Signs and Symptoms: Coronavirus Disease 2019

Signs and symptoms
Main article: Coronavirus disease 2019
Symptoms of COVID-19[388]
Symptoms of COVID-19 can be relatively non-specific and infected people may be asymptomatic. The two
most common symptoms are fever (88 per cent) and dry cough (68 per cent). Less common symptoms include
fatigue, respiratory sputum production (phlegm), loss of the sense of smell, loss of taste, shortness of breath,
muscle and joint pain, sore throat, headache, chills, vomiting, hemoptysis, and diarrhea.[389][390][391]
The WHO says approximately one person in five becomes seriously ill and has difficulty breathing.[8] The U.S.
Centers for Disease Control and Prevention (CDC) lists emergency symptoms as difficulty breathing, persistent
chest pain or pressure, sudden confusion, difficulty waking, and bluish face or lips; immediate medical attention
is advised if these symptoms are present.[15]
Further development of the disease can lead to potentially fatal complications including pneumonia, acute
respiratory distress syndrome, sepsis, septic shock, and kidney failure.[390]
Some of those infected may be asymptomatic, with no clinical symptoms but test results that confirm infection,
so researchers have issued advice that those with close contact to confirmed infected people should be closely
monitored and examined to rule out infection.[392] Chinese estimates of the asymptomatic ratio range from few
to 44 per cent.[393] The usual incubation period (the time between infection and symptom onset) ranges from
one to 14 days; it is most commonly five days.[394][8]
Cause
Transmission
Respiratory droplets produced when a man sneezes, visualised using Tyndall scattering

A video discussing the basic reproduction number and case fatality rate in the context of the pandemic
COVID-19 is a new disease, and the ways it spreads between people are under investigation, including: the
predominant role of small droplets, the extent to when and how it may be transmitted through air, and how long
expelled droplets remain infectious on surfaces.[8][9][11] The disease is spread during close contact, often by
small droplets produced during coughing, sneezing, or talking.[8][11] During close contact, (1 to 2 metres, 3 to 6
feet), people catch the disease after breathing in contaminated droplets that were exhaled by infected people.
However, the droplets are relatively heavy and usually fall to the ground or surfaces, as opposed to being
infectious over large distances.[8][11]
After the droplets fall to floors or surfaces, they still can infect other people, if they touch contaminated surfaces
and then their eyes, nose or mouth with unwashed hands.[8] On surfaces the amount of active virus decreases
over time until it can no longer cause infection.[11] However, experimentally, the virus can survive on various
surfaces for some time, (for example copper or cardboard for a few hours, and plastic or steel for a few days).
[11][395]
Surfaces are easily decontaminated with household disinfectants which kill the virus outside the human
body or on the hands.[8] Disinfectants or bleach are not a treatment for COVID-19, and cause health problems
when not used properly, such as inside the human body.[396]
Sputum and saliva carry large amounts of virus.[397][8][9][11] Some medical procedures may result in the virus
being transmitted easier than normal for such small droplets, known as airborne transmission.[8][11]
The virus is most contagious during the first three days after onset of symptoms, although spread is known to
occur up to two days before symptoms appear (presymptomatic transmission) and in later stages of the
disease.[9][11][398][399] Some people have been infected and recovered without showing symptoms, but
uncertainties remain in terms of asymptomatic transmission.[11]
Although COVID-19 is not a sexually transmitted infection, kissing, intimate contact, and faecal oral routes are
suspected to transmit the virus.[400][401]
Virology
Main article: Severe acute respiratory syndrome coronavirus 2
Illustration of SARSr-CoV virion

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel virus, first isolated from three
people with pneumonia connected to the cluster of acute respiratory illness cases in Wuhan.[334] All features of
the novel SARS-CoV-2 virus occur in related coronaviruses in nature.[402]
SARS-CoV-2 is closely related to SARS-CoV, and is thought to have a zoonotic origin.[331] SARS-CoV-2
genetically clusters with the genus Betacoronavirus, and is 96 per cent identical at the whole genome level to
other bat coronavirus samples[403] and 92 per cent identical to pangolin coronavirus.[404]

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Signs and symptoms

Main article: Coronavirus disease 2019

Respiratory droplets produced when a man sneezes, visualised using Tyndall scattering

Illustration of SARSr-CoV virion

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