The incubation period to develop symptoms in COVID-19 ranges from 2–14 days. Average incubation period is 5 days and majority develop symptoms by 10–11 days. Median interval from onset of symptoms to hospital admission is about 7 days. Majority of the infected individuals (80%) develop mild symptoms, whereas 15% develop moderate symptoms and 5% develop critical manifestations with respiratory failure and multiorgan dysfunction syndrome and septic shock. Amongst the hospitalized patients, 15–20% require high dependency or intensive care facility.

COVID-19 infection can occur at any age, but symptomatic and severe manifestations are mostly seen in adult age group. The severity and death among male gender is observed more commonly than females. Children are mostly asymptomatic or pauci-symptomatic, and hospitalization and severe manifestations are rare. Death among <18 years though reported but extremely rare.

COVID-19 infected individuals may remain asymptomatic or may develop symptoms. It has been observed that majority of individuals who are asymptomatic at the time of positive detection, develop some or other mild symptom in next a few days.

The clinical severity in symptomatic patients ranges from mild, moderate to severe and critical. The disease course of COVID-19 severity is shown in Fig. 1.

Fig1. Time course of COVID-19 disease

Mild: Fever is the most common symptom present in almost all symptomatic patients. Cough, sore throat, malaise and body ache, fatigue are the other common manifestations. Some proportion of patients develop loss of smell and alteration in taste. Headache, diarrhea also seen in 5–8% patients. Respiratory rate is <24 and normal SpO2 on room air.

Moderate: Persistence of high fever and cough with shortness of breath, features of pneumonia with development of hypoxemia and corroborative findings on high resolution chest CT. Respiratory rate is between 24 and 30/minute and SpO2 on room air is 90–93%.

Severe: Fever or suspected respiratory infection, plus one of the following: Respiratory rate >30 breaths/minute, severe respiratory distress with respiratory rate >30 and SpO2 <90 % in room air.

Critical: New or worsening respiratory symptoms with development of acute respiratory syndrome (ARDS) requiring invasive mechanical ventilation, along with features of shock, coagulation defects, acute kidney injury, cardiac failure and encephalopathy. Chest imaging showing bilateral opacities, not fully explained by effusions, lobar or lung collapse, or nodules.

Most of the moderately severe patients need hospitalization. The common manifestations among the hospitalized patients are fever, shortness of breath, cough, myalgia and fatigue. The presence of comorbidity acts as the risk factor for development of severe disease. Diabetes, hypertension, chronic kidney disease, cardiovascular disease, chronic liver disease and malignancy are the common comorbid conditions.

COVID-19 in children: Majority of the infected children remain asymptomatic or develop only mild symptoms. Fever and cough are the two most common symptoms in children and occur in about 50% of cases. COVID-19 positive children account for <1.5% of all COVID-19 related hospitalizations. Among the hospitalized children, about 30–70% have underlying comorbid conditions, such as immunosuppressive conditions, chronic pulmonary or cardiac diseases, or neurologic disease. In children, a newly recognized spectrum of disease known as multiorgan inflammatory syndrome in children (MIS-C) has been associated with COVID-19. The syndrome was noticed when many children were admitted to hospital in Europe and North America with symptoms resembling Kawasaki disease. Later it was named multi organ inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome (PIMS). The estimated incidence is 1 in 100,000. A confirmed case of MIS C is defined by increased level of two or more inflammatory markers and virologic evidence with SARS-CoV-2 RNA detection or IgM or IgG antibody against SARS-CoV-2 within 10 days of admission. Suspected case of MIS-C is defined when clinical criteria are fulfilled in presence of history of contact with a known COVID-19 case in last 6 weeks but without virologic evidence. Most of the cases present 2–4 weeks after SARS-CoV-2 infection and are positive for SARS-CoV-2 antibodies. Fever, chill, pain abdomen, rash, myocarditis, vomiting, and diarrhea are the common presenting symptoms. Level of C-reactive protein, lactate dehydrogenase, proBNP, troponin and D-dimer are elevated in most of the cases. About 80% of them require ICU admission of them 10% need mechanical ventilation. Majority of the patients recover with treatment with IVIG and glucocorticoid. Mortality of about 2% has been reported.

اخر الاخبار

اخبار العتبة العباسية المقدسة

موكب العتبتين المقدستين يحيي ذكرى استشهاد الإمام الهادي (عليه السلام) في سامراء

العتبة العسكرية المقدسة تكرّم وفد العتبة العباسية المقدسة لمشاركته في تقديم الخدمات للزائرين

العتبة العباسية المقدسة تختتم مشاركتها في تقديم الخدمات لزائري مرقد الإمامين العسكريين (عليهما السلام)

وفد متحف الكفيل يطلع على الفنون التراثية والحرف الأصيلة في ورش مدينة أصفهان

المزيد

الآخبار الصحية

كنز غذائي على طبقك.. ماذا تفعل السبانخ بجسمك؟

ما لا يتوقعه أحد.. "سر غذائي" في الجبن الدسم

لتحسين الهضم والنوم.. هذا أفضل وقت لتناول العشاء

10 طرق بسيطة وغير مألوفة لحرق المزيد من السعرات يوميا

المزيد

الآخبار التكنلوجية

سابقة بعالم الطيران.. طائرة تقرر الهبوط بنفسها بعد ظرف طارئ

"الإنفلونزا الخارقة" تكتسح دول العالم.. وتثير قلقا كبيرا

مرحلة ما قبل الأعراض.. دواء جديد يستهدف "شرارة" الزهايمر

إزالة ثاني أكسيد الكربون من الغلاف الجوي.. ما دور المحيطات والبحار؟

المزيد

مواضيع ذات صلة

Complications of COVID-19

Modes of Transmission SARS-CoV-2 and COVID-19

Papillomaviruses

Arenaviruses

Adenoviruses

Viral Serology: Immune Status Testing

Structure and Function of Hemagglutinin

Structure and Composition of influenza viruses

Filoviruses Diseases

Pathogenesis of SARS-CoV-2 and COVID-19

Viral Serology :General Principles

Virus detection methods: Cell Culture