Coronavirus Disease 2019 - Wikipedia PDF

Coronavirus disease
2019
Coronavirus disease 2019 (COVID-19) is

an infectious disease caused by severe
acute respiratory syndrome coronavirus 2
(SARS-CoV-2).[8] The disease was first
identified in December 2019 in Wuhan, the
capital of China's Hubei province, and has
since spread globally, resulting in the
ongoing 2019–20 coronavirus
pandemic.[9][10] Common symptoms
include fever, cough, and shortness of
breath.[5] Other symptoms may include
fatigue, muscle pain, diarrhea, sore throat,
loss of smell, and abdominal pain.[5][11][12]
The time from exposure to onset of
symptoms is typically around five days, but
may range from two to fourteen days.[5][13]
While the majority of cases result in mild
symptoms, some progress to viral
pneumonia and multi-organ failure.[9][14]
Coronavirus disease 2019 (COVID-
19)
Other names Coronavirus

COVID
2019-nCoV acute
respiratory disease
Novel coronavirus
pneumonia[1][2]
Wuhan
pneumonia[3][4]
Symptoms of COVID-19
Pronunciation /kəˈroʊnəˌvaɪrəs dɪ
ˈziːz/, /ˈkoʊvɪd/
Specialty Infectious diseases
Symptoms Fever, cough,

shortness of breath,
none[5][6]
Complications Pneumonia, viral

sepsis, acute
respiratory distress
syndrome, kidney
failure
Usual onset 2–14 days (typically

5) from exposure
Causes Severe acute

respiratory syndrome
coronavirus 2 (SARS-
CoV-2)
Risk factors Travel, viral exposure
Diagnostic method rRT-PCR testing, CT

scan
Prevention Hand washing,
quarantine, social
distancing
Treatment Symptomatic and

supportive
Frequency 1,859,011[7] confirmed

cases
Deaths 114,979 (6.2% of

confirmed cases)[7]
The virus is mainly spread between people
during close contact,[a] often via small
droplets produced during coughing,[b]
sneezing, or talking.[6][15][17] While these
droplets are produced when breathing out,
they usually fall to the ground or onto
surfaces rather than being infectious over
large distances.[6][18][19] People may also
become infected by touching a
contaminated surface and then their
face.[6][15] The virus can survive on
surfaces for up to 72 hours.[20] It is most
contagious during the first three days after
onset of symptoms, although spread may
be possible before symptoms appear and
in later stages of the disease.[21]
The standard method of diagnosis is by

real-time reverse transcription polymerase
chain reaction (rRT-PCR) from a
nasopharyngeal swab.[22] Chest CT
imaging may also be helpful for diagnosis
in individuals where there is a high
suspicion of infection based on symptoms
and risk factors but is not recommended
for routine screening.[23][24]
Recommended measures to prevent

infection include frequent hand washing,
maintaining physical distance from others
(especially from those with symptoms),
covering coughs and sneezes with a tissue
or inner elbow, and keeping unwashed
hands away from the face.[25][26] The use
of masks is recommended for those who
suspect they have the virus and their
caregivers.[27] Recommendations for mask
use by the general public vary, with some
authorities recommending against their
use, some recommending their use, and
others requiring their use.[28][29][30]
Currently, there is no vaccine or specific
antiviral treatment for COVID-19.[6]
Management involves treatment of
symptoms, supportive care, isolation, and
experimental measures.[31]
The World Health Organization (WHO)

declared the 2019–20 coronavirus
outbreak a Public Health Emergency of
International Concern (PHEIC)[32][33] on 30
January 2020 and a pandemic on 11
March 2020.[10] Local transmission of the
disease has been recorded in many
countries across all six WHO regions.[34]
Play media
Video summary (script)
Signs and symptoms

Symptom[35] %
Fever 88
Dry cough 68
Fatigue 38
Sputum production 33
Loss of smell 15[36] to 30[12][37]
Shortness of breath 19
Muscle or joint pain 15
Sore throat 14
Headache 14
Chills 11
Nausea or vomiting 5
Nasal congestion 5
Diarrhoea 4 to 31[38]
Haemoptysis 0.9
Pink eyes 0.8
Those infected with the virus may be

asymptomatic or develop flu-like
symptoms, including fever, cough, fatigue,
and shortness of breath.[5][39][40]
Emergency symptoms include difficulty
breathing, persistent chest pain or
pressure, confusion, difficulty waking and
bluish face or lips; immediate medical
attention is advised if these symptoms are
present.[5] Less commonly, upper
respiratory symptoms, such as sneezing,
runny nose or sore throat may be seen.
Symptoms such as nausea, vomiting and
diarrhoea have been observed in varying
percentages.[38][41][42] Some cases in
China initially presented only with chest
tightness and palpitations.[43] In March
2020 there were reports indicating that
loss of the sense of smell (anosmia) may
be a common symptom among those who
have mild disease,[12][37] although not as
common as initially reported.[36] In some,
the disease may progress to pneumonia,
multi-organ failure and death.[9][14] In those
who develop severe symptoms, time from
symptom onset to needing mechanical
ventilation is typically eight days.[44]
As is common with infections, there is a

delay between the moment when a person
is infected with the virus and the time
when they develop symptoms. This is
called the incubation period. The
incubation period for COVID-19 is typically
five to six days but may range from two to
14 days.[45][46] 97.5% of people who
develop symptoms will do so within 11.5
days of infection.[47]
Reports indicate that not all who are

infected develop symptoms, but their role
in transmission is unknown.[48] Preliminary
evidence suggests asymptomatic cases
may contribute to the spread of the
disease.[49][50] The proportion of infected
people who do not display symptoms is
currently unknown and being studied, with
the Korea Centers for Disease Control and
Prevention (KCDC) reporting that 20% of
all confirmed cases remained
asymptomatic during their hospital
stay.[50][51] China's National Health
Commission began including
asymptomatic cases in its daily cases on
1 April, of the 166 infections on that day,
130 (78%) were asymptomatic.[52]
Cause
Transmission
Respiratory droplets produced when a man is
sneezing visualised using Tyndall scattering
Play media
A video discussing the basic reproduction number
and case fatality rate in the context of the pandemic
Some details about how the disease is
spread are still being determined.[15][17]
The WHO and the U.S. Centers for Disease
Control and Prevention (CDC) say it is
primarily spread during close contact and
by small droplets produced when people
cough, sneeze or talk;[6][15] with close
contact being within 1–3 m (3 ft 3 in–9 ft
10 in).[6] A study in Hong Kong observed
that the virus was present in most
patients' saliva in quantities reaching
100 million virus strands per 1 mL.[53] A
study in Singapore found that an
uncovered cough can lead to droplets
travelling up to 4.5 meters (15 feet).[54] A
second study, produced during the 2020
pandemic, found that advice on the
distance droplets could travel might be
based on old 1930s research which
ignored the protective effect and speed of
the warm moist outbreath surrounding the
droplets. This study found that an
uncovered cough or sneeze can travel up
to 8.2 metres (27 feet).[16]
Respiratory droplets may also be produced

while breathing out, including when
talking. Though the virus is not generally
airborne,[6][55] the National Academy of
Science has suggested that bioaerosol
transmission may be possible and air
collectors positioned in the hallway
outside of people's rooms yielded samples
positive for viral RNA.[56] The droplets can
land in the mouths or noses of people who
are nearby or possibly be inhaled into the
lungs.[15] Some medical procedures such
as intubation and cardiopulmonary
resuscitation (CPR) may cause respiratory
secretions to be aerosolised and thus
result in airborne spread.[55] It may also
spread when one touches a contaminated
surface, known as fomite transmission,
and then touches one's eyes, nose or
mouth.[6] While there are concerns it may
spread by feces, this risk is believed to be
low.[6][15]
The virus is most contagious when people

are symptomatic; while spread may be
possible before symptoms appear, this
risk is low.[6][15] The European Centre for
Disease Prevention and Control (ECDC)
says while it is not entirely clear how easily
the disease spreads, one person generally
infects two to three others.[17]
The virus survives for hours to days on
surfaces.[6][17] Specifically, the virus was
found to be detectable for one day on
cardboard, for up to three days on plastic
(polypropylene) and stainless steel (AISI
304) and for up to four hours on 99%
copper.[20][57] This, however, varies based
on the humidity and temperature.[58][59]
Surfaces may be decontaminated with a
number of solutions (within one minute of
exposure to the disinfectant to achieve a
4 or more log reduction), including 78–
95% ethanol (alcohol used in spirits), 70–
100% 2-propanol (isopropyl alcohol), the
combination of 45% 2-propanol with 30%
1-propanol, 0.21% sodium hypochlorite
(bleach), 0.5% hydrogen peroxide, or 0.23–
7.5% povidone-iodine. Soap and detergent
are also effective if correctly used; soap
products degrade the virus' fatty protective
layer, deactivating it, as well as freeing
them from skin and other surfaces.[60]
Other solutions, such as benzalkonium
chloride and chlorhexidine gluconate (a
surgical disinfectant), are less effective.[61]
Virology
Illustration of SARSr-CoV virion
Severe acute respiratory syndrome

coronavirus 2 (SARS-CoV-2) is a novel
severe acute respiratory syndrome
coronavirus, first isolated from three
people with pneumonia connected to the
cluster of acute respiratory illness cases in
Wuhan.[62] All features of the novel SARS-
CoV-2 virus occur in related coronaviruses
in nature.[63] Outside the human body, the
virus is killed by household soap, which
bursts its protective bubble.[23]
SARS-CoV-2 is closely related to the

original SARS-CoV.[64] It is thought to have
a zoonotic origin. Genetic analysis has
revealed that the coronavirus genetically
clusters with the genus Betacoronavirus,
in subgenus Sarbecovirus (lineage B)
together with two bat-derived strains. It is
96% identical at the whole genome level to
other bat coronavirus samples (BatCov
RaTG13).[35] In February 2020, Chinese
researchers found that there is only one
amino acid difference in certain parts of
the genome sequences between the
viruses from pangolins and those from
humans, however, whole-genome
comparison to date found at most 92% of
genetic material shared between pangolin
coronavirus and SARS-CoV-2, which is
insufficient to prove pangolins to be the
intermediate host.[65]
Pathophysiology
The lungs are the organs most affected by
COVID-19 because the virus accesses host
cells via the enzyme angiotensin-
converting enzyme 2 (ACE2), which is
most abundant in the type II alveolar cells
of the lungs. The virus uses a special
surface glycoprotein called a "spike"
(peplomer) to connect to ACE2 and enter
the host cell.[66] The density of ACE2 in
each tissue correlates with the severity of
the disease in that tissue and some have
suggested that decreasing ACE2 activity
might be protective,[67][68] though another
view is that increasing ACE2 using
angiotensin II receptor blocker
medications could be protective and that
these hypotheses need to be tested.[69] As
the alveolar disease progresses,
respiratory failure might develop and death
may follow.[68]
The virus also affects gastrointestinal

organs as ACE2 is abundantly expressed
in the glandular cells of gastric, duodenal
and rectal epithelium[70] as well as
endothelial cells and enterocytes of the
small intestine.[71]
Autopsies of people who died of COVID-19

have found diffuse alveolar damage (DAD),
and lymphocyte-containing inflammatory
infiltrates within the lung.[72]
Immunopathology
Although SARS-COV-2 has a tropism for

ACE2-expressing epithelial cells of the
respiratory tract, patients with severe
COVID-19 have symptoms of systemic
hyperinflammation. Clinical laboratory
findings of elevated IL-2, IL-7, IL-6,
granulocyte-macrophage colony-
stimulating factor (GM-CSF), interferon-γ
inducible protein 10 (IP-10), monocyte
chemoattractant protein 1 (MCP-1),
macrophage inflammatory protein 1-α
(MIP-1α), and tumour necrosis factor-α
(TNF-α) indicative of cytokine release
syndrome (CRS) suggest an underlying
immunopathology.[73]
Additionally, people with COVID-19 and

acute respiratory distress syndrome
(ARDS) have classical serum biomarkers
of CRS including elevated C-reactive
protein (CRP), lactate dehydrogenase
(LDH), D-dimer, and ferritin.[74]
Systemic inflammation results in
vasodilation, allowing inflammatory
lymphocytic and monocytic infiltration of
the lung and the heart. In particular,
pathogenic GM-CSF-secreting T-cells were
shown to correlate with the recruitment of
inflammatory IL-6-secreting monocytes
and severe lung pathology in COVID-19
patients.[75] Lymphocytic infiltrates have
also been reported at autopsy.[72]
Diagnosis
Demonstration of a nasopharyngeal swab for
COVID-19 testing
CDC rRT-PCR test kit for COVID-19[76]

The WHO has published several testing
protocols for the disease.[77] The standard
method of testing is real-time reverse
transcription polymerase chain reaction
(rRT-PCR).[78] The test is typically done on
respiratory samples obtained by a
nasopharyngeal swab, however a nasal
swab or sputum sample may also be
used.[22][79] Results are generally available
within a few hours to two days.[80][81]
Blood tests can be used, but these require
two blood samples taken two weeks apart
and the results have little immediate
value.[82] Chinese scientists were able to
isolate a strain of the coronavirus and
publish the genetic sequence so
laboratories across the world could
independently develop polymerase chain
reaction (PCR) tests to detect infection by
the virus.[9][83][84] As of 4 April 2020,
antibody tests (which may detect active
infections and whether a person had been
infected in the past) were in development,
but not yet widely used.[85][86][87] The
Chinese experience with testing has show
the accuracy is only 60 to 70%.[88] The FDA
approved the first point-of-care test on 21
March 2020 for use at the end of that
month.[89]
Diagnostic guidelines released by

Zhongnan Hospital of Wuhan University
suggested methods for detecting
infections based upon clinical features
and epidemiological risk. These involved
identifying people who had at least two of
the following symptoms in addition to a
history of travel to Wuhan or contact with
other infected people: fever, imaging
features of pneumonia, normal or reduced
white blood cell count or reduced
lymphocyte count.[90]
Along with laboratory testing, chest CT

scans may be helpful to diagnose COVID-
19 in individuals with a high clinical
suspicion of infection but is not
recommended for routine screening.[23][24]
Bilateral multilobar ground-glass opacities
with a peripheral, asymmetric and
posterior distribution are common in early
infection.[23] Subpleural dominance, crazy
paving (lobular septal thickening with
variable alveolar filling), and consolidation
may appear as the disease
progresses.[23][91]
Typical CT imaging findings
CT imaging of rapid progression stage
Pathology
Few data are available about microscopic
lesions and the pathophysiology of COVID-
19.[92][93] The main pathological findings at
autopsy are:
Macroscopy: pleurisy, pericarditis, lung

consolidation and pulmonary oedema
Four types of severity of viral pneumonia
can be observed:
minor pneumonia: minor serous
exudation, minor fibrin exudation
mild pneumonia: pulmonary
oedema, pneumocyte hyperplasia,
large atypical pneumocytes,
interstitial inflammation with
lymphocytic infiltration and
multinucleated giant cell formation
severe pneumonia: diffuse alveolar
damage (DAD) with diffuse alveolar
exudates. DAD is the cause of acute
respiratory distress syndrome
(ARDS) and severe hypoxemia.
healing pneumonia: organisation of
exudates in alveolar cavities and
pulmonary interstitial fibrosis
plasmocytosis in BAL[94]
Blood: disseminated intravascular
coagulation (DIC);[95] leukoerythroblastic
reaction[96]
Liver: microvesicular steatosis
Prevention
Inhibiting new infections to reduce the number of

cases at any given time—known as "flattening the
curve"—allows healthcare services to better manage
the same volume of patients.[97][98][99] Conversely,
increasing healthcare capacity—called raising the
line such as by increasing bed count personnel
line—such as by increasing bed count, personnel,
and equipment, can help to meet increased
demand.[100]
Inadequate mitigation, such as premature relaxation

of physical distancing rules or stay-at-home orders,
can result in a resurgence of pandemics.[98][101]
Preventive measures to reduce the

chances of infection include staying at
home, avoiding crowded places, washing
hands with soap and water often and for
at least 20 seconds, practising good
respiratory hygiene and avoiding touching
the eyes, nose or mouth with unwashed
hands.[102][103][104] The CDC recommends
covering the mouth and nose with a tissue
when coughing or sneezing and
recommends using the inside of the elbow
if no tissue is available.[102] They also
recommend proper hand hygiene after any
cough or sneeze.[102] Social distancing
strategies aim to reduce contact of
infected persons with large groups by
closing schools and workplaces,
restricting travel and cancelling large
public gatherings.[105] Distancing
guidelines also includes that people stay
at least 6 feet (1.8 m) apart.[106]
As a vaccine is not expected until 2021 at

the earliest,[107] a key part of managing
COVID-19 is trying to decrease the
epidemic peak, known as "flattening the
curve".[98] This is done by slowing the
infection rate to decrease the risk of health
services being overwhelmed, allowing for
better treatment of current cases and
delaying additional cases until effective
treatments or a vaccine become
available.[98][101]
According to the WHO, the use of masks is

recommended only if a person is coughing
or sneezing or when one is taking care of
someone with a suspected infection.[108]
Some countries also recommend healthy
individuals to wear face masks, including
China,[109] Hong Kong,[110] Thailand,[111]
Czech Republic,[112] and Austria.[113] In
order to meet the need for masks, the
WHO estimates that global production will
need to increase by 40%. Hoarding and
speculation have worsened the problem,
with the price of masks increasing sixfold,
N95 respirators tripled, and gowns
doubled.[114] Some health experts consider
wearing non-medical grade masks and
other face coverings like scarves or
bandanas a good way to prevent people
from touching their mouths and noses,
even if non-medical coverings would not
protect against a direct sneeze or cough
from an infected person.[115]
Those diagnosed with COVID-19 or who

believe they may be infected are advised
by the CDC to stay home except to get
medical care, call ahead before visiting a
healthcare provider, wear a face mask
before entering the healthcare provider's
office and when in any room or vehicle
with another person, cover coughs and
sneezes with a tissue, regularly wash
hands with soap and water and avoid
sharing personal household items.[27][116]
The CDC also recommends that
individuals wash hands often with soap
and water for at least 20 seconds,
especially after going to the toilet or when
hands are visibly dirty, before eating and
after blowing one's nose, coughing or
sneezing. It further recommends using an
alcohol-based hand sanitiser with at least
60% alcohol, but only when soap and
water are not readily available.[102]
For areas where commercial hand

sanitisers are not readily available, the
WHO provides two formulations for local
production. In these formulations, the
antimicrobial activity arises from ethanol
or isopropanol. Hydrogen peroxide is used
to help eliminate bacterial spores in the
alcohol; it is "not an active substance for
hand antisepsis". Glycerol is added as a
humectant.[117]
Prevention efforts are multiplicative, with
effects far beyond that of a single spread.
Each avoided case leads to more avoided
cases down the line, which in turn can
stop the outbreak in its tracks.
Play media
Handwashing instructions
Management
People are managed with supportive care,
which may include fluid therapy, oxygen
support, and supporting other affected
vital organs.[118][119][120] The CDC
recommends that those who suspect they
carry the virus wear a simple face
mask.[27] Extracorporeal membrane
oxygenation (ECMO) has been used to
address the issue of respiratory failure, but
its benefits are still under
consideration.[121][122]
The WHO and Chinese National Health

Commission have published
recommendations for taking care of
people who are hospitalised with COVID-
19.[123][124] Intensivists and
pulmonologists in the U.S. have compiled
treatment recommendations from various
agencies into a free resource, the
IBCC.[125][126]
Medications
Some medical professionals recommend

paracetamol (acetaminophen) over
ibuprofen for first-line use.[127][128][129] The
WHO does not oppose the use of non-
steroidal anti-inflammatory drugs
(NSAIDs) such as ibuprofen for
symptoms,[130] and the FDA says currently
there is no evidence that NSAIDs worsen
COVID-19 symptoms.[131]
While theoretical concerns have been

raised about ACE inhibitors and
angiotensin receptor blockers, as of 19
March 2020, these are not sufficient to
justify stopping these
medications.[132][133][134] Steroids, such as
methylprednisolone, are not
recommended unless the disease is
complicated by acute respiratory distress
syndrome.[135][136]
Personal protective equipment

Four steps to putting on personal protective
equipment (PPE)[137]
Precautions must be taken to minimise the

risk of virus transmission, especially in
healthcare settings when performing
procedures that can generate aerosols,
such as intubation or hand ventilation.[138]
For healthcare professionals caring for
people with COVID-19, the CDC
recommends placing the person in an
Airborne Infection Isolation Room (AIIR) in
addition to using standard precautions,
contact precautions and airborne
precautions.[139]
CDC outlines the specific guidelines for

the use of personal protective equipment
(PPE) during the pandemic. The
recommended gear includes:
Respirator or facemask[140][141]
Gown[142]
Medical gloves[143][144]
Eye protection[145]
When available, respirators (instead of

facemasks) are preferred.[146] N95
respirators are approved for industrial
settings but the FDA has authorised the
masks for use under an Emergency Use
Authorisation (EUA). They are designed to
protect from airborne particles like dust
but effectiveness against a specific
biological agent is not guaranteed for off-
label uses.[147] When masks are not
available, the CDC recommends using face
shields or, as a last resort, homemade
masks.[148]
Mechanical ventilation
Most cases of COVID-19 are not severe

enough to require mechanical ventilation
(artificial assistance to support breathing),
but a percentage of cases do.[149][150]
Some Canadian doctors recommend the
use of invasive mechanical ventilation
because this technique limits the spread
of aerosolised transmission vectors.[149]
On 9 April it came to light that British and

American doctors were reviewing the
recommendations to use the "highly
invasive" Canadian procedure which
"require the patient to be rendered
unconscious" which in the opinion of NHS
consultants at the University Hospitals
Birmingham were "being used too early
and may cause more harm than good...
less invasive forms of oxygen treatment
through face masks or nasal cannulas
work better for patients".[151]
Severe cases are most common in older

adults (those older than 60 years[149] and
especially those older than 80 years).[152]
Many developed countries do not have
enough hospital beds per capita, which
limits a health system's capacity to handle
a sudden spike in the number of COVID-19
cases severe enough to require
hospitalisation.[153] This limited capacity is
a significant driver of the need to flatten
the curve (to keep the speed at which new
cases occur and thus the number of
people sick at one point in time lower).[153]
One study in China found 5% were
admitted to intensive care units, 2.3%
needed mechanical support of ventilation,
and 1.4% died.[121] Around 20–30% of the
people in hospital with pneumonia from
COVID-19 needed ICU care for respiratory
support.[44]
Acute respiratory distress syndrome
Mechanical ventilation becomes more

complex as acute respiratory distress
syndrome (ARDS) develops in COVID-19
and oxygenation becomes increasingly
difficult.[154] Ventilators capable of
pressure control modes and high PEEP[155]
are needed to maximise oxygen delivery
while minimising the risk of ventilator-
associated lung injury and
pneumothorax.[156] High PEEP may not be
available on older ventilators.
Options for ARDS[154]
Therapy Recommendations
High-flow nasal oxygen For SpO2 <93%. May prevent the need for intubation and ventilation
Tidal volume 6mL per kg and can be reduced to 4mL/kg
Keep below 30 cmH2O if possible (high respiratory rate (35 per

Plateau airway pressure
minute) may be required)
Positive end-expiratory
Moderate to high levels
pressure
Prone positioning For worsening oxygenation
Fluid management Goal is a negative balance of 0.5–1L per day
Antibiotics For secondary bacterial infections
Glucocorticoids Not recommended
Experimental treatment
No medications are approved to treat the

disease by the WHO although some are
recommended by individual national
medical authorities.[157] Research into
potential treatments started in January
2020,[158] and several antiviral drugs are in
clinical trials.[159][160] Although new
medications may take until 2021 to
develop,[161] several of the medications
being tested are already approved for
other uses or are already in advanced
testing.[157] Antiviral medication may be
tried in people with severe disease.[118]
The WHO recommended volunteers take
part in trials of the effectiveness and
safety of potential treatments.[162]
The FDA has granted temporary

authorization to convalescent plasma as
an experimental treatment in cases where
the person's life is seriously or
immediately threatened. It has not
undergone the clinical studies needed to
show it is safe and effective for the
disease.[163][164][165]
Information technology
In February 2020, China launched a mobile

app to deal with the disease outbreak.[166]
Users are asked to enter their name and ID
number. The app is able to detect 'close
contact' using surveillance data and
therefore a potential risk of infection.
Every user can also check the status of
three other users. If a potential risk is
detected, the app not only recommends
self-quarantine, it also alerts local health
officials.[167]
Big data analytics on cellphone data, facial

recognition technology, mobile phone
tracking and artificial intelligence are used
to track infected people and people whom
they contacted in South Korea, Taiwan and
Singapore.[168][169] In March 2020, the
Israeli government enabled security
agencies to track mobile phone data of
people supposed to have coronavirus. The
measure was taken to enforce quarantine
and protect those who may come into
contact with infected citizens.[170] Also in
March 2020, Deutsche Telekom shared
aggregated phone location data with the
German federal government agency,
Robert Koch Institute, in order to research
and prevent the spread of the virus.[171]
Russia deployed facial recognition
technology to detect quarantine
breakers.[172] Italian regional health
commissioner Giulio Gallera said he has
been informed by mobile phone operators
that "40% of people are continuing to move
around anyway".[173] German government
conducted a 48 hours weekend hackathon
with more than 42.000
participants.[174][175] Also the president of
Estonia, Kersti Kaljulaid, made a global call
for creative solutions against the spread of
coronavirus.[176]
Psychological support
Individuals may experience distress from

quarantine, travel restrictions, side effects
of treatment or fear of the infection itself.
To address these concerns, the National
Health Commission of China published a
national guideline for psychological crisis
intervention on 27 January 2020.[177][178]
Prognosis
This article relies too much on references to
primary sources.
The severity of diagnosed
COVID-19 cases in China[179]
Case fatality rates by age

group in China. Data through
11 February 2020.[180]
Case fatality rate in China

y
depending on other health
problems. Data through 11
February 2020.[180]
The number of deaths vs total

cases by country and
approximate case fatality
rate[181]
The severity of COVID-19 varies. The

disease may take a mild course with few
or no symptoms, resembling other
common upper respiratory diseases such
as the common cold. Mild cases typically
recover within two weeks, while those with
severe or critical diseases may take three
to six weeks to recover. Among those who
have died, the time from symptom onset
to death has ranged from two to eight
weeks.[35]
Children are susceptible to the disease,

but are likely to have milder symptoms and
a lower chance of severe disease than
adults; in those younger than 50 years, the
risk of death is less than 0.5%, while in
those older than 70 it is more than
8%.[182][183] Pregnant women may be at
higher risk for severe infection with COVID-
19 based on data from other similar
viruses, like SARS and MERS, but data for
COVID-19 is lacking.[184][185]
In some people, COVID-19 may affect the

lungs causing pneumonia. In those most
severely affected, COVID-19 may rapidly
progress to acute respiratory distress
syndrome (ARDS) causing respiratory
failure, septic shock or multi-organ
failure.[186][187] Complications associated
with COVID-19 include sepsis, abnormal
clotting and damage to the heart, kidneys
and liver. Clotting abnormalities,
specifically an increase in prothrombin
time, have been described in 6% of those
admitted to hospital with COVID-19, while
abnormal kidney function is seen in 4% of
this group.[188] Liver injury as shown by
blood markers of liver damage is
frequently seen in severe cases.[189]
Some studies have found that the

neutrophil to lymphocyte ratio (NLR) may
be helpful in early screening for severe
illness.[190]
Many of those who die of COVID-19 have

pre-existing (underlying) conditions,
including hypertension, diabetes mellitus
and cardiovascular disease.[191] The
Istituto Superiore di Sanità reported that
out of 8.8% of deaths where medical
charts were available for review, 97.2% of
sampled patients had at least one
comorbidity with the average patient
having 2.7 diseases.[192] According to the
same report, the median time between
onset of symptoms and death was ten
days, with five being spent hospitalised.
However, patients transferred to an ICU
had a median time of seven days between
hospitalisation and death.[192] In a study of
early cases, the median time from
exhibiting initial symptoms to death was
14 days, with a full range of six to 41
days.[193] In a study by the National Health
Commission (NHC) of China, men had a
death rate of 2.8% while women had a
death rate of 1.7%.[194] Histopathological
examinations of post-mortem lung
samples show diffuse alveolar damage
with cellular fibromyxoid exudates in both
lungs. Viral cytopathic changes were
observed in the pneumocytes. The lung
picture resembled acute respiratory
distress syndrome (ARDS).[35] In 11.8% of
the deaths reported by the National Health
Commission of China, heart damage was
noted by elevated levels of troponin or
cardiac arrest.[43] According to March data
from the United States, 89% of those
hospitalised had preexisting
conditions.[195]
Availability of medical resources and the
socioeconomics of a region may also
affect mortality.[196] Estimates of the
mortality from the condition vary because
of those regional differences,[197] but also
because of methodological difficulties.
The under-counting of mild cases can
cause the mortality rate to be
overestimated.[198] However, the fact that
deaths are the result of cases contracted
in the past can mean the current mortality
rate is underestimated.[199][200]
Concerns have been raised about long-
term sequelae of the disease. The Hong
Kong Hospital Authority found a drop of
20% to 30% in lung capacity in some
people who recovered from the disease,
and lung scans suggested organ
damage.[201] This may also lead to post-
intensive care syndrome following
recovery.[202]
Case fatality rates (%) by age and country
0– 10– 20– 30– 40– 50– 60– 70– 80-
Age 90+
9 19 29 39 49 59 69 79 89
China as of 11
0.0 0.2 0.2 0.2 0.4 1.3 3.6 8.0 14.8
February[180]
Denmark as of 9 April[203] 0.2 3.8 12.3 21.1 38.0
Italy as of 9 April[204] 0.1 0.0 0.1 0.4 0.9 2.4 9.0 23.4 31.0 26.1
Netherlands as of 6
0.0 0.0 0.1 0.1 0.4 1.2 6.2 16.0 25.1 22.0
April[205]
South Korea as of 7
0.0 0.0 0.0 0.1 0.1 0.7 2.0 8.3 20.0
April[206]
Spain as of 9 April[207] 0.3 0.2 0.2 0.2 0.4 1.0 3.4 10.7 20.6 24.1
Switzerland as of 9
0.0 0.0 0.0 0.1 0.0 0.4 2.0 7.3 18.4
April[208]
Case fatality rates (%) by age in the United States

Age 0–19 20–44 45–54 55–64 65–74 75–84 85+
United States as of 16 0.1– 0.5– 1.4–

0.0 2.7–4.9 4.3–10.5 10.4–27.3
March[209] 0.2 0.8 2.6
Note: The lower bound includes all cases. The upper bound excludes cases that were missing
data.
Estimate of infection fatality rates and probability of severe disease course (%) by age based
on cases from China[210]
60– 70–
0–9 10–19 20–29 30–39 40–49 50–59 80+
69 79
0.04 1.0 3.4 4.3 8.2 11 17 18

Severe 0.0
(0.02– (0.62– (2.0– (2.5– (4.9– (7.0– (9.9– (11–
disease (0.0–0.0)
0.08) 2.1) 7.0) 8.7) 17) 24) 34) 38)
0.0016 0.0070 0.031 0.084 0.16 0.60 1.9 4.3 7.8

Death (0.00016– (0.0015– (0.014– (0.041– (0.076– (0.34– (1.1– (2.5– (3.8–
0.025) 0.050) 0.092) 0.19) 0.32) 1.3) 3.9) 8.4) 13)
Total infection fatality rate is estimated to be 0.66% (0.39–1.3). Infection fatality rate is fatality
per all infected individuals, regardless of whether they were diagnosed or had any symptoms.
Numbers in parentheses are 95% credible intervals for the estimates.
Reinfection
As of March 2020, it was unknown if past

infection provides effective and long-term
immunity in people who recover from the
disease.[211] Immunity is seen as likely,
based on the behaviour of other
coronaviruses,[212] but cases in which
recovery from COVID-19 have been
followed by positive tests for coronavirus
at a later date have been reported.[213]
[214][215][216] These cases are believed to be
worsening of a lingering infection rather
than re-infection.[216]
History
The virus is thought to be natural and have
an animal origin,[63] through spillover
infection.[217] The actual origin is unknown,
but by December 2019 the spread of
infection was almost entirely driven by
human-to-human transmission.[180][218] A
study of the first 41 cases of confirmed
COVID-19, published in January 2020 in
The Lancet, revealed the earliest date of
onset of symptoms as 1 December
2019.[219][220][221] Official publications from
the WHO reported the earliest onset of
symptoms as 8 December 2019.[222]
Epidemiology
Several measures are commonly used to
quantify mortality.[223] These numbers vary
by region and over time and are influenced
by the volume of testing, healthcare
system quality, treatment options, time
since initial outbreak and population
characteristics such as age, sex and
overall health.[224] In late 2019, WHO
assigned the emergency ICD-10 disease
codes U07.1 for deaths from lab-
confirmed SARS-CoV-2 infection and
U07.2 for deaths from clinically or
epidemiologically diagnosed COVID-19
without lab-confirmed SARS-CoV-2
infection.[225]
The death-to-case ratio reflects the

number of deaths divided by the number
of diagnosed cases within a given time
interval. Based on Johns Hopkins
University statistics, the global death-to-
case ratio is 6.2% (114,979/1,859,011) as
of 13 April 2020.[7] The number varies by
region.[226]
Other measures include the case fatality

rate (CFR), which reflects the percent of
diagnosed individuals who die from a
disease, and the infection fatality rate
(IFR), which reflects the percent of
infected individuals (diagnosed and
undiagnosed) who die from a disease.
These statistics are not time bound and
follow a specific population from infection
through case resolution. A number of
academics have attempted to calculate
these numbers for specific
populations.[227] In the epicentre of the
outbreak in Italy, Castiglione d'Adda, a
small village of 4500, 80 (1.8%) are already
dead. Most people in the village appear to
have developed antibodies and plausible
immunity, most did so without being
diagnosed, and many did not have
symptoms.[228][229] An investigation is
underway to test the entire population to
learn more about the disease.[230][231]
In the German region of Gangelt, where
0.06% of the population has died, 14%
have antibodies and are now considered
immune (15% have been infected and 2%
were currently infectious).[232][233][234] In
Gangelt, the disease was spread by
Carnival festivals, and spread to younger
people, causing a relatively lower
mortality,[235] and not all COVID-19 deaths
may have been formally classified as such.
Furthermore, the German health system
has not been overwhelmed.
Total confirmed cases over time
Total deaths over time

Total confirmed cases of COVID-19 per
million people, 10 April 2020[236]
Total confirmed deaths due to COVID-19
per million people, 10 April 2020[237]
Society and culture
Nomenclature
The World Health Organization announced

in February 2020 that COVID-19 is the
official name of the disease. World Health
Organisation chief Tedros Adhanom
Ghebreyesus explained that CO stands for
corona, VI for virus and D for disease,
while 19 is for when the outbreak was first
identified: 31 December 2019.[238] The
name had been chosen to avoid
references to a specific geographical
location (e.g. China), animal species or
group of people, in line with international
recommendations for naming aimed at
preventing stigmatisation.[239][240]
The virus that causes COVID-19 is named
severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2).[241] The WHO
additionally uses "the COVID-19 virus" and
"the virus responsible for COVID-19" in
public communications.[241] Coronaviruses
were named in 1968 for their appearance
in electron micrographs which was
reminiscent of the solar corona, corōna
meaning crown in Latin.[242][243][244] Both
the disease and virus are commonly
referred to as "coronavirus".
During the initial outbreak in Wuhan, China,
the virus and disease were commonly
referred to as "coronavirus" and "Wuhan
coronavirus".[245][246][247] In January 2020,
WHO recommended 2019-nCov[248] and
2019-nCoV acute respiratory disease[249]
as interim names for the virus and disease
in accordance with 2015 guidance against
using locations in disease and virus
names.[250] The official names COVID-19
and SARS-CoV-2 were issued on 11
February 2020.[251][252]
Manufacturing
It has been suggested that this article be merged
into 2019–20 coronavirus
Due to capacity limitations in the standard

supply chains, some digital manufacturers
are printing healthcare material such as
nasal swabs and ventilator parts.[253][254]
In one example, when an Italian hospital
urgently required a ventilator valve, and the
supplier was unable to deliver in the
timescale required, a local startup reverse-
engineered and printed the required 100
valves overnight.[255][256]
Misinformation
After the initial outbreak of COVID-19,

conspiracy theories, misinformation and
disinformation emerged regarding the
origin, scale, prevention, treatment and
other aspects of the disease and rapidly
spread online.[257][258][259][260]
Other animals
Humans appear to be capable of
spreading the virus to some other animals.
A domestic cat in Liège tested positive
after it started showing symptoms
(diarrhoea, vomiting, shortness of breath)
a week later than its owner, who was also
positive.[261] Tigers at the Bronx Zoo
tested positive for the virus and showed
symptoms of COVID-19, including a dry
cough and loss of appetite.[262]
A study on domesticated animals

inoculated with the virus found that cats
and ferrets appear to be "highly
susceptible" to the disease, while dogs
appear to be less susceptible, with lower
levels of viral replication. The study failed
to find evidence of viral replication in pigs,
ducks, and chickens.[263]
Research
International research on vaccines and
medicines in COVID-19 are underway by
government organisations, academic
groups and industry researchers.[264][265] In
March, the World Health Organization
initiated the "SOLIDARITY Trial" to assess
treatment effects of four existing antiviral
compounds with the most promise of
efficacy.[266]
Vaccine
There is no available vaccine, but various

agencies are actively developing vaccine
candidates. Previous work on SARS-CoV is
being utilised because SARS-CoV and
SARS-CoV-2 both use the ACE2 receptor to
enter human cells.[267] There are three
vaccination strategies being investigated.
First, researchers aim to build a whole
virus vaccine. The use of such a virus, be it
inactive or dead, aims to elicit a prompt
immune response of the human body to a
new infection with COVID-19. A second
strategy, subunit vaccines, aims to create
a vaccine that sensitises the immune
system to certain subunits of the virus. In
the case of SARS-CoV-2, such research
focuses on the S-spike protein that helps
the virus intrude the ACE2 enzyme
receptor. A third strategy is that of the
nucleic acid vaccines (DNA or RNA
vaccines, a novel technique for creating a
vaccination). Experimental vaccines from
any of these strategies would have to be
tested for safety and efficacy.[268]
On 16 March 2020, the first clinical trial of
a vaccine started with four volunteers in
Seattle. The vaccine contains a harmless
genetic code copied from the virus that
causes the disease.[269]
Antibody dependent enhancement has

been suggested as a potential challenge
for vaccine development for SARS-COV-2,
but this is controversial.[270]
Medications
At least 29 phase II–IV efficacy trials in

COVID-19 were concluded in March 2020
or scheduled to provide results in April
from hospitals in China.[271][272] Seven
trials were evaluating already approved
treatments for malaria, including four
studies on hydroxychloroquine or
chloroquine.[272] Repurposed antiviral
drugs make up most of the Chinese
research, with nine phase III trials on
remdesivir across several countries due to
report by the end of April.[271][272] Other
potential candidates in trials include
vasodilators, corticosteroids, immune
therapies, lipoic acid, bevacizumab, and
recombinant angiotensin-converting
enzyme 2.[272]
The COVID-19 Clinical Research Coalition

has goals to 1) facilitate rapid reviews of
clinical trial proposals by ethics
committees and national regulatory
agencies, 2) fast-track approvals for the
candidate therapeutic compounds, 3)
ensure standardised and rapid analysis of
emerging efficacy and safety data and 4)
facilitate sharing of clinical trial outcomes
before publication.[273][274] A dynamic
review of clinical development for COVID-
19 vaccine and drug candidates was in
place, as of April 2020.[274]
Several existing antiviral medications are

being evaluated for treatment of COVID-
19,[157] including remdesivir, chloroquine
and hydroxychloroquine, lopinavir/ritonavir
and lopinavir/ritonavir combined with
interferon beta.[266][275] There is tentative
evidence for efficacy by remdesivir, as of
March 2020.[276] Remdesivir inhibits SARS-
CoV-2 in vitro.[277] Phase 3 clinical trials
are being conducted in the U.S., China and
Italy.[157][271][278]
Chloroquine, previously used to treat
malaria, was studied in China in February
2020, with preliminary results.[279]
However, there are calls for peer review of
the research.[280] The Guangdong
Provincial Department of Science and
Technology and the Guangdong Provincial
Health and Health Commission issued a
report stating that chloroquine phosphate
"improves the success rate of treatment
and shortens the length of person's
hospital stay" and recommended it for
people diagnosed with mild, moderate and
severe cases of novel coronavirus
pneumonia.[281]
On 17 March, the Italian Pharmaceutical

Agency included chloroquine and
hydroxychloroquine in the list of drugs
with positive preliminary results for
treatment of COVID-19.[282] Korean and
Chinese Health Authorities recommend
the use of chloroquine.[283][284] However,
the Wuhan Institute of Virology, while
recommending a daily dose of one gram,
notes that twice that dose is highly
dangerous and could be lethal. On 28
March 2020, the FDA issued an emergency
use authorisation for hydroxychloroquine
and chloroquine at the discretion of
physicians treating people with COVID-
19.[285][286]
The Chinese 7th edition guidelines also

include interferon, ribavirin or umifenovir
for use against COVID-19.[284]
In 2020, a trial found that

lopinavir/ritonavir was ineffective in the
treatment of severe illness.[287]
Nitazoxanide has been recommended for
further in vivo study after demonstrating
low concentration inhibition of SARS-CoV-
2.[277]
Studies have demonstrated that initial

spike protein priming by transmembrane
protease serine 2 (TMPRSS2) is essential
for entry of SARS-CoV-2 via interaction
with the ACE2 receptor.[288] These findings
suggest the TMPRSS2 inhibitor camostat
approved for use in Japan for inhibiting
fibrosis in liver and kidney disease might
constitute an effective off-label treatment.
In February 2020, favipiravir was being

studied in China for experimental
treatment of the emergent COVID-19
disease.[289][290]
In April 2020 ivermectin is being studied in

Australia for a possible treatment for
COVID-19 and has been shown to stop
viral growth within 48 hours in
vitro.[291][292]
There are mixed results as of 3 April 2020

as to the effectiveness of
hydroxychloroquine as a treatment for
COVID-19, with some studies showing
little or no improvement.[293][294]
Anti-cytokine storm
Cytokine storm can be a complication in

the later stages of severe COVID-19. There
is evidence that hydroxychloroquine may
have anti-cytokine storm properties.[295]
Tocilizumab has been included in

treatment guidelines by China's National
Health Commission after a small study
was completed.[296][297] It is undergoing a
phase 2 non randomised test at the
national level in Italy after showing
positive results in people with severe
disease.[282][298][299] Combined with a
serum ferritin blood test to identify
cytokine storms, it is meant to counter
such developments, which are thought to
be the cause of death in some affected
people.[300][301][302] The interleukin-6
receptor antagonist was approved by the
FDA based on retrospective case studies
for treatment of steroid refractory cytokine
release syndrome induced by a different
cause, CAR T cell therapy, in 2017.[303] To
date, there is no randomised, controlled
evidence that tocilizumab is an efficacious
treatment for CRS. Prophylactic
tocilizumab has been shown to increase
serum IL-6 levels by saturating the IL-6R,
driving IL-6 across the blood brain barrier
and exacerbating neurotoxicity while
having no impact on incidence of CRS.[304]
Lenzilumab, an anti-GM-CSF monoclonal

antibody, has been shown to be protective
in murine models for CAR T cell induced
CRS and neurotoxicity and is a viable
therapeutic option due to the observed
increase of pathogenic GM-CSF secreting
T-cells in hospitalised patients with COVID-
19.[305]
The Feinstein Institute of Northwell Health
announced in March a study on "a human
antibody that may prevent the activity" of
IL-6.[306]
Passive antibody therapy
Transferring purified and concentrated

antibodies produced by the immune
systems of those who have recovered
from COVID-19 to people who need them
is being investigated as a non-vaccine
method of passive immunisation.[307] This
strategy was tried for SARS with
inconclusive results.[307] Viral
neutralisation is the anticipated
mechanism of action by which passive
antibody therapy can mediate defence
against SARS-CoV-2. Other mechanisms
however, such as antibody-dependent
cellular cytotoxicity and/or phagocytosis,
may be possible.[307] Other forms of
passive antibody therapy, for example,
using manufactured monoclonal
antibodies, are in development.[307]
Production of convalescent serum, which
consists of the liquid portion of the blood
from recovered patients and contains
antibodies specific to this virus, could be
increased for quicker deployment.[308]
See also
2019–20 coronavirus pandemic for
conditions in specific countries
Coronavirus diseases, a group of closely
related syndromes
Coronavirus recession
Disease X, a WHO term
Li Wenliang, a doctor at Central Hospital
of Wuhan, who later contracted and died
of COVID-19 after raising awareness of
the spread of the virus.
Notes
a. Close contact is defined as one metre
(three feet) by the WHO[6] and two
metres (six feet) by the CDC.[15]
b. An uncovered cough can travel up to
8.2 metres (27 feet).[16]
References
1. Chen N, Zhou M, Dong X, Qu J, Gong
F, Han Y, et al. (February 2020).
"Epidemiological and clinical
characteristics of 99 cases of 2019
novel coronavirus pneumonia in
Wuhan, China: a descriptive study" .
Lancet. 395 (10223): 507–513.
doi:10.1016/S0140-6736(20)30211-
7 . PMC 7135076 . PMID 32007143 .
2. Han X, Cao Y, Jiang N, Chen Y, Alwalid
O, Zhang X, et al. (March 2020).
"Novel Coronavirus Pneumonia
(COVID-19) Progression Course in 17
Discharged Patients: Comparison of
Clinical and Thin-Section CT Features
During Recovery". Clinical Infectious
Diseases. doi:10.1093/cid/ciaa271 .
PMID 32227091 .
3. Campbell C (20 January 2020). "The
Wuhan Pneumonia Crisis Highlights
the Danger in China's Opaque Way of
Doing Things" . Time. Archived from
the original on 13 March 2020.
Retrieved 13 March 2020.
4. Lucey D, Sparrow A (14 January
2020). "China Deserves Some Credit
for Its Handling of the Wuhan
Pneumonia" . Foreign Policy.
Archived from the original on 15
January 2020. Retrieved 13 March
2020.
5. "Symptoms of Coronavirus" . U.S.
Centers for Disease Control and
Prevention (CDC). 10 February 2020.
January 2020.
. "Q&A on coronaviruses" . World
Health Organization. 8 April 2020.
January 2020. Retrieved 12 April
2020.
7. "Coronavirus COVID-19 Global Cases
by the Center for Systems Science
and Engineering (CSSE) at Johns
Hopkins University (JHU)" . ArcGIS.
Johns Hopkins CSSE. Retrieved
13 April 2020.
. "Naming the coronavirus disease
(COVID-19) and the virus that causes
it" . World Health Organization
(WHO). Archived from the original on
28 February 2020. Retrieved
28 February 2020.
9. Hui DS, I Azhar E, Madani TA, Ntoumi
F, Kock R, Dar O, et al. (February
2020). "The continuing 2019-nCoV
epidemic threat of novel
coronaviruses to global health—The
latest 2019 novel coronavirus
outbreak in Wuhan, China". Int J
Infect Dis. 91: 264–66.
doi:10.1016/j.ijid.2020.01.009 .
PMID 31953166 .
10. "WHO Director-General's opening
remarks at the media briefing on
COVID-19" . World Health
Organization (WHO) (Press release).
11 March 2020. Archived from the
original on 11 March 2020. Retrieved
12 March 2020.
11. "Q&A on coronaviruses (COVID-19)" .
World Health Organization (WHO).
January 2020. Retrieved 11 March
2020.
12. Hopkins, Claire. "Loss of sense of
smell as marker of COVID-19
infection" . Ear, Nose and Throat
surgery body of United Kingdom.
13. Velavan, T. P.; Meyer, C. G. (March
2020). "The COVID-19 epidemic".
Tropical Medicine & International
Health. n/a (n/a): 278–80.
doi:10.1111/tmi.13383 .
PMID 32052514 .
14. "Q&A on coronaviruses" . World
Health Organization (WHO).
January 2020. Retrieved 27 January
2020.
15. "How COVID-19 Spreads" . Centers
for Disease Control and Prevention
(CDC). 2 April 2020. Archived from
the original on 3 April 2020. Retrieved
3 April 2020.
1 . Bourouiba L (March 2020). "Turbulent
Gas Clouds and Respiratory
Pathogen Emissions: Potential
Implications for Reducing
Transmission of COVID-19". JAMA.
doi:10.1001/jama.2020.4756 .
PMID 32215590 .
17. "Q & A on COVID-19" . European
Centre for Disease Prevention and
Control. Archived from the original
on 5 February 2020. Retrieved
23 March 2020.
1 . "Modes of transmission of virus
causing COVID-19: implications for
IPC precaution recommendations" .
World Health Organization. 29 March
2020. Retrieved 3 April 2020.
"According to current evidence,
COVID-19 virus is primarily
transmitted between people through
respiratory droplets and contact
routes."
19. Organization (WHO), World Health
(28 March 2020). "FACT: #COVID19 is
NOT airborne. The #coronavirus is
mainly transmitted through droplets
generated when an infected person
coughs, sneezes or speaks.To
protect yourself:-keep 1m distance
from others-disinfect surfaces
frequently-wash/rub your -avoid
touching your
pic.twitter.com/fpkcpHAJx7" .
@WHO. Retrieved 3 April 2020.
"These droplets are too heavy to hang
in the air. They quickly fall on floors or
surfaces."
20. "New coronavirus stable for hours on
surfaces" . National Institutes of
Health. 17 March 2020. Archived
from the original on 23 March 2020.
21. "Coronavirus disease 2019 (COVID-
19) Situation Report—73" (PDF).
World Health Organization. 2 April
2020. Retrieved 3 April 2020.
22. "Interim Guidelines for Collecting,
Handling, and Testing Clinical
Specimens from Persons for
Coronavirus Disease 2019 (COVID-
19)" . Centers for Disease Control
and Prevention (CDC). 11 February
2020. Archived from the original on 4
March 2020. Retrieved 26 March
2020.
23. Salehi, Sana; Abedi, Aidin;
Balakrishnan, Sudheer;
Gholamrezanezhad, Ali (14 March
2020). "Coronavirus Disease 2019
(COVID-19): A Systematic Review of
Imaging Findings in 919 Patients".
American Journal of Roentgenology:
1–7. doi:10.2214/AJR.20.23034 .
ISSN 0361-803X . PMID 32174129 .
24. "ACR Recommendations for the use
of Chest Radiography and Computed
Tomography (CT) for Suspected
COVID-19 Infection" . American
College of Radiology. 22 March 2020.
March 2020.
25. "Advice for public" . World Health
Organization (WHO). Archived from
the original on 26 January 2020.
Retrieved 25 February 2020.
2 . "Guidance on social distancing for
everyone in the UK" . GOV.UK.
2020.
27. Centers for Disease Control and
Prevention (5 April 2020). "What to
Do if You Are Sick" . Centers for
Disease Control and Prevention
(CDC). Archived from the original on
14 February 2020. Retrieved 9 April
2020.
2 . Feng, Shuo; Shen, Chen; Xia, Nan;
Song, Wei; Fan, Mengzhen; Cowling,
Benjamin J. (20 March 2020).
"Rational use of face masks in the
COVID-19 pandemic" . The Lancet
Respiratory Medicine. 0.
doi:10.1016/S2213-2600(20)30134-
X . ISSN 2213-2600 . PMC 7118603 .
PMID 32203710 .
29. "When and how to use masks" .
www.who.int. Archived from the
31 March 2020.
30. Tait, Robert (30 March 2020).
"Czechs get to work making masks
after government decree" . The
Guardian. ISSN 0261-3077 .
2020.
31. "How to Protect Yourself & Others" .
Prevention (CDC). 8 April 2020.
February 2020. Retrieved 9 April
2020.
32. "Statement on the second meeting of
the International Health Regulations
(2005) Emergency Committee
regarding the outbreak of novel
coronavirus (2019-nCoV)" . World
January 2020. Retrieved 11 February
2020.
33. Mahtani, S.; Berger, M.; O'Grady, S.;
Iati, M. (6 February 2020). "Hundreds
of evacuees to be held on bases in
California; Hong Kong and Taiwan
restrict travel from mainland China" .
The Washington Post. Archived from
the original on 7 February 2020.
34. "WHO Situation Report #65" (PDF).
WHO. 25 March 2020.
35. Report of the WHO-China Joint
Mission on Coronavirus Disease
2019 (COVID-19) (PDF) (Report).
16–24 February 2020. Archived
(PDF) from the original on 29
February 2020. Retrieved 21 March
2020.
3 . Palus, Shannon (27 March 2020).
"The Key Stat in the NYTimes' Piece
About Losing Your Sense of Smell
Was Wrong" . Slate Magazine.
2020.
37. Iacobucci, Gareth (2020). "Sixty
seconds on ... anosmia". BMJ. 368:
m1202. doi:10.1136/bmj.m1202 .
ISSN 1756-1833 . PMID 32209546 .
3 . Wei, Xiao-Shan; Wang, Xuan; Niu, Yi-
Ran; Ye, Lin-Lin; Peng, Wen-Bei; Wang,
Zi-Hao; Yang, Wei-Bing; Yang, Bo-Han;
Zhang, Jian-Chu; Ma, Wan-Li; Wang,
Xiao-Rong; Zhou, Qiong (26 February
2020). "Clinical Characteristics of
SARS-CoV-2 Infected Pneumonia with
Diarrhea".
doi:10.2139/ssrn.3546120 .
39. Chen N, Zhou M, Dong X, Qu J, Gong
F, Han Y, et al. (February 2020).
"Epidemiological and clinical
characteristics of 99 cases of 2019
novel coronavirus pneumonia in
Wuhan, China: a descriptive study".
Lancet. 395 (10223): 507–513.
doi:10.1016/S0140-6736(20)30211-
7 . PMID 32007143 .
40. Hessen MT (27 January 2020).
"Novel Coronavirus Information
Center: Expert guidance and
commentary" . Elsevier Connect.
January 2020. Retrieved 31 January
2020.
41. Huang C, Wang Y, Li X, Ren L, Zhao J,
Hu Y, et al. (February 2020). "Clinical
features of patients infected with
2019 novel coronavirus in Wuhan,
China". Lancet. 395 (10223): 497–
506. doi:10.1016/S0140-
6736(20)30183-5 . PMID 31986264 .
42. Lai, Chih-Cheng; Shih, Tzu-Ping; Ko,
Wen-Chien; Tang, Hung-Jen; Hsueh,
Po-Ren (1 March 2020). "Severe
acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) and
coronavirus disease-2019 (COVID-
19): The epidemic and the
challenges". International Journal of
Antimicrobial Agents. 55 (3): 105924.
doi:10.1016/j.ijantimicag.2020.1059
24 . ISSN 0924-8579 .
PMID 32081636 .
43. Zheng YY, Ma YT, Zhang JY, Xie X
(March 2020). "COVID-19 and the
cardiovascular system". Nature
Reviews. Cardiology.
doi:10.1038/s41569-020-0360-5 .
PMID 32139904 .
44. "Interim Clinical Guidance for
Management of Patients with
Confirmed Coronavirus Disease
(COVID-19)" . Centers for Disease
Control and Prevention. 11 February
2020. Archived from the original on 2
2020.
45. World Health Organization (19
February 2020). "Coronavirus disease
2019 (COVID-19): situation report,
29". World Health Organization
(WHO). hdl:10665/331118 .
4 . "Q&A on coronaviruses (COVID-19):
How long is the incubation period for
COVID-19?" . World Health
47. Lauer, Stephen A.; Grantz, Kyra H.; Bi,
Qifang; Jones, Forrest K.; Zheng,
Qulu; Meredith, Hannah R.; Azman,
Andrew S.; Reich, Nicholas G.;
Lessler, Justin (10 March 2020). "The
Incubation Period of Coronavirus
Disease 2019 (COVID-19) From
Publicly Reported Confirmed Cases:
Estimation and Application" . Annals
of Internal Medicine.
doi:10.7326/M20-0504 . ISSN 0003-
4819 . PMC 7081172 .
PMID 32150748 . Archived from the
24 March 2020.
4 . "Clinical Questions about COVID-19:
Questions and Answers" . Centers for
Disease Control and Prevention. 11
February 2020. Archived from the
original on 14 February 2020.
49. Bai, Yan; Yao, Lingsheng; Wei, Tao;
Tian, Fei; Jin, Dong-Yan; Chen, Lijuan;
Wang, Meiyun (21 February 2020).
"Presumed Asymptomatic Carrier
Transmission of COVID-19" . JAMA.
doi:10.1001/jama.2020.2565 .
ISSN 0098-7484 . PMC 7042844 .
8 March 2020.
50. "China Reveals 1,541 Symptom-Free
Virus Cases Under Pressure" .
www.bloomberg.com. 31 March
2020. Retrieved 31 March 2020.
51. "코로나19 국내 발생현황 브리핑 (20.
03. 16. 14시)" . ktv.go.kr (in Korean).
52. Day, Michael (2 April 2020). "Covid-
19: four fifths of cases are
asymptomatic, China figures
indicate". BMJ. 369: m1375.
doi:10.1136/bmj.m1375 . ISSN 1756-
1833 . PMID 32241884 .
53. To, Kelvin Kai-Wang; Tsang, Owen
Tak-Yin; Yip, Cyril Chik-Yan; Chan,
Kwok-Hung; et al. (12 February 2020).
"Consistent Detection of 2019 Novel
Coronavirus in Saliva" . Clinical
Infectious Diseases. Oxford
University Press.
doi:10.1093/cid/ciaa149 .
PMC 7108139 .
54. Loh NW, Tan Y, Taculod J, Gorospe B,
Teope AS, Somani J, et al. (March
2020). "The impact of high-flow nasal
cannula (HFNC) on coughing
distance: implications on its use
during the novel coronavirus disease
outbreak" . Canadian Journal of
Anesthesia. doi:10.1007/s12630-020-
01634-3 . PMC 7090637 .
PMID 32189218 .
55. "Modes of transmission of virus
causing COVID-19: implications for
IPC precaution recommendations" .
www.who.int. Retrieved 29 March
2020.
5 . "Rapid Expert Consultation on the
Possibility of Bioaerosol Spread of
SARS-CoV-2 for the COVID-19
Pandemic" . The National Academies
Press. 1 April 2020. Retrieved 1 April
2020.
57. van Doremalen N, Bushmaker T,
Morris DH, Holbrook MG, Gamble A,
Williamson BN, et al. (March 2020).
"Aerosol and Surface Stability of
SARS-CoV-2 as Compared with SARS-
CoV-1" . New England Journal of
Medicine: NEJMc2004973.
doi:10.1056/NEJMc2004973 .
ISSN 0028-4793 . PMC 7121658 .
PMID 32182409 .
5 . Moriyama M, Hugentobler WJ,
Iwasaki A (20 March 2020).
"Seasonality of Respiratory Viral
Infections". Annual Review of
Virology. 7. doi:10.1146/annurev-
virology-012420-022445 .
PMID 32196426 .
59. Holden, Emily, Do you need to wash
your groceries? And other advice for
shopping safely , The Guardian,
Thursday, April 2, 2020
0. "COVID-19 prevention: Why soap,
sanitizer and warm water work
against coronavirus—CNN" .
Edition.cnn.com. 24 March 2020.
Retrieved 7 April 2020.
1. Kampf, G.; Todt, D.; Pfaender, S.;
Steinmann, E. (March 2020).
"Persistence of coronaviruses on
inanimate surfaces and their
inactivation with biocidal agents" .
The Journal of Hospital Infection.
104 (3): 246–251.
doi:10.1016/j.jhin.2020.01.022 .
PMID 32035997 .
2. "Outbreak of severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-
2): increased transmission beyond
China—fourth update" (PDF).
European Centre for Disease
Prevention and Control. 14 February
3. Andersen KG, Rambaut A, Lipkin WI,
Holmes EC, Garry RF (17 March
2020). "The proximal origin of SARS-
CoV-2" . Nature Medicine: 1–3.
doi:10.1038/s41591-020-0820-9 .
ISSN 1546-170X . PMC 7095063 .
2020.
4. Zhu N, Zhang D, Wang W, Li X, Yang B,
Song J, et al. (February 2020). "A
Novel Coronavirus from Patients with
Pneumonia in China, 2019" . The New
England Journal of Medicine. 382 (8):
727–733.
doi:10.1056/NEJMoa2001017 .
PMC 7092803 . PMID 31978945 .
5. Cyranoski D (26 February 2020).
"Mystery deepens over animal source
of coronavirus". Nature. 579 (7797):
18–19.
Bibcode:2020Natur.579...18C .
doi:10.1038/d41586-020-00548-w .
PMID 32127703 .
. Letko M, Marzi A, Munster V (2020).
"Functional assessment of cell entry
and receptor usage for SARS-CoV-2
and other lineage B
betacoronaviruses". Nature
Microbiology. 5 (4): 562–569.
doi:10.1038/s41564-020-0688-y .
PMID 32094589 .
7. Zhang H, Penninger JM, Li Y, Zhong
N, Slutsky AS (March 2020).
"Angiotensin-converting enzyme 2
(ACE2) as a SARS-CoV-2 receptor:
molecular mechanisms and potential
therapeutic target" . Intensive Care
Medicine. 46 (4): 586–590.
doi:10.1007/s00134-020-05985-9 .
PMC 7079879 . PMID 32125455 .
. Xu H, Zhong L, Deng J, Peng J, Dan H,
Zeng X, et al. (February 2020). "High
expression of ACE2 receptor of 2019-
nCoV on the epithelial cells of oral
mucosa" . International Journal of
Oral Science. 12 (1): 8.
doi:10.1038/s41368-020-0074-x .
PMC 7039956 . PMID 32094336 .
9. Gurwitz D (March 2020). "Angiotensin
receptor blockers as tentative SARS‐
CoV‐2 therapeutics". Drug
Development Research.
doi:10.1002/ddr.21656 .
PMID 32129518 .
70. Gu, Jinyang; Han, Bing; Wang, Jian
(27 February 2020). "COVID-19:
Gastrointestinal manifestations and
potential fecal-oral transmission".
Gastroenterology.
doi:10.1053/j.gastro.2020.02.054 .
ISSN 0016-5085 . PMID 32142785 .
71. Hamming, I.; Timens, W.; Bulthuis, M.
L. C.; Lely, A. T.; Navis, G. J.; Goor, H.
van (2004). "Tissue distribution of
ACE2 protein, the functional receptor
for SARS coronavirus. A first step in
understanding SARS pathogenesis".
The Journal of Pathology. 203 (2):
631–637. doi:10.1002/path.1570 .
ISSN 1096-9896 . PMID 15141377 .
72. Barton L, Duval E, Stroberg E, Ghosh
S, Mukhopadhyay S (April 2020).
"COVID-19 autopsies, Oklahoma,
USA". American Journal of Clinical
Pathology.
doi:10.1093/ajcp/aqaa062 .
73. Huang C, Wang Y, Li X, Ren L, Zhao J,
Hu Y, et al. (February 2020). "Clinical
features of patients infected with
2019 novel coronavirus in Wuhan,
China". Lancet. 395 (10223): 497–
506. doi:10.1016/S0140-
6736(20)30183-5 . PMID 31986264 .
74. Zhang C, Wu Z, Li JW, Zhao H, Wang
GQ (March 2020). "The cytokine
release syndrome (CRS) of severe
COVID-19 and Interleukin-6 receptor
(IL-6R) antagonist Tocilizumab may
be the key to reduce the mortality" .
International Journal of Antimicrobial
Agents: 105954.
54 . PMC 7118634 .
PMID 32234467 .
75. Zhou Y, Fu B, Zheng X, Wang D, Zhao
C, Qi Y, et al. (2020). "Aberrant
pathogenic GM-CSF+ T cells and
inflammatory CD14+CD16+
monocytes in severe pulmonary
syndrome patients of a new
coronavirus" . bioRxiv Pre-print.
doi:10.1101/2020.02.12.945576 .
7 . "CDC Tests for 2019-nCoV" . Centers
for Disease Control and Prevention. 5
77. "Laboratory testing for 2019 novel
coronavirus (2019-nCoV) in
suspected human cases" . World
2020.
7 . "2019 Novel Coronavirus (2019-
nCoV) Situation Summary" . Centers
for Disease Control and Prevention.
30 January 2020. Archived from the
original on 26 January 2020.
Retrieved 30 January 2020.
79. "Real-Time RT-PCR Panel for
Detection 2019-nCoV" . Centers for
January 2020. Archived from the
0. "Curetis Group Company Ares
Genetics and BGI Group Collaborate
to Offer Next-Generation Sequencing
and PCR-based Coronavirus (2019-
nCoV) Testing in Europe" .
GlobeNewswire News Room. 30
January 2020. Archived from the
1. Brueck H (30 January 2020). "There's
only one way to know if you have the
coronavirus, and it involves machines
full of spit and mucus" . Business
Insider. Archived from the original on
1 February 2020.
2. "Laboratory testing for 2019 novel
coronavirus (2019-nCoV) in
suspected human cases" . Archived
from the original on 21 February
2020. Retrieved 26 February 2020.
3. Cohen J, Normile D (January 2020).
"New SARS-like virus in China triggers
alarm" (PDF). Science. 367 (6475):
234–35.
Bibcode:2020Sci...367..234C .
doi:10.1126/science.367.6475.234 .
PMID 31949058 . Archived (PDF)
4. "Severe acute respiratory syndrome
coronavirus 2 data hub" . NCBI.
March 2020. Retrieved 4 March 2020.
5. Petherick, Anna (4 April 2020).
"Developing antibody tests for SARS-
CoV-2". The Lancet. 395 (10230):
1101–1102. doi:10.1016/s0140-
6736(20)30788-1 . ISSN 0140-6736 .
PMID 32247384 .
. Vogel, Gretchen (19 March 2020).
"New blood tests for antibodies could
show true scale of coronavirus
pandemic". Science.
doi:10.1126/science.abb8028 .
ISSN 0036-8075 .
7. Pang J, Wang MX, Ang IY, Tan SH,
Lewis RF, Chen JI, et al. (February
2020). "Potential Rapid Diagnostics,
Vaccine and Therapeutics for 2019
Novel Coronavirus (2019-nCoV): A
Systematic Review". Journal of
Clinical Medicine. 9 (3): 623.
doi:10.3390/jcm9030623 .
PMID 32110875 .
. AFP News Agency (11 April 2020).
"How false negatives are
complicating COVID-19 testing". Al
Jazeera website Retrieved 12 April
2020.
9. "Coronavirus (COVID-19) Update: FDA
Issues first Emergency Use
Authorization for Point of Care
Diagnostic" (Press release). FDA. 21
March 2020. Archived from the
22 March 2020.
90. Jin YH, Cai L, Cheng ZS, Cheng H,
Deng T, Fan YP, et al. (February 2020).
"A rapid advice guideline for the
diagnosis and treatment of 2019
novel coronavirus (2019-nCoV)
infected pneumonia (standard
version)" . Military Medical Research.
7 (1): 4. doi:10.1186/s40779-020-
0233-6 . PMC 7003341 .
PMID 32029004 .
91. Lee, Elaine Y. P.; Ng, Ming-Yen; Khong,
Pek-Lan (24 February 2020). "COVID-
19 pneumonia: what has CT taught
us?" . The Lancet Infectious
Diseases. 0 (4): 384–385.
doi:10.1016/S1473-3099(20)30134-
1 . ISSN 1473-3099 .
13 March 2020.
92. Hanley B, Lucas SB, Youd E, Swift B,
Osborn M (March 2020). "Autopsy in
suspected COVID-19 cases". J. Clin.
Pathol.: jclinpath-2020-206522.
doi:10.1136/jclinpath-2020-206522 .
PMID 32198191 .
93. Yao XH, Li TY, He ZC, Ping YF, Liu HW,
Yu SC, et al. (March 2020). "[A
pathological report of three COVID-19
cases by minimally invasive
autopsies]". Zhonghua Bing Li Xue Za
Zhi (in Chinese). 49: E009.
doi:10.3760/cma.j.cn112151-
20200312-00193 . PMID 32172546 .
94. Giani, Marco; Seminati, Davide;
Lucchini, Alberto; Foti, Giuseppe;
Pagni, Fabio (16 March 2020).
"Exuberant plasmocytosis in
bronchoalveolar lavage of the first
patient requiring Extracorporeal
Membrane Oxygenation for SARS-
CoV-2 in Europe" . Journal of
Thoracic Oncology.
doi:10.1016/j.jtho.2020.03.008 .
PMC 7118681 . PMID 32194247 .
95. Lillicrap, David (1 April 2020).
"Disseminated intravascular
coagulation in patients with 2019-
nCoV pneumonia". Journal of
Thrombosis and Haemostasis: JTH.
18 (4): 786–787.
doi:10.1111/jth.14781 .
PMID 32212240 .
9 . Mitra, Anupam; Dwyre, Denis M.;
Schivo, Michael; Thompson, George
R.; Cohen, Stuart H.; Ku, Nam; Graff,
John P. (25 March 2020).
"Leukoerythroblastic reaction in a
patient with COVID-19 infection".
American Journal of Hematology.
doi:10.1002/ajh.25793 .
PMID 32212392 .
97. Wiles S (9 March 2020). "The three
phases of Covid-19—and how we can
make it manageable" . The Spinoff.
9 . Anderson RM, Heesterbeek H,
Klinkenberg D, Hollingsworth TD
(March 2020). "How will country-
based mitigation measures influence
the course of the COVID-19
epidemic?". Lancet. 395 (10228):
931–934. doi:10.1016/S0140-
6736(20)30567-5 . PMID 32164834 .
"A key issue for epidemiologists is
helping policy makers decide the
main objectives of mitigation—e.g.
minimising morbidity and associated
mortality, avoiding an epidemic peak
that overwhelms health-care services,
keeping the effects on the economy
within manageable levels, and
flattening the epidemic curve to wait
for vaccine development and
manufacture on scale and antiviral
drug therapies."
99. Barclay E (10 March 2020). "How
canceled events and self-quarantines
save lives, in one chart" . Vox.
2020.
100. Barclay, Eliza; Scott, Dylan;
Animashaun, Animashaun (7 April
2020). "The US doesn't just need to
flatten the curve. It needs to "raise the
line." " . Vox. Archived from the
original on 7 April 2020.
101. Wiles, Siouxsie (14 March 2020).
"After 'Flatten the Curve', we must
now 'Stop the Spread'. Here's what
that means" . The Spinoff. Archived
102. Centers for Disease Control (3
February 2020). "Coronavirus Disease
2019 (COVID-19): Prevention &
Treatment" . Archived from the
original on 15 December 2019.
103. World Health Organization. "Advice
for Public" . Archived from the
104. "My Hand-Washing Song: Readers
Offer Lyrics For A 20-Second Scrub" .
NPR.org. Archived from the original
on 20 March 2020. Retrieved
20 March 2020.
105. Maragakis LL. "Coronavirus, Social
Distancing and Self Quarantine" .
www.hopkinsmedicine.org. Johns
Hopkins University. Archived from
10 . Parker-Pope, Tara (19 March 2020).
"Deciding How Much Distance You
Should Keep" . The New York Times.
ISSN 0362-4331 . Archived from the
20 March 2020.
107. Grenfell R, Drew T (17 February
2020). "Here's Why It's Taking So
Long to Develop a Vaccine for the
New Coronavirus" . Science Alert.
February 2020. Retrieved 26 February
2020.
10 . "When and how to use masks" .
109. "For different groups of people: how
to choose masks" . NHC.gov.cn.
National Health Commission of the
People's Republic of China. 7
February 2020. Retrieved 22 March
2020. "Disposable medical masks:
Recommended for: · People in
crowded places · Indoor working
environment with a relatively dense
population · People going to medical
institutions · Children in kindergarten
and students at school gathering to
study and do other activities"
110. "Prevention of Coronavirus Disease
2019 (COVID-19)" (PDF). Centre for
Health Protection. Archived (PDF)
Retrieved 22 March 2020. "Wear a
surgical mask when taking public
transport or staying in crowded
places."
111. Kuhakan, Jiraporn (12 March 2020).
" 'Better than nothing': Thailand
encourages cloth masks amid
surgical mask shortage" . Reuters.
2020. "Thailand's health authorities
are encouraging people to make cloth
face masks at home to guard against
the spread of the coronavirus amid a
shortage of surgical masks. ... The
droplet from coughing and sneezing
is around five microns and we have
tested already that cloth masks can
protect against droplets bigger than
one micron."
112. "Coronavirus: Czechs facing up to
COVID-19 crisis by making masks
mandatory" . euronews. 2020.
March 2020.
113. "Austria is making everyone who
goes inside a supermarket wear a
face mask" . www.cbsnews.com.
2020.
114. "Shortage of personal protective
equipment endangering health
workers worldwide" (Press release).
WHO. 3 March 2020. Archived from
115. "Guidance against wearing masks for
the coronavirus is wrong—you should
cover your face—The Boston Globe" .
BostonGlobe.com. Archived from the
22 March 2020.
11 . "Coronavirus Disease 2019 (COVID-
19)—Prevention & Treatment" .
Prevention. U.S. Department of
Health & Human Services. 10 March
2020. Archived from the original on
11 March 2020. Retrieved 11 March
2020.
117. "WHO-recommended handrub
formulations" . WHO Guidelines on
Hand Hygiene in Health Care: First
Global Patient Safety Challenge Clean
Care Is Safer Care. World Health
Organization. 19 March 2009.
11 . Fisher D, Heymann D (February
2020). "Q&A: The novel coronavirus
outbreak causing COVID-19" . BMC
Medicine. 18 (1): 57.
doi:10.1186/s12916-020-01533-w .
PMC 7047369 . PMID 32106852 .
119. Kui L, Fang YY, Deng Y, Liu W, Wang
MF, Ma JP, et al. (February 2020).
"Clinical characteristics of novel
coronavirus cases in tertiary
hospitals in Hubei Province". Chinese
Medical Journal: 1.
doi:10.1097/CM9.00000000000007
44 . PMID 32044814 .
120. Wang T, Du Z, Zhu F, Cao Z, An Y, Gao
Y, Jiang B (March 2020).
"Comorbidities and multi-organ
injuries in the treatment of COVID-
19". Lancet. Elsevier BV. 395 (10228):
e52. doi:10.1016/s0140-
6736(20)30558-4 . PMID 32171074 .
121. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou
CQ, He JX, et al. (February 2020).
"Clinical Characteristics of
Coronavirus Disease 2019 in China" .
The New England Journal of
Medicine. Massachusetts Medical
Society.
doi:10.1056/nejmoa2002032 .
PMC 7092819 . PMID 32109013 .
122. Henry BM (2020). "COVID-19, ECMO,
and lymphopenia: a word of caution" .
The Lancet Respiratory Medicine.
Elsevier BV. 8 (4): e24.
doi:10.1016/s2213-2600(20)30119-
3 . ISSN 2213-2600 . PMC 7118650 .
PMID 32178774 .
123. Cheng ZJ, Shan J (February 2020).
"2019 Novel coronavirus: where we
are and what we know". Infection. 48
(2): 155–163. doi:10.1007/s15010-
020-01401-y . PMID 32072569 .
124. "Clinical management of severe
acute respiratory infection when
novel coronavirus (nCoV) infection is
suspected" . World Health
125. Farkas J (March 2020). COVID-19—
The Internet Book of Critical Care
(digital) (Reference manual). USA:
EMCrit. Archived from the original on
2020.
12 . "COVID19—Resources for Health
Care Professionals" . Penn Libraries.
13 March 2020.
127. Day, Michael (17 March 2020).
"Covid-19: ibuprofen should not be
used for managing symptoms, say
doctors and scientists" . BMJ. 368:
m1086. doi:10.1136/bmj.m1086 .
ISSN 1756-1833 . PMID 32184201 .
2020.
12 . "Self-isolation advice—Coronavirus
(COVID-19)" . National Health Service
(United Kingdom). 28 February 2020.
2020.
129. Godoy, Maria (18 March 2020).
"Concerned About Taking Ibuprofen
For Coronavirus Symptoms? Here's
What Experts Say" . NPR. Retrieved
8 April 2020.
130. AFP (19 March 2020). "Updated:
WHO Now Doesn't Recommend
Avoiding Ibuprofen For COVID-19
Symptoms" . ScienceAlert. Archived
131. Research, Center for Drug Evaluation
and (19 March 2020). "FDA advises
patients on use of non-steroidal anti-
inflammatory drugs (NSAIDs) for
COVID-19" . Drug Safety and
Availability. Archived from the
27 March 2020.
132. "Patients taking ACE-i and ARBs who
contract COVID-19 should continue
treatment, unless otherwise advised
by their physician" . Archived from
133. "Patients taking ACE-i and ARBs who
contract COVID-19 should continue
treatment, unless otherwise advised
by their physician" . American Heart
Association (Press release). 17
25 March 2020.
134. de Simone, Giovanni. "Position
Statement of the ESC Council on
Hypertension on ACE-Inhibitors and
Angiotensin Receptor Blockers" .
Council on Hypertension of the
European Society of Cardiology.
2020.
135. Vetter P, Eckerle I, Kaiser L (February
2020). "Covid-19: a puzzle with many
missing pieces". BMJ. 368: m627.
doi:10.1136/bmj.m627 .
PMID 32075791 .
13 . "Novel Coronavirus—COVID-19: What
Emergency Clinicians Need to
Know" . www.ebmedicine.net.
137. "Sequence for Putting On Personal
Protective Equipment (PPE)" (PDF).
CDC. Archived (PDF) from the
8 March 2020.
13 . Cheung JC, Ho LT, Cheng JV, Cham
EY, Lam KN (February 2020). "Staff
safety during emergency airway
management for COVID-19 in Hong
Kong". Lancet Respiratory Medicine.
8 (4): e19. doi:10.1016/s2213-
2600(20)30084-9 . PMID 32105633 .
139. "What healthcare personnel should
know about caring for patients with
confirmed or possible coronavirus
disease 2" (PDF). CDC. 12 March
140. Filtering out Confusion: Frequently
Asked Questions about Respiratory
Protection, User Seal Check
Archived 16 August 2019 at the
Wayback Machine. The National
Institute for Occupational Safety and
Health (April 2018). Retrieved 16
March 2020.
141. Proper N95 Respirator Use for
Respiratory Protection Preparedness
Archived 27 March 2020 at the
Wayback Machine. NIOSH Science
Blog (16 March 2020). Retrieved 16
March 2020.
142. "Coronavirus Disease 2019 (COVID-
and Prevention. 11 February 2020.
2020.
145. "Strategies for Optimizing the Supply
of Eye Protection" . CDC. 11 February
2020.
14 . CDC (11 February 2020). "Interim
Infection Prevention and Control
Recommendations for Patients with
Suspected or Confirmed Coronavirus
Disease 2019 (COVID-19) in
Healthcare Settings" . Centers for
Disease Control and Prevention.
2020.
19) Frequently Asked Questions" .
Food and Drug Administration.
14 . "Strategies for Optimizing the Supply
of Facemasks" . CDC. 11 February
2020.
149. Murthy S, Gomersall CD, Fowler RA
(11 March 2020). "Care for Critically
Ill Patients With COVID-19" . JAMA.
doi:10.1001/jama.2020.3633 .
18 March 2020.
150. World Health Organization (28
January 2020). "Clinical management
of severe acute respiratory infection
when novel coronavirus (2019-nCoV)
infection is suspected" (PDF).
Archived (PDF) from the original on
18 March 2020.
151. "Intensive care doctors question
'overly aggressive' use of ventilators
in coronavirus crisis" . Telegraph
Media Group Limited. 9 April 2020.
152. Ferguson, N.; Laydon, D.; Nedjati
Gilani, G.; Imai, N.; Ainslie, K.;
Baguelin, M.; Bhatia, S.; Boonyasiri, A.;
Cucunuba Perez, Zulma; Cuomo-
Dannenburg, G.; Dighe, A. (16 March
2020). "Report 9: Impact of non-
pharmaceutical interventions (NPIs)
to reduce COVID19 mortality and
healthcare demand" . Imperial
College London. Table 1.
doi:10.25561/77482 .
hdl:20.1000/100 . Archived from the
25 March 2020.
153. Scott, Dylan (16 March 2020).
"Coronavirus is exposing all of the
weaknesses in the US health system
High health care costs and low
medical capacity made the US
uniquely vulnerable to the
coronavirus" . Vox. Archived from
154. Matthay, Michael A.; Aldrich, J.
Matthew; Gotts, Jeffrey E. (March
2020). "Treatment for severe acute
respiratory distress syndrome from
COVID-19" . The Lancet Respiratory
Medicine. doi:10.1016/S2213-
2600(20)30127-2 . PMC 7118607 .
PMID 32203709 .
155. Briel, Matthias; Meade, Maureen;
Mercat, Alain; Brower, Roy G.; Talmor,
Daniel; Walter, Stephen D.; Slutsky,
Arthur S.; Pullenayegum, Eleanor;
Zhou, Qi; Cook, Deborah; Brochard,
Laurent; Richard, Jean-Christophe M.;
Lamontagne, François; Bhatnagar,
Neera; Stewart, Thomas E.; Guyatt,
Gordon (3 March 2010). "Higher vs
Lower Positive End-Expiratory
Pressure in Patients With Acute Lung
Injury and Acute Respiratory Distress
Syndrome". JAMA. 303 (9): 865–73.
doi:10.1001/jama.2010.218 .
PMID 20197533 .
15 . Diaz, Raiko; Heller, Daniel (2020).
Barotrauma And Mechanical
Ventilation . StatPearls. StatPearls
Publishing. PMID 31424810 .
157. Li G, De Clercq E (March 2020).
"Therapeutic options for the
2019 novel coronavirus (2019-
nCoV)". Nature Reviews. Drug
Discovery. 19 (3): 149–150.
doi:10.1038/d41573-020-00016-0 .
PMID 32127666 .
15 . "Chinese doctors using plasma
therapy on coronavirus, WHO says
'very valid' approach" . Reuters. 17
19 March 2020 – via
www.reuters.com.
159. Steenhuysen J, Kelland K (24 January
2020). "With Wuhan virus genetic
code in hand, scientists begin work
on a vaccine" . Reuters. Archived
from the original on 25 January 2020.
Retrieved 25 January 2020.
1 0. Duddu P (19 February 2020).
"Coronavirus outbreak:
Vaccines/drugs in the pipeline for
Covid-19" . clinicaltrialsarena.com.
February 2020.
1 1. Lu H (28 January 2020). "Drug
treatment options for the 2019-new
coronavirus (2019-nCoV)". Biosci
Trends. 14 (1): 69–71.
doi:10.5582/bst.2020.01020 .
PMID 31996494 .
1 2. Nebehay S, Kelland K, Liu R (5
February 2020). "WHO: 'no known
effective' treatments for new
coronavirus" . Thomson Reuters.
2020.
1 3. "Blood plasma taken from covid-19
survivors might help patients fight off
the disease" . MIT Technology
Review.
1 4. "Trials of Plasma From Recovered
Covid-19 Patients Have Begun" – via
www.wired.com.
1 5. "FDA now allows treatment of life-
threatening COVID-19 cases using
blood from patients who have
recovered" . TechCrunch. Retrieved
9 April 2020.
1 . "China launches coronavirus 'close
contact' app" . BBC News. 11
1 7. Chen A. "China's coronavirus app
could have unintended
consequences" . MIT Technology
Review. Retrieved 7 March 2020.
1 . "Gov in the Time of Corona" .
GovInsider. 19 March 2020. Archived
1 9. Manancourt, Vincent (10 March
2020). "Coronavirus tests Europe's
resolve on privacy" . POLITICO.
2020.
170. Tidy, Joe (17 March 2020).
"Coronavirus: Israel enables
emergency spy powers" . BBC News.
2020.
171. Bünte, Oliver (18 March 2020).
"Corona-Krise: Deutsche Telekom
liefert anonymisierte Handydaten an
RKI" [Corona crisis: Deutsche
Telekom delivers anonymized cell
phone data to RKI]. Heise Online (in
German). Archived from the original
25 March 2020.
172. "Moscow deploys facial recognition
technology for coronavirus
quarantine" . Reuters. 21 February
20 March 2020.
173. "Italians scolded for flouting
lockdown as death toll nears 3,000" .
Pittsburgh Post-Gazette. Archived
174. "Kreative Lösungen gesucht" .
Startseite (in German). Archived
175. Dannewitz, Juliane (23 March 2020).
"Hackathon Germany: #WirvsVirus" .
Datenschutzbeauftragter (in
German).
17 . Whyte, Andrew (21 March 2020).
"President makes global call to
combat coronavirus via hackathon" .
ERR. Archived from the original on
2020.
177. Xiang YT, Yang Y, Li W, Zhang L,
Zhang Q, Cheung T, et al. (March
2020). "Timely mental health care for
the 2019 novel coronavirus outbreak
is urgently needed". The Lancet.
Psychiatry. 7 (3): 228–29.
doi:10.1016/S2215-0366(20)30046-
8 . PMID 32032543 .
17 . Kang L, Li Y, Hu S, Chen M, Yang C,
Yang BX, et al. (March 2020). "The
mental health of medical workers in
Wuhan, China dealing with the
2019 novel coronavirus". The Lancet.
Psychiatry. 7 (3): e14.
doi:10.1016/S2215-0366(20)30047-
X . PMID 32035030 .
179. Roser M, Ritchie H, Ortiz-Ospina E (4
March 2020). "Coronavirus Disease
(COVID-19)" . Our World in Data.
2020.
1 0. Yanping Z, et al. (The Novel
Coronavirus Pneumonia Emergency
Response Epidemiology Team) (17
February 2020). "The Epidemiological
Characteristics of an Outbreak of
2019 Novel Coronavirus Diseases
(COVID-19)—China, 2020" . China
CDC Weekly. Chinese Center for
Disease Control and Prevention. 2 (8):
113–122. Archived from the original
on 19 February 2020. Retrieved
18 March 2020.
1 1. Roser M, Ritchie H, Ortiz-Ospina E (6
April 2020). "Coronavirus Disease
(COVID-19)" . Our World in Data.
1 2. Lu X, Zhang L, Du H, Zhang J, Li YY,
Qu J, et al. (18 March 2020). "SARS-
CoV-2 Infection in Children" . New
England Journal of Medicine.
Massachusetts Medical Society.
doi:10.1056/nejmc2005073 .
ISSN 0028-4793 . PMC 7121177 .
PMID 32187458 .
1 3. Dong Y, Mo X, Hu Y, Qi X, Jiang F,
Jiang Z, Tong S (2020).
"Epidemiological Characteristics of
2143 Pediatric Patients With 2019
Coronavirus Disease in China" (PDF).
Pediatrics: e20200702.
doi:10.1542/peds.2020-0702 .
PMID 32179660 . Archived (PDF)
1 4. Fang L, Karakiulakis G, Roth M
(March 2020). "Are patients with
hypertension and diabetes mellitus at
increased risk for COVID-19
infection?" . The Lancet Respiratory
Medicine. 395 (10224): e40.
doi:10.1016/S0140-6736(20)30311-
1 . PMC 7118626 . PMID 32171062 .
1 5. "Coronavirus Disease 2019 (COVID-
1 . Heymann DL, Shindo N, et al. (WHO
Scientific and Technical Advisory
Group for Infectious Hazards)
(February 2020). "COVID-19: what is
next for public health?". Lancet.
Elsevier BV. 395 (10224): 542–545.
doi:10.1016/s0140-6736(20)30374-
3 . PMID 32061313 .
1 7. Cascella M, Rajnik M, Cuomo A,
Dulebohn SC, Di Napoli R (2020).
"Features, Evaluation and Treatment
Coronavirus (COVID-19)" . StatPearls.
Treasure Island (FL): StatPearls
Publishing. PMID 32150360 .
1 . Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z,
et al. (2020). "Clinical course and risk
factors for mortality of adult
inpatients with COVID-19 in Wuhan,
China: a retrospective cohort study".
The Lancet. Elsevier BV. 395 (10229):
1054–1062. doi:10.1016/s0140-
6736(20)30566-3 . ISSN 0140-6736 .
PMID 32171076 .
1 9. Xu L, Liu J, Lu M, Yang D, Zheng X
(March 2020). "Liver injury during
highly pathogenic human coronavirus
infections". Liver International.
doi:10.1111/liv.14435 .
PMID 32170806 .
190. Tian, Dai-Shi; Wang, Wei; Shang, Ke;
Ma, Ke; Xie, Cuihong; Tao, Yu; Yang,
Sheng; Zhang, Shuoqi; Hu, Ziwei;
Zhou, Luoqi; Qin, Chuan (12 March
2020). "Dysregulation of immune
response in patients with COVID-19 in
Wuhan, China" . Clinical Infectious
Diseases. doi:10.1093/cid/ciaa248 .
PMC 7108125 . PMID 32161940 .
191. "WHO Director-General's statement
on the advice of the IHR Emergency
Committee on Novel Coronavirus" .
192. Palmieri L, Andrianou X, Barbariol P,
Bella A, Bellino S, Benelli E, et al. (3
April 2020). Characteristics of COVID-
19 patients dying in Italy Report
based on available data on April 2th,
2020 (PDF) (Report). Istituto
Superiore di Sanità. Retrieved 3 April
2020.
193. Wang W, Tang J, Wei F (April 2020).
"Updated understanding of the
outbreak of 2019 novel coronavirus
(2019-nCoV) in Wuhan, China".
Journal of Medical Virology. 92 (4):
441–47. doi:10.1002/jmv.25689 .
PMID 31994742 .
194. "Coronavirus Age, Sex, Demographics
(COVID-19)" .
www.worldometers.info. Archived
195. Garg, Shikha; et al. (8 April 2020).
"Hospitalization Rates and
Characteristics of Patients
Hospitalized with Laboratory-
Confirmed Coronavirus Disease 2019
—COVID-NET, 14 States, March 1–30,
2020" . MMWR. Morbidity and
Mortality Weekly Report. 69 (15).
doi:10.15585/mmwr.mm6915e3 .
ISSN 0149-2195 .
19 . Ji Y, Ma Z, Peppelenbosch MP, Pan Q
(February 2020). "Potential
association between COVID-19
mortality and health-care resource
availability". Lancet Global Health. 8
(4): e480. doi:10.1016/S2214-
109X(20)30068-1 . PMID 32109372 .
197. Li XQ, Cai WF, Huang LF, Chen C, Liu
YF, Zhang ZB, et al. (March 2020). "
[Comparison of epidemic
characteristics between SARS in2003
and COVID-19 in 2020 in
Guangzhou]". Zhonghua Liu Xing Bing
Xue Za Zhi = Zhonghua
Liuxingbingxue Zazhi (in Chinese). 41
(5): 634–637.
doi:10.3760/cma.j.cn112338-
20200228-00209 . PMID 32159317 .
19 . Jung SM, Akhmetzhanov AR, Hayashi
K, Linton NM, Yang Y, Yuan B, et al.
(February 2020). "Real-Time
Estimation of the Risk of Death from
Novel Coronavirus (COVID-19)
Infection: Inference Using Exported
Cases" . Journal of Clinical Medicine.
9 (2): 523. doi:10.3390/jcm9020523 .
PMC 7074479 . PMID 32075152 .
199. Chughtai A, Malik A (March 2020). "Is
Coronavirus disease (COVID-19) case
fatality ratio underestimated?". Global
Biosecurity. 1 (3).
doi:10.31646/gbio.56 (inactive 19
March 2020).
200. Baud D, Qi X, Nielsen-Saines K,
Musso D, Pomar L, Favre G (March
2020). "Real estimates of mortality
following COVID-19 infection" . The
Lancet Infectious Diseases.
doi:10.1016/S1473-3099(20)30195-
X . PMC 7118515 . PMID 32171390 .
201. Cheung E (13 March 2020). "Some
recovered Covid-19 patients may
have lung damage, doctors say" .
South China Morning Post. Archived
202. Servick, Kelly (8 April 2020). "For
survivors of severe COVID-19, beating
the virus is just the beginning" .
Science.
doi:10.1126/science.abc1486 .
ISSN 0036-8075 .
203. COVID-19 i Danmark: Epidemiologisk
overvågningsrapport den 10. april
2020 (Report) (in Danish). Statens
Serum Institut. 10 April 2020.
204. Epidemia COVID-19. Aggiornamento
nazionale 9 aprile 2020 (PDF)
(Report) (in Italian). Rome: Istituto
Superiore di Sanità. 9 April 2020.
205. Epidemiologische situatie COVID-19
in Nederland 06 april 2020 (PDF)
(Report) (in Dutch). Bilthoven:
Rijksinstituut voor Volksgezondheid
en Milie. 6 April 2020. Retrieved
6 April 2020.
20 . The updates on COVID-19 in Korea as
of 7 April (Report). Korea Centers for
April 2020. Retrieved 9 April 2020.
207. Actualización nº 71. Enfermedad por
el coronavirus (COVID-19) (PDF)
(Report) (in Spanish). Ministerio de
Sanidad, Consumo y Bienestar Social.
10 April 2020. Retrieved 10 April
2020.
20 . BAG, Bundesamt für Gesundheit.
"Neues Coronavirus: Situation
Schweiz und International" .
www.bag.admin.ch.
209. CDC COVID-19 Response Team (18
March 2020). "Severe Outcomes
Among Patients with Coronavirus
Disease 2019 (COVID-19)—United
States, February 12 – March 16,
2020" . Morbidity and Mortality
Weekly Report. Centers for Disease
Control. 69 (12): 343–346.
doi:10.15585/mmwr.mm6912e2 .
22 March 2020.
210. Verity, Robert; Okell, Lucy C; Dorigatti,
Ilaria; Winskill, Peter; Whittaker,
Charles; Imai, Natsuko; Cuomo-
Dannenburg, Gina; Thompson, Hayley;
Walker, Patrick G T; Fu, Han; Dighe,
Amy (30 March 2020). "Estimates of
the severity of coronavirus disease
2019: a model-based analysis". The
Lancet Infectious Diseases.
doi:10.1016/s1473-3099(20)30243-
7 . ISSN 1473-3099 .
PMID 32240634 .
211. "BSI open letter to Government on
SARS-CoV-2 outbreak response" .
immunology.org. British Society for
Immunology. Archived from the
15 March 2020.
212. "Can you get coronavirus twice or
does it cause immunity?" . The
Independent. 13 March 2020.
2020.
213. Politi, Daniel (11 April 2020). "WHO
Investigating Reports of Coronavirus
Patients Testing Positive Again After
Recovery" . Slate. Retrieved 11 April
2020.
214. "They survived the coronavirus. Then
they tested positive again. Why?" .
Los Angeles Times. 13 March 2020.
2020.
215. "14% of Recovered Covid-19 Patients
in Guangdong Tested Positive
Again" . caixinglobal.com. Caixin
Global. Archived from the original on
2020.
21 . Omer, SB; Malani, P; del Rio, C (6 April
2020). "The COVID-19 Pandemic in
the US A Clinical Update". JAMA.
doi:10.1001/jama.2020.5788 .
PMID 32250388 .
217. Berger K (12 March 2020). "The Man
Who Saw the Pandemic Coming" .
Nautilus. Archived from the original
16 March 2020.
21 . Heymann DL, Shindo N (February
2020). "COVID-19: what is next for
public health?". Lancet. 395 (10224):
542–45. doi:10.1016/S0140-
6736(20)30374-3 . PMID 32061313 .
219. Wu, Yi-Chi; Chen, Ching-Sung; Chan,
Yu-Jiun (March 2020). "The outbreak
of COVID-19: An overview". Journal of
the Chinese Medical Association. 83
(3): 217–220.
doi:10.1097/JCMA.0000000000000
270 . ISSN 1726-4901 .
220. Wang, C.; Horby, P. W.; Hayden, F. G.;
Gao, G. F. (February 2020). "A novel
coronavirus outbreak of global health
concern" . Lancet. 395 (10223): 470–
473. doi:10.1016/S0140-
6736(20)30185-9 . PMID 31986257 .
221. Cohen, Jon (January 2020). "Wuhan
seafood market may not be source of
novel virus spreading globally" .
Science.
222. "Novel Coronavirus—China" .
www.who.int. 12 January 2020.
223. "Principles of Epidemiology | Lesson
3—Section 3" . www.cdc.gov. 18
224. Ritchie, Hannah; Roser, Max (25
March 2020). Chivers, Tom (ed.).
"What do we know about the risk of
dying from COVID-19?" . Our World in
Data. Archived from the original on
2020.
225. "ICD-10 Version:2019" . World Health
Organization. 2019. Archived from
Retrieved 31 March 2020. "U07.2—
COVID-19, virus not identified—
COVID-19 NOS—Use this code when
COVID-19 is diagnosed clinically or
epidemiologically but laboratory
testing is inconclusive or not
available. Use additional code, if
desired, to identify pneumonia or
other manifestations"
22 . Lazzerini, Marzia; Putoto, Giovanni
(18 March 2020). "COVID-19 in Italy:
momentous decisions and many
uncertainties" . The Lancet Global
Health. 0. doi:10.1016/S2214-
109X(20)30110-8 . ISSN 2214-109X .
PMC 7104294 . PMID 32199072 .
227. "What do we know about the risk of
dying from COVID-19?" . Our World in
2020.
22 . "Castiglione: contagiati senza
saperlo, all'Avis sono ben 40 donatori
su 60" . Il Cittadino di Lodi (in Italian).
229. Bernasconi, Francesca (2 April 2020).
"Asintomatici, ma con anticorpi: dal
loro plasma arriva la cura?" .
ilGiornale.it (in Italian). Retrieved
5 April 2020.
230. "Coronavirus, Galli: "Pronti a test a
tappeto a Castiglione d'Adda" " .
Adnkronos. Retrieved 5 April 2020.
231. "Coronavirus—Tutti gli aggiornamenti
—Comune di Castiglione d'Adda" (in
Italian). Retrieved 12 April 2020.
232. "Blood tests show 14% of people are
now immune to covid-19 in one town
in Germany" . MIT Technology
Review. Retrieved 10 April 2020.
233. "Vorläufiges Ergebnis und
Schlussfolgerungen der COVID-19
Case-ClusterStudy (Gemeinde
Gangelt)" (PDF) (in German).
13 April 2020. Retrieved 13 April
2020.
234. "r/Coronavirus - Representative
German study (n=500) finds 0.37%
CFR" . reddit. Retrieved 13 April 2020.
"The Mortality in relation to the total
population in Gangelt is currently
0.15%. Editor: This was corrected
later to 0.06%. Which is undoubtly
food for paranoid conspiracy
theorists."
235. Ellyatt, Holly (3 April 2020). "Germany
has a low coronavirus mortality rate:
Here's why" . CNBC. Retrieved
11 April 2020.
23 . "Total confirmed cases of COVID-19
per million people" . Our World in
19 March 2020. Retrieved 10 April
2020.
237. "Total confirmed deaths due to
COVID-19 per million people" . Our
World in Data. Archived from the
10 April 2020.
23 . "Novel coronavirus disease 2019
(COVID-19) pandemic: increased
transmission in the EU/EEA and the
UK—sixth update" (PDF). ecdc.
2020.
239. "Novel coronavirus named 'Covid-19':
WHO" . TODAYonline. Archived from
240. "The coronavirus spreads racism
against—and among—ethnic
Chinese" . The Economist. 17
241. "Naming the coronavirus disease
it" . World Health Organization
(WHO). Archived from the original on
13 March 2020.
242. "Virology: Coronaviruses" . Nature.
220 (5168): 650. 1968.
Bibcode:1968Natur.220..650. .
doi:10.1038/220650b0 . ISSN 0028-
0836 . PMC 7086490 .
243. Definition of Coronavirus by Merriam-
Webster , Merriam-Webster, archived
from the original on 23 March 2020,
retrieved 24 March 2020
244. Definition of Corona by Merriam-
Webster , Merriam-Webster, archived
from the original on 24 March 2020,
retrieved 24 March 2020
245. "2nd U.S. Case Of Wuhan Coronavirus
Confirmed" . NPR.org. Retrieved
4 April 2020.
24 . Jr, Donald G. McNeil (2 February
2020). "Wuhan Coronavirus Looks
Increasingly Like a Pandemic, Experts
Say" . The New York Times.
ISSN 0362-4331 . Retrieved 4 April
2020.
247. Griffiths, James. "Wuhan coronavirus
deaths spike again as outbreak
shows no signs of slowing" . CNN.
24 . "Novel Coronavirus (2019-nCoV)
SITUATION REPORT—1" (PDF). WHO.
21 January 2020.
249. "Novel Coronavirus(2019-nCoV)
Situation Report—10" (PDF). WHO.
30 January 2020.
250. "World Health Organization Best
Practices for the Naming of New
Human Infectious Diseases" (PDF).
WHO. May 2015.
251. "Naming the coronavirus disease
it" . www.who.int. Retrieved 4 April
2020.
252. "Novel Coronavirus(2019-nCoV)
Situation Report—10" (PDF). World
Health Organization (WHO). 30
January 2020. Archived (PDF) from
253. Temple, James. "How 3D printing
could save lives in the coronavirus
outbreak" . MIT Technology Review.
254. Tibken, Shara. "3D printing may help
supply more essential coronavirus
medical gear" . CNET. Retrieved
5 April 2020.
255. "[Updating] Italian hospital saves
Covid-19 patients lives by 3D printing
valves for reanimation devices" . 3D
Printing Media Network. 14 March
25 . Peters, Jay (17 March 2020).
"Volunteers produce 3D-printed
valves for life-saving coronavirus
treatments" . The Verge. Retrieved
20 March 2020.
257. "China coronavirus: Misinformation
spreads online about origin and
scale" . BBC News. 30 January 2020.
2020.
25 . Taylor, Josh (31 January 2020). "Bat
soup, dodgy cures and 'diseasology':
the spread of coronavirus
misinformation" . The Guardian.
2020.
259. Kassam, Natasha (25 March 2020).
"Disinformation and coronavirus" .
The Interpreter. Lowy Institute.
2 0. "Here's A Running List Of
Disinformation Spreading About The
Coronavirus" . Buzzfeed News.
2020.
2 1. "Coronavirus: Belgian cat infected by
owner" . Brusselstimes.com. 27
March 2020. Retrieved 12 April 2020.
2 2. Goldstein, Joseph (6 April 2020).
"Bronx Zoo Tiger Is Sick With the
Coronavirus" . The New York Times.
2 3. Shi, Jianzhong; Wen, Zhiyuan; Zhong,
Gongxun (8 April 2020).
"Susceptibility of ferrets, cats, dogs,
and other domesticated animals to
SARS–coronavirus 2" . Science.
PMID 32269068 . Retrieved 9 April
2020.
2 4. Dhama K, Sharun K, Tiwari R, Dadar
M, Malik YS, Singh KP, et al. (March
2020). "COVID-19, an emerging
coronavirus infection: advances and
prospects in designing and
developing vaccines,
immunotherapeutics, and
therapeutics" . Human Vaccines and
Immunotherapeutics: 1–7.
doi:10.1080/21645515.2020.173522
7 . ISSN 2164-5515 . PMC 7103671 .
PMID 32186952 .
2 5. Zhang L, Liu Y (March 2020).
"Potential interventions for novel
coronavirus in China: A systematic
review". Journal of Medical Virology.
92 (5): 479–90.
doi:10.1002/jmv.25707 . ISSN 0146-
6615 . PMID 32052466 .
2 . Kupferschmidt, Kai; Cohen, Jon (22
March 2020). "WHO launches global
megatrial of the four most promising
coronavirus treatments" . Science
Magazine.
2 7. Cascella M, Rajnik M, Cuomo A,
Dulebohn SC, Di Napoli R (March
2020). "Features, Evaluation and
Treatment Coronavirus (COVID-19)" .
StatPearls [Internet]. StatPearls.
PMID 32150360 . Bookshelf ID:
NBK554776.
2 . Chen WH, Strych U, Hotez PJ,
Bottazzi ME (3 March 2020). "The
SARS-CoV-2 Vaccine Pipeline: an
Overview" . Current Tropical Medicine
Reports: 1–4. doi:10.1007/s40475-
020-00201-6 . PMC 7094941 .
PMID 32219057 .
2 9. Roberts M (17 March 2020).
"Coronavirus: US volunteers test first
vaccine" . BBC News. Archived from
270. Peeples, Lynn. "News Feature:
Avoiding pitfalls in the pursuit of a
COVID-19 vaccine" . www.pnas.org.
Proceedings of the National
Academy of Sciences. Retrieved
11 April 2020.
271. "COVID-19 treatment and vaccine
tracker" (PDF). Milken Institute. 2
April 2020. Retrieved 2 April 2020.
Lay summary .
272. Selina Koch; Winnie Pong (13 March
2020). "First up for COVID-19: nearly
30 clinical readouts before end of
April" . BioCentury Inc. Retrieved
1 April 2020.
273. COVID-19 Clinical Research Coalition
(2020). "Global coalition to accelerate
COVID-19 clinical research in
resource-limited settings" . The
Lancet. doi:10.1016/s0140-
6736(20)30798-4 . ISSN 0140-6736 .
PMID 32247324 .
274. Maguire, Brittany J.; Guérin, Philippe
J. (2 April 2020). "A living systematic
review protocol for COVID-19 clinical
trial registrations" . Wellcome Open
Research. 5: 60.
doi:10.12688/wellcomeopenres.158
21.1 . ISSN 2398-502X .
275. "UN health chief announces global
'solidarity trial' to jumpstart search
for COVID-19 treatment" . UN News.
23 March 2020.
27 . Ko WC, Rolain JM, Lee NY, Chen PL,
Huang CT, Lee PI, Hsueh PR (March
2020). "Arguments in favor of
remdesivir for treating SARS-CoV-2
infections". International Journal of
Antimicrobial Agents: 105933.
33 . PMID 32147516 .
277. Wang M, Cao R, Zhang L, Yang X, Liu
J, Xu M, et al. (February 2020).
"Remdesivir and chloroquine
effectively inhibit the recently
emerged novel coronavirus (2019-
nCoV) in vitro" . Cell Research. 30 (3):
269–71. doi:10.1038/s41422-020-
0282-0 . PMC 7054408 .
PMID 32020029 .
27 . Beeching NJ, Fletcher TE, Fowler R
(2020). "BMJ Best Practices: COVID-
19" (PDF). BMJ. Archived (PDF)
279. Gao J, Tian Z, Yang X (February
2020). "Breakthrough: Chloroquine
phosphate has shown apparent
efficacy in treatment of COVID-19
associated pneumonia in clinical
studies". Bioscience Trends. 14 (1):
72–73. doi:10.5582/bst.2020.01047 .
PMID 32074550 .
2 0. Touret F, de Lamballerie X (March
2020). "Of chloroquine and COVID-
19". Antiviral Research. 177: 104762.
doi:10.1016/j.antiviral.2020.104762 .
PMID 32147496 .
2 1. multicenter collaboration group of
Department of Science Technology of
Guangdong Province Health
Commission of Guangdong Province
for chloroquine in the treatment of
novel coronavirus pneumonia
(February 2020). "[Expert consensus
on chloroquine phosphate for the
treatment of novel coronavirus
pneumonia]". Zhonghua Jie He He Hu
Xi Za Zhi = Zhonghua Jiehe He Huxi
Zazhi = Chinese Journal of
Tuberculosis and Respiratory
Diseases. 43: E019.
doi:10.3760/cma.j.issn.1001-
0939.2020.0019 . PMID 32075365 .
2 2. "Azioni intraprese per favorire la
ricerca e l'accesso ai nuovi farmaci
per il trattamento del COVID-19" .
aifa.gov.it (in Italian). Retrieved
18 March 2020.
2 3. "Physicians work out treatment
guidelines for coronavirus" .
m.koreabiomed.com (in Korean). 13
10 March 2020.
2 4. "Novel Coronavirus Pneumonia
Diagnosis and Treatment Plan
(Provisional 7th Edition)" . China Law
Translate. 4 March 2020. Archived
2 5. Denise M Hinton (28 March 2020).
"Request for Emergency Use
Authorization For Use of Chloroquine
Phosphate or Hydroxychloroquine
Sulfate Supplied From the Strategic
National Stockpile for Treatment of
2019 Coronavirus Disease" . U.S.
Food and Drug Administration.
2020.
2 . Commissioner, Office of the (29
March 2020). "Emergency Use
Authorization" . FDA. Archived from
2 7. Cao B, Wang Y, Wen D, Liu W, Wang J,
Fan G, et al. (March 2020). "A Trial of
Lopinavir-Ritonavir in Adults
Hospitalized with Severe Covid-19" .
The New England Journal of
Medicine.
doi:10.1056/NEJMoa2001282 .
PMC 7121492 . PMID 32187464 .
2 . Iwata-Yoshikawa N, Okamura T,
Shimizu Y, Hasegawa H, Takeda M,
Nagata N (March 2019). "TMPRSS2
Contributes to Virus Spread and
Immunopathology in the Airways of
Murine Models after Coronavirus
Infection" . Journal of Virology. 93
(6). doi:10.1128/JVI.01815-18 .
PMC 6401451 . PMID 30626688 .
2 9. Li G, De Clercq E. Therapeutic options
for the 2019 novel coronavirus (2019-
nCoV). Nature Reviews Drug
Discovery 2020 Feb
doi:10.1038/d41573-020-00016-0
290. BRIEF-Corrected-Zhejiang Hisun
Pharma gets approval for clinical trial
to test flu drug Favipiravir for
pneumonia caused by new
coronavirus Archived 18 March
2020 at the Wayback Machine.
Reuters Healthcare, 16 February
2020.
291. Caly, Leon; Druce, Julian D.; Catton,
Mike G.; Jans, David A.; Wagstaff,
Kylie M. (3 April 2020). "The FDA-
approved Drug Ivermectin inhibits the
replication of SARS-CoV-2 in vitro" .
Antiviral Research: 104787.
doi:10.1016/j.antiviral.2020.104787 .
PMID 32251768 – via ScienceDirect.
292. "Possible coronavirus drug identified
by Monash University scientists" .
Monash Biomedicine Discovery
Institute. 3 April 2020. Retrieved
7 April 2020.
293. Seley-Radtke, Katherine (3 April
2020). "Professor of Chemistry and
Biochemistry and President-Elect of
the International Society for Antiviral
Research, University of Maryland,
Baltimore County" . The
Conversation. Retrieved 5 April 2020.
294. Molina, Jean Michel; Delaugerre,
Constance; Goff, Jerome Le; Mela-
Lima, Breno; Ponscarme, Diane;
Goldwirt, Lauriane; de Castro,
Nathalie (March 2020). "No Evidence
of Rapid Antiviral Clearance or
Clinical Benefit with the Combination
of Hydroxychloroquine and
Azithromycin in Patients with Severe
COVID-19 Infection" . Médecine et
Maladies Infectieuses (in French):
S0399077X20300858.
doi:10.1016/j.medmal.2020.03.006 .
PMID 32240719 .
295. Yao X, Ye F, Zhang M, Cui C, Huang B,
Niu P, Liu X, Zhao L, Dong E, Song C,
Zhan S, Lu R, Li H, Tan W, Liu D
(March 2020). "In Vitro Antiviral
Activity and Projection of Optimized
Dosing Design of Hydroxychloroquine
for the Treatment of Severe Acute
Respiratory Syndrome Coronavirus 2
(SARS-CoV-2)" . Clin. Infect. Dis.
doi:10.1093/cid/ciaa237 .
PMC 7108130 . PMID 32150618 .
29 . Liu R, Miller J (3 March 2020). "China
approves use of Roche drug in battle
against coronavirus complications" .
Reuters. Archived from the original
14 March 2020.
297. "Effective Treatment of Severe
COVID-19 Patients with
Tocilizumab" . ChinaXiv.org. 5 March
2020. doi:10.12074/202003.00026
(inactive 16 March 2020). Archived
29 . "3 patients get better on arthritis
drug" . 5 March 2020. Archived from
299. "Coronavirus, via libera dell'Aifa al
farmaco anti-artrite efficace su 3
pazienti e a un antivirale: test in 5
centri" [Coronavirus, Aifa gives go-
ahead to effective anti-arthritis drug
on 3 patients and an antiviral: test in
5 centers]. Il Messaggero (in Italian).
2020.
300. "How doctors can potentially
significantly reduce the number of
deaths from Covid-19" . Vox. 12
14 March 2020.
301. Ruan Q, Yang K, Wang W, Jiang L,
Song J (March 2020). "Clinical
predictors of mortality due to COVID-
19 based on an analysis of data of
150 patients from Wuhan, China" .
Intensive Care Medicine.
doi:10.1007/s00134-020-05991-x .
PMC 7080116 . PMID 32125452 .
302. Mehta P, McAuley DF, Brown M, et al.
(16 March 2020). "COVID-19:
consider cytokine storm syndromes
and immunosuppression" . The
Lancet. 395 (10229): 1033–1034.
doi:10.1016/S0140-6736(20)30628-
0 . PMID 32192578 . Archived from
303. "China turns Roche arthritis drug
Actemra against COVID-19 in new
treatment guidelines" .
FiercePharma. Archived from the
14 March 2020.
304. Locke FL, Neelapu SS, Bartlett NL,
Lekakis LJ, Jacobson CA,
Braunschweig I, et al. (2017).
"Preliminary Results of Prophylactic
Tocilizumab after
Axicabtageneciloleucel (axi-cel; KTE-
C19) Treatment for Patients with
Refractory,Aggressive Non-Hodgkin
Lymphoma (NHL)" . Blood.
doi:10.1182/blood.V130.Suppl_1.154
7.1547 (inactive 11 April 2020).
305. Sterner RM, Sakemura R, Cox MJ,
Yang N, Khadka RH, Forsman CL, et
al. (2019). "GM-CSF inhibition
reduces cytokine release syndrome
and neuroinflammation but enhances
CAR-T cell function in xenografts" .
Blood. 133 (7): 697–709.
doi:10.1182/blood-2018-10-881722 .
PMC 6376281 . PMID 30463995 .
30 . "Northwell Health Initiates Clinical
Trials of 2 COVID-19 Drugs" . 21
23 March 2020.
307. Casadevall A, Pirofski LA (March
2020). "The convalescent sera option
for containing COVID-19" . The
Journal of Clinical Investigation. 130
(4): 1545–1548.
doi:10.1172/JCI138003 .
PMC 7108922 . PMID 32167489 .
30 . Pearce K (13 March 2020).
"Antibodies from COVID-19 survivors
could be used to treat patients,
protect those at risk: Infusions of
antibody-laden blood have been used
with reported success in prior
outbreaks, including the SARS
epidemic and the 1918 flu
pandemic" . The Hub at Johns
Hopkins University. Archived from
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Coronavirus disease

Coronavirus disease 2019 (COVID-19) is

Other names Coronavirus

Specialty Infectious diseases

Symptoms Fever, cough,

Complications Pneumonia, viral

Usual onset 2–14 days (typically

Causes Severe acute

Risk factors Travel, viral exposure

Diagnostic method rRT-PCR testing, CT

Treatment Symptomatic and

Frequency 1,859,011[7] conﬁrmed

Deaths 114,979 (6.2% of

The standard method of diagnosis is by

Recommended measures to prevent

The World Health Organization (WHO)

Signs and symptoms

Loss of smell 15[36] to 30[12][37]

Muscle or joint pain 15

Pink eyes 0.8

Those infected with the virus may be

As is common with infections, there is a

Reports indicate that not all who are

Respiratory droplets may also be produced

The virus is most contagious when people

Severe acute respiratory syndrome

SARS-CoV-2 is closely related to the

The virus also affects gastrointestinal

Autopsies of people who died of COVID-19

Although SARS-COV-2 has a tropism for

Additionally, people with COVID-19 and

CDC rRT-PCR test kit for COVID-19[76]

Diagnostic guidelines released by

Along with laboratory testing, chest CT

CT imaging of rapid progression stage

Macroscopy: pleurisy, pericarditis, lung

Inhibiting new infections to reduce the number of

Inadequate mitigation, such as premature relaxation

Preventive measures to reduce the

As a vaccine is not expected until 2021 at

According to the WHO, the use of masks is

Those diagnosed with COVID-19 or who

For areas where commercial hand

The WHO and Chinese National Health

Some medical professionals recommend

While theoretical concerns have been

Personal protective equipment

Precautions must be taken to minimise the

CDC outlines the speciﬁc guidelines for

When available, respirators (instead of

Most cases of COVID-19 are not severe

On 9 April it came to light that British and

Severe cases are most common in older

Acute respiratory distress syndrome

Mechanical ventilation becomes more

Tidal volume 6mL per kg and can be reduced to 4mL/kg

Keep below 30 cmH2O if possible (high respiratory rate (35 per

Prone positioning For worsening oxygenation

Fluid management Goal is a negative balance of 0.5–1L per day

Antibiotics For secondary bacterial infections

Glucocorticoids Not recommended

No medications are approved to treat the

The FDA has granted temporary