COVID-19 What we Know so Far

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Coronavirus disease or COVID-19 has a relatively low case fatality rate, but the actual numbers of deaths are considerable given the huge scale of this pandemic. 

The first confirmed death was in Wuhan on 9 January 2020. The first death outside mainland China occurred in February in the Philippines, and the first death outside Asia was in France on 14 February.

By 28 February, outside mainland China, more than a dozen deaths each were recorded in Iran, South Korea, and Italy.

By end of March, nearly 100 countries reported deaths due to COVID-19.

Since then, the epidemic has spread to virtually every country, with 326.000 deaths, 5 million infected, and 1.75 million recovered on May 21.

Demographics

Deaths are more common in those aged over 60 years and those with co-morbidities. Men are more likely to die than women after being infected with COVID-19. The exact reasons for this sex-difference is not known, but genetic and behavioral factors could be a reason for this difference.

Most people affected with the disease will recover without any particular treatment.

Graph 1: Demographics – number of deaths per age group.

Comorbidities

Individuals with comorbidities such as hypertension, diabetes and other illnesses will have poorer outcomes.

In Italy, the most common comorbidities observed in deceased patients were hypertension (68%), diabetes (31%), ischemic heart disease (28%), atrial fibrillation (20%), chronic obstructive pulmonary disease (18%) and active cancer in the last 5 years (16%). 

In New York state, 86% of those died from COVID-19 had at least one comorbidity.

The main cause of death in people with COVID-19 is respiratory failure, similar to the causes of death in types of flu. Other causes of mortality in COVID-19 infection are septic shock and multiple organ failure.

Acute kidney injury, cardiogenic shock due to acute myocardial injury or myocarditis are also causes of death due to COVID-19.

Graph 2: Comorbidities.

Symptoms

Fever is the most common symptom, although some older people and those with other health problems experience fever later in the disease. In one study, 44% of people had fever when they presented to the hospital, while 89% went on to develop fever at some point during their hospitalization.

A lack of fever does not imply someone is disease free.

Other common symptoms include cough, loss of appetite, fatigue, shortness of breath (dyspnoea), sputum production, and muscle and joint pains.

Symptoms such as nausea, vomiting, and diarrhea have been observed in varying percentages. Less common symptoms include sneezing, runny nose, or sore throat.

A decreased sense of smell or disturbances in taste may occur. Loss of smell was a symptom in 30% of confirmed cases in South Korea.

As is common with infections, there is a delay between the moment a person is first infected and the time he or she develops symptoms.

The average incubation period for COVID‑19 is five to six days but commonly ranges from one to 14 days.

Graph 3: Symptoms.

References:

Wei-jie Guan, et al. “Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis“. European Respiratory Journal: 2000547 (1 January 2020)

John PA Ioannidis, et al. “Population-level COVID-19 mortality risk for non-elderly individuals overall and for non-elderly individuals without underlying diseases in pandemic epicenters” MedRxiv (8 April 2020)

Luigi Palmieri. “Characteristics of SARS-CoV-2 patients dying in Italy

Clare Wenham, etc al. “COVID-19: the gendered impacts of the outbreak“. The Lancet. 395 (10227): 846–848 (14 March 2020)

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