A Primer on COVID-19 for Clinicians: Clinical Manifestation and Natural Course

Keywords: COVID-19, Disease Progression, Symptom Assessment

Abstract

Context: COVID-19 is a new pandemic in the world and data in the various aspect of this disease are evolving. In this review, the authors try to cover different aspects of clinical manifestations and the natural course of the disease. Evidence acquisition: For data gathering, the authors searched through MEDLINE, Cochrane library, google scholar and Scopus. The key phrases for search were "clinical presentation of COVID-19", "clinical features of COVID-19", "natural course of COVID-19", "neurologic manifestation of COVID-19", "cardiovascular manifestation of COVID-19" and "gastrointestinal manifestation of COVID-19". Results: After screening of titles and abstracts, the authors finally enrolled 55 articles. Then the full texts of the selected articles were read carefully to determine eligibility and extracting relevant information. Conclusion: The most common presentations of COVID-19 patients were fever, non-producing cough and dyspnea but a considerable amount of patients may seek heath care without these complaints. Asymptomatic patients and patients with only gastrointestinal and neurologic symptoms remain a significant challenge for medical practitioners.

Downloads

Download data is not yet available.

References

1. Yu N, Li W, Kang Q, Xiong Z, Wang S, Ling X, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. Lancet Infect Dis. 2020; [Epub ahead of print].
2. Park SE. Epidemiology, virology, and clinical features of severe acute respiratory syndrome -coronavirus-2 (SARS-CoV-2; Coronavirus Disease-19). Clin Exp Pediatr. 2020; 63(4):119-24.
3. World Health Organization. Coronavirus disease 2019 (COVID-19) situation report-81. [10 April 2020]. Avalable from: http:// www.who.int/docs/default-source/coronavirus/situation-report/20200410.
4. Escalera-Antezana JP, Lizon-Ferrufino NF, Maldonado-Alanoca A, Alarcón-De-la-Vega G, Alvarado-Arnez LE, Balderrama-Saavedra MA, et al. Clinical features of the first cases and a cluster of Coronavirus Disease 2019 (COVID-19) in Bolivia imported from Italy and Spain. Travel Med Infect Dis. 2020; [Epub ahead of print].
5. Ling Z, Xu X, Gan Q, Zhang L, Luo L, Tang X, Liu J.Asymptomatic SARS-CoV-2 infected patients with persistent negative CT findings. Eur J Radiol. 2020; [Epub ahead of print].
6. Hassan SA, Sheikh FN, Jamal S, Ezeh JK, Akhtar A. Coronavirus (COVID-19): A Review of Clinical Features, Diagnosis, and Treatment. Cureus. 2020;12(3):e7355.
7. Rasmussen SA, Smulian JC, Lednicky JA, Wen TS, Jamieson DJ. Coronavirus Disease 2019 (COVID-19) and pregnancy: what obstetricians need to know? Am J Obstet Gynecol. 2020; [Epub ahead of print].
8. Jia J, Hu X, Yang F, Song X, Dong L, Zhang J, et al. Epidemiological Characteristics on the Clustering Nature of COVID-19 in Qingdao City, 2020: A Descriptive Analysis. Disaster Med Public Health Prep. 2020:1-5.
9. Song JY, Yun JG, Noh JY, Cheong HJ, Kim WJ. Covid-19 in South Korea - Challenges of Subclinical Manifestations. N Engl J Med. 2020; [Epub ahead of print].
10. Di Lorenzo G, Di Trolio R. Coronavirus Disease (COVID-19) in Italy: Analysis of Risk Factors and Proposed Remedial Measures. Front Med. 2020;7:140.
11. Wang Y, Wang Y, Chen Y, Qin Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID‐19) implicate special control measures. J Med Virol. 2020; [Epub ahead of print].
12. Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, evaluation and treatment coronavirus (COVID-19). InStatPearls [Internet] 2020 Mar 8. StatPearls Publishing.
13. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020; [Epub ahead of print].
14. Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020; [Epub ahead of print].
15. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. N Engl J Med. 2020; [Epub ahead of print].
16. Lupia T, Scabini S, Pinna SM, Di Perri G, De Rosa FG, Corcione S. 2019-novel coronavirus outbreak: A new challenge. J Glob Antimicrob Resist. 2020;21:22-7.
17. Cao J, Tu WJ, Cheng W, Yu L, Liu YK, Hu X, et al. Clinical Features and Short-term Outcomes of 102 Patients with Corona Virus Disease 2019 in Wuhan, China. Clin Infect Dis. 2020; [Epub ahead of print].
18. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223):507-13.
19. Xie M, Chen Q. Insight into 2019 novel coronavirus—an updated intrim review and lessons from SARS-CoV and MERS-CoV. Int J Infect Dis. 2020; [Epub ahead of print].
20. Mo P, Xing Y, Xiao Y, Deng L, Zhao Q, Wang H, et al. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Clin Infect Dis. 2020:ciaa270.
21. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; [Epub ahead of print].
22. Zhao D, Yao F, Wang L, Zheng L, Gao Y, Ye J, et al. A comparative study on the clinical features of COVID-19 pneumonia to other pneumonias. Clin Infect Dis. 2020:ciaa247.
23. Xu X, Yu C, Qu J, Zhang L, Jiang S, Huang D, et al. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2. Eur J Nucl Med Mol Imaging. 2020; [Epub ahead of print].
24. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
25. Adhikari SP, Meng S, Wu YJ, Mao YP, Ye RX, Wang QZ, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty. 2020;9(1):29.
26. Young BE, Ong SW, Kalimuddin S, Low JG, Tan SY, Loh J, et al. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA. 2020; [Epub ahead of print].
27. Jiang F, Deng L, Zhang L, Cai Y, Cheung CW, Xia Z. Review of the clinical characteristics of coronavirus disease 2019 (COVID-19). J Gen Intern Med. 2020; [Epub ahead of print].
28. Jin X, Lian JS, Hu JH, Gao J, Zheng L, Zhang YM, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. 2020:gutjnl-2020-320926.
29. Zhou Z, Zhao N, Shu Y, Han S, Chen B, Shu X. Effect of gastrointestinal symptoms on patients infected with COVID-19. Gastroenterology. 2020; [Epub ahead of print].
30. Pan L, Mu M, Yang P, Sun Y, Wang R, Yan J, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Am J Gastroenterol. 2020;115:10.14309/ajg.0000000000000620.
31. Tian Y, Rong L, Nian W, He Y. Gastrointestinal features in COVID‐19 and the possibility of faecal transmission. Aliment Pharmacol Ther. 2020;51(9):843-51.
32. Gupta R, Misra A. Contentious issues and evolving concepts in the clinical presentation and management of patients with COVID-19 infectionwith reference to use of therapeutic and other drugs used in Co-morbid diseases (Hypertension, diabetes etc). Diabetes Metab Syndr. 2020;14(3):251-4.
33. Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr. 2020;14(3):247-50.
34. Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020; [Epub ahead of print].
35. Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, et al. Coronavirus disease 2019 (COVID-19) and cardiovascular disease. Circulation. 2020; [Epub ahead of print].
36. Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020:e201017.
37. Tan W, Aboulhosn J. The cardiovascular burden of coronavirus disease 2019 (COVID-19) with a focus on congenital heart disease. Int J Cardiol. 2020;309: 70-7.
38. Guo J, Huang Z, Lin L, Lv J. Coronavirus Disease 2019 (COVID‐19) and Cardiovascular Disease: A Viewpoint on the Potential Influence of Angiotensin‐Converting Enzyme Inhibitors/Angiotensin Receptor Blockers on Onset and Severity of Severe Acute Respiratory Syndrome Coronavirus 2 Infection. J Am Heart Assoc. 2020;9(7):e016219.
39. Naicker S, Yang CW, Hwang SJ, Liu BC, Chen JH, Jha V. The Novel Coronavirus 2019 epidemic and kidneys. Kidney Int. 2020;97(5):824-8.
40. Baig AM. Neurological manifestations in COVID‐19 caused by SARS‐CoV‐2. CNS Neurosci Ther. 2020; 26(5):499-501.
41. Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020; [Epub ahead of print].
42. Asadi-Pooya AA, Simani L. Central nervous system manifestations of COVID-19: A systematic review. J Neurol Sci. 2020;413:116832.
43. Azhideh A. COVID-19 Neurological Manifestations. Int Clin Neurosci J. 2020;7(2):54.
44. Chen H, Guo J, Wang C, Luo F, Yu X, Zhang W, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809-15.
45. Dashraath P, Jeslyn WJ, Karen LM, Min LL, Sarah L, Biswas A, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020; [Epub ahead of print].
46. Liu Y, Chen H, Tang K, Guo Y. Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy. J Infect. 2020; [Epub ahead of print].
47. Wang L, He W, Yu X, Hu D, Bao M, Liu H, Zhou J, et al. Coronavirus Disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up. J Infect. 2020; [Epub ahead of print].
48. Lian J, Jin X, Hao S, Cai H, Zhang S, Zheng L, et al. Analysis of Epidemiological and Clinical features in older patients with Corona Virus Disease 2019 (COVID-19) out of Wuhan. Clin Infect Dis. 2020; [Epub ahead of print].
49. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020; [Epub ahead of print].
50. Li B, Shen J, Li L, Yu C. Radiographic and Clinical Features of Children with 2019 Novel Coronavirus (COVID-19) Pneumonia. Indian Pediatr. 2020; [Epub ahead of print].
51. Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 infection in children. N Engl J Med. 2020; [Epub ahead of print].
52. Choi SH, Kim HW, Kang JM, Kim DH, Cho EY. Epidemiology and clinical features of coronavirus disease 2019 in children. Clin Exp Pediatr. 2020;63(4):125-32.
53. Antonio R, Silvia M. Immunosuppression drug‐related and clinical manifestation of Coronavirus disease 2019: a therapeutical hypothesis. Am J Transplant. 2020; [Epub ahead of print].
54. Monti S, Balduzzi S, Delvino P, Bellis E, Quadrelli VS, Montecucco C. Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies. Ann Rheum Dis. 2020 May;79(5):667-8.
55. Zhang L, Zhu F, Xie L, Wang C, Wang J, Chen R, et al. Clinical characteristics of COVID-19-infected cancer patients: A retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020; [Epub ahead of print].
Published
2020-05-04
How to Cite
Naderpour, Z., & Saeedi, M. (2020). A Primer on COVID-19 for Clinicians: Clinical Manifestation and Natural Course. Advanced Journal of Emergency Medicine, 4(2s). https://doi.org/10.22114/ajem.v4i2s.418
Section
Review article