What physicians need to know about coronavirus

Residency Program Insider, February 13, 2020

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A recent article published by the Journal of the American Medical Association provides clinical insights about the new coronavirus outbreak that started in China.

As of February 13, more than 60,000 cases of infections had been reported, with the vast majority of the cases in China, and the virus had been tied to more than 1,300 deaths, according to CBS News. A CDC webpage has updated information about the spread of 2019-nCoV and the response to the epidemic.

The JAMA article features several key points of information for clinicians:

  • One study reported the incubation period for coronavirus is 5.2 days, but it could be as long as 14 days. It is possible that the virus can be transmitted when an infected person is asymptomatic, but it is likely that most transmission occurs when an infected person is symptomatic.
  • A study of 99 coronavirus patients in Wuhan found that most symptomatic people presented with fever and dry cough, with shortness of breath experienced by nearly a third of patients. Other symptoms included headache, sore throat and diarrhea. The study found the average age of patients was 55.5 years old. There have been few cases reported in children.
  • Clinicians should obtain a travel history when patients have fever and respiratory symptoms, especially a dry cough. If these patients have a history of travel to Hubei Province in the prior 14 days, they should be considered a person under investigation (PUI).
  • If a PUI presents, clinicians should report the case as soon as possible to their healthcare facility's infection prevention staff and to local or state health departments. Currently, the CDC is conducting all diagnostic testing for coronavirus. Clinicians should test PUIs for other respiratory pathogens, and they should consider prescribing oseltamivir until influenza testing is completed.
  • If there is a high level of suspicion that a PUI has coronavirus, the patient should don a face mask immediately and caregivers should wear N95 respirators.
  • There is no vaccine for coronavirus and no medications have been proven effective against the virus. Care has been mainly supportive. The antiviral remdesivir was prescribed for the first U.S. coronavirus patient.

Source: HealthLeaders Media

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