Update on COVID-19 pandemic
Over 18.7 million cases of COVID-19 have been reported globally, with over 11.3 million cases recovered so far, and approximately 708,000 deaths according to data compiled by the Center for Systems Science and Engineering at Johns Hopkins University. The US has the highest number of reported infections and deaths in the world, accounting for approximately one quarter of all global cases and deaths. Brazil has the second largest number of reported cases with over 2.8 million infections. India, Russia, South Africa, Mexico, Peru, Chile, and Colombia are the countries with the most numbers of cases after Brazil.
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Summary
Definition
History and exam
Other diagnostic factors
- fatigue
- myalgia or arthralgia
- anorexia
- sputum production/expectoration
- chest tightness
- sore throat
- gastrointestinal symptoms
- dizziness
- headache
- neurologic symptoms
- cutaneous symptoms
- rhinorrhea/nasal congestion
- chest pain
- conjunctivitis
- hemoptysis
- bronchial breath sounds
- tachypnea
- tachycardia
- cyanosis
- crackles/rales on auscultation
Risk factors
- residence in/travel to location reporting community transmission
- close contact with a confirmed case
- older age
- residence in a long-term care facility
- male sex
- ethnicity
- presence of comorbidities
- cardiovascular disease
- hypertension
- diabetes
- chronic respiratory disease
- chronic kidney disease
- malignancy
- obesity
- sickle cell disease
- solid organ transplant
- smoking
- cerebrovascular disease
- chronic liver disease
- metabolic dysfunction-associated fatty liver disease
- surgery
- pregnancy
- immunosuppression
- air pollution
- climate and latitude
- residence in urban or deprived areas
- vitamin D deficiency
- ACE inhibitor/angiotensin-II receptor antagonist use
- statin use
- autoimmune disease
- neurologic conditions
- thalassemia
- children with certain underlying conditions
- blood group A
- gut dysbiosis
Diagnostic investigations
1st investigations to order
- pulse oximetry
- ABG
- CBC
- comprehensive metabolic panel
- blood glucose level
- coagulation screen
- serum C-reactive protein
- serum erythrocyte sedimentation rate
- serum lactate dehydrogenase
- serum interleukin-6 level
- cardiac biomarkers
- serum procalcitonin
- serum ferritin level
- serum amyloid A level
- serum creatine kinase
- blood and sputum cultures
- real-time reverse transcription polymerase chain reaction (RT-PCR)
- chest x-ray
Emerging tests
- antigen test
- reverse transcription loop-mediated isothermal amplification (RT-LAMP)
- lung ultrasound
Treatment algorithm
Contributors
Authors
Consultant and Honorary Senior Lecturer in Infectious Diseases
Royal Liverpool University Hospital and Liverpool School of Tropical Medicine
Liverpool
UK
Disclosures
NJB is partially supported by the National Institute of Health Research Health Protection Unit (NIHR HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE), in collaboration with Liverpool School of Tropical Medicine. He is affiliated with Liverpool School of Tropical Medicine. The views expressed are those of the author and not necessarily those of the NHS, the NIHR, the Department of Health, or PHE.
Senior Clinical Lecturer and Defence Consultant in Infectious Diseases
Royal Liverpool University Hospital and Liverpool School of Tropical Medicine
Liverpool
UK
Disclosures
TEF is a consultant/expert panel member to the World Health Organization, and is funded by the UK Surgeon General, the NHS, and Liverpool School of Tropical Medicine. TEF is partially supported by the National Institute of Health Research Health Protection Unit (NIHR HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE), in collaboration with Liverpool School of Tropical Medicine. He is affiliated with Liverpool School of Tropical Medicine. He has received research grants from the Wellcome Trust, Medical Research Council, and the UK Public Health Rapid Support Team (UK-PHRST). The views expressed are those of the author and not necessarily those of the NHS, the NIHR, the Department of Health, or PHE.
H. Barrie Fairley Professor of Critical Care
University Health Network and Interdepartmental Division of Critical Care Medicine
Director
Clinical Epidemiology and Health Care Research
Institute of Health Policy, Management and Evaluation
Dalla Lana School of Public Health
University of Toronto
Chief
Tory Trauma Program
Sunnybrook Hospital
Toronto
Canada
Disclosures
RF declares that he has no competing interests.
Peer reviewers
Professor
Division of Infectious Diseases and International Health
University of Virginia
Charlottesville
VA
Disclosures
WAP declares that he has no competing interests.
Attending Physician
The Fifth Medical Center of PLA General Hospital
Clinical Division and Research Center of Infectious Disease
Beijing
China
Disclosures
XZ declares that he has no competing interests.
Associate Professor in Medicine
Department of Clinical Microbiology and Infectious Diseases
Hadassah Hebrew University Medical Center
Jerusalem
Israel
Disclosures
RNP has received research grants from US-Israel Binational Science Foundation, Hebrew University, Rosetrees Trust, and SpeeDx. He is chair of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Mycoplasma and Chlamydia Infections (ESGMAC). RNP is a consultant for and has stocks in eDAS Healthcare. He is also chairperson of the Israeli Society for Infectious Diseases guidelines committee.
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