share food and drink, utensils, bedding, towels, or personal supplies with others in the home. High-touch household areas, including door knobs, counter tops, and other surfaces, should be cleaned routinely with disinfectant by those who are not infected.

With a new coronavirus pandemic like COVID-19, all of these preventative measures are essential to limiting its spread and mitigating its negative impacts. Public health and government officials have urged the widespread use of social distancing—staying home whenever possible and maintaining a distance of six feet (two meters) from others when it is necessary to go out—during the COVID-19 outbreak. Additionally, those who are ill with COVID-19 should stay home unless they need medical care; wear a facemask if they are able to and need to go out; stay in a designated sick room; and use a separate bathroom if possible. Although there is no evidence yet to support the human-to-animal spread of COVID-19, the CDC recommends that those who are ill with the virus find someone to care for their pets or else wash their hands before and after contact.

Bibliography

Eccles, Ronald, and Olaf Weber, eds. Common Cold. Boston: Birkhäuser, 2009.

Peiris, M., et al., eds. Severe Acute Respiratory Syndrome. Malden, Mass.: Blackwell, 2005.

Wagner, Edward K., and Martinez J. Hewlett. Basic Virology. 3d ed. Malden, Mass.: Blackwell Science, 2008.

“Coronavirus (COVID-19).” Centers for Disease Control and Prevention, www.cdc.gov/coronavirus/2019-nCoV/index.html. Accessed 17 Mar. 2020.

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