- Fever (>100.4F)
- Fatigue and Myalgia (muscle pain)
- Dry Cough
- Loss of appetite
- Sputum production
- Loss of taste and smell
Associated with severe disease:
- Shortness of breath
- Upper respiratory tract symptoms (nasal congestion, nasal discharge, and sore throat)
- Gastrointestinal symptoms (abdominal pain and diarrhea)
- Male > Female
- Comorbidities: hypertension, diabetes, cardiovascular disease, COPD, malignancy (3)
- No or low fever
- Age > 50
- Severe Pneumonia
- Pulmonary Edema
- Acute respiratory distress syndrome (ARDS)
- Multiple organ failure possibly related to multi-clotting
- Suplemental oxygen
- Mechanical ventilation
- Trials of the following ongoing:
• Antivirals: lopinavir and ritonavir, Interferon
• Hydroxychloroquine (Plaquinil) or Chloroquine (considered in combination with azithromycin)
DIFFERENCES IN THE YOUNG AND OLD
- Lower virus fighting white blood cells
- Higher inflammatory mediators in lungs
- Males > Females
- Worse outcome with low or no fewer
• Most common: fever, cough
• Less common: diarrhea (15%), nasal discharge (15%), sore throat (5%), vomiting (10%), tachypnea (rapid breathing) (10%), and fatigue (5%)
- Median age of 2-3 years
- Males > Females
- In an observational study of 20 pediatric patients with confirmed SARS-COV-2 pneumonia, Procalcitonin (PCT) was increased in 16/20 or 80% of cases. This marker rises in response to bacterial infections suggesting a possible confection in these children may explain the development in pneumonia.
These observations suggest that the SARS-COV-2 virus is more virulent in older populations due to a combination of factors.
- Lower numbers of lymphocytes seen in older populations with SARS-COV-2 suggests that the infection overwhelms the immune system.
- Higher levels of inflammatory mediators suggests that older populations have an inflated inflammatory response and/or weak anti-inflammatory/anti-oxidant control and this leads to more severe cases of respiratory distress and need for intervention.
Other viral illnesses the create a milder course in children: Varicella zoster, the virus that causes the chicken pox produces a mild illness in children but can cause pneumonia in adults.