The CDC is no longer reporting the number of patients under investigation for COVID-19 or patients who have tested negative for the virus.
“With more and more testing done at states, these numbers would not be representative of the testing being done nationally,” said Nancy Messonnier, MD, director of the Center for the National Center for Immunization and Respiratory Diseases (NCIRD) at the CDC.
Health officials in Washington state reported Saturday that a man in his 50s with underlying health conditions died at a hospital in Kirkland after testing positive for COVID-19, the first reported fatality from the virus in the U.S.10
Transmission and systemic manifestations
There is growing evidence the COVID-19 virus is transmitted human-to-human among close contacts.8 The route of transmission of COVID-19 is not yet fully known, but it is thought to be mainly respiratory.11
Comparisons are being made to severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), as both were caused by a coronavirus. SARS emerged in 2003 and caused the first pandemic of the 21st century, infecting more than 8000 people and killing 774 in 26 countries.12 MERS coronavirus was isolated in 201213 with over 2,400 reported cases and over 850 deaths.14
The CDC currently believes symptoms of COVID-19 may appear in as few as two days or as long as two weeks, with median estimates of five to six days post exposure based on what has been previously seen as the incubation period of the MERS virus. Symptom onset include fever, cough, fatigue, and shortness of breath.15 Sore throat has also been reported in some patients early in the clinical course of the disease. Less commonly reported symptoms include nausea, diarrhea, headache, and sputum production with or without blood.16
In more severe cases, COVID-19 infection can cause pneumonia, SARS, kidney failure, and death.17
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2. Huang C , Wang Y , Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506.
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4. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) Situation Summary. Available at: https://www.cdc.gov/coronavirus/2019-ncov/summary.html. Accessed 3/3/20.
5. World Health Organization. Coronavirus disease (COVID-19) outbreak.
Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed 3/3/20.
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9. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) in the U.S. Available at: https://www.cdc.gov/coronavirus/2019-nCOV/cases-in-us.html. Accessed 3/3/20.
10. Centers for Disease Control and Prevention Transcript for the CDC Telebriefing Update on COVID-19. Available at: https://www.cdc.gov/media/releases/2020/t0303-COVID-19-update.html. Accessed 3/4/20.
11. Bellware K, Achenbach J, Mettler K, et al. Coronavirus live updates. Wash Post. Available at: https://www.washingtonpost.com/world/2020/03/01/coronavirus-live-updates/. Accessed 3/5/20.
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13. Peiris JSM, Yuen KY, Osterhaus AD, Stöhr K. The severe acute respiratory syndrome. N Engl J Med. 2003 Dec 18;349(25):2431-41.
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16. Centers for Disease Control and Prevention. About Coronavirus Disease 2019 (COVID-19). Available at: https://www.cdc.gov/coronavirus/2019-ncov/about/index.html. Accessed 3/4/20.
17. American Optometric Association. Health Policy Institute. Statement: Doctors of Optometry and COVID-19. Available at: https://www.aoa.org/documents/HPI/HPI%20CoronaVirus%20Statement%201-30-2.... Accessed 3/4/20.
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21. Li JO, Lam DSC, Chen Y, Ting DSW. Novel Coronavirus disease 2019 (COVID-19): The importance of recognizing possible early ocular manifestation and using protective eyewear. Br J Ophthalmol. 2020 Mar;104(3):297-298.
22. US. Food & Drug Administration. Coronavirus (COVID-19) Update: FDA and CDC take action to increase access to respirators, including N95s, for health care personnel. Available at: http://s2027422842.t.en25.com/e/es?s=2027422842&e=307673&elqTrackId=376c.... Accessed 3/4/20.
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24. National Institutes of Health. NIH clinical trial of remdesivir to treat COVID-19 begins.
Available at: https://www.nih.gov/news-events/news-releases/nih-clinical-trial-remdesi.... Accessed 3/4/20.
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