What Is COVID 19? Symptoms Testing Vaccines Prevention Everyday Health
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So far one of these medications has been granted EUA use for COVID-19, baricitinib. It blocks the activity of one or more of a specific family of enzymes, thus interfering with the pathway that leads to inflammation. The drug is sold under the name Olumiant and is FDA-approved for the treatment of rheumatoid arthritis. It is approved for use in COVID-19 only when combined with remdesivir.The combination of the two drugs was shown to reduce recovery time within 29 days compared with remdesivir alone. Immunomodulators are still actively being evaluated for their benefit in the treatment of COVID-19.
What Is COVID-19 Symptoms Testing Vaccines and Prevention
By Becky UphamMedically Reviewed by Justin Laube, MDReviewed: November 1, 2021Medically ReviewedCOVID-19, the disease caused by the new (or novel) coronavirus, has a wide range of symptoms — or, often, no symptoms at all.Everyday HealthCOVID-19 is an infectious disease caused by a new (or novel) coronavirus, SARS-CoV-2, that was first discovered in 2019 and has since killed millions of people around the world. Coronaviruses can produce a range of illnesses, from the common cold to the potentially fatal SARS (severe acute respiratory syndrome). There currently is no cure for COVID-19, but there are approved and investigational treatments. International groups of scientists have also created COVID-19 vaccines, with three extremely effective ones available in the United States as well as booster shots. While vaccines are a powerful defense against COVID-19, people can take other precautions as well, such as wearing a face covering in indoor public spaces, washing hands frequently, and social distancing (staying at least six feet away from anyone who is not part of your household).Most Recent in Coronavirus
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Signs and Symptoms of COVID-19
Many people with COVID-19 experience symptoms ranging from mild to life-threatening. Symptoms may appear 2 to 14 days after coronavirus exposure, although a significant number of people infected with the virus are asymptomatic, meaning they never develop any symptoms. According to the Centers for Disease Control and Prevention (CDC), people with these symptoms may have COVID-19:Fever or chillsCoughShortness of breath or difficulty breathingFatigueMuscle or body achesHeadacheNew loss of taste or smellSore throatCongestion or runny noseNausea or vomitingDiarrheaLoss of smell and taste is a common symptom of COVID-19. A study published in October 2020 in PLoS Medicine found that 4 out of 5 people who experienced recent loss of smell or taste tested positive for coronavirus antibodies (proteins produced by the immune system to fight infection), and nearly 40 percent of those did not have the symptoms of cough or fever. more on CoronavirusFrom Nose to Toes the List of COVID-19 Symptoms Keeps Growing
The authors concluded that people who notice that they can’t smell common odors such as garlic and coffee should self-isolate (stay away from other people and pets) and get tested for COVID-19.Research published in the Journal of Internal Medicine in January 2021 found that 86 percent of people with a mild case of COVID-19 lost their sense of taste and smell compared with only 4 to 7 percent of people with a moderate to severe case of the coronavirus. Although rashes aren’t on the CDC list, dermatologists have identified a phenomenon called "COVID toes" — red lesions similar to chilblains that can appear on the hands and feet of people who are infected with the virus. A study published June 20, 2020, in the British Journal of Dermatology reported a likely causal relationship between SARS-CoV-2 and COVID toes. There is still debate in the scientific community whether there is a true association between COVID-19 and chilblains, and more research is needed.How Much Do You Know About the Coronavirus
By Christina VogtMedically Reviewed by Justin Laube, MDReviewed: October 28, 2021Start QuizCauses and Risk Factors of COVID-19
COVID-19 mainly spreads by way of respiratory droplets or small airborne particles (aerosols) that are produced when a person coughs, sneezes, or talks. If these coronavirus-laden droplets land in a nearby person’s nose or mouth or are inhaled into the lungs, that person could become infected, according to the CDC.The CDC says that the risk of transmission is highest within three to six feet of an infected person, but adds, “Although infections through inhalation at distances greater than six feet from an infectious source are less likely than at closer distances, the phenomenon has been repeatedly documented under certain preventable circumstances.” Because of aerosols, indoor environments without good ventilation increase the risk of viral spread. Respiratory droplets and aerosols can land on surfaces, which means that people may get COVID-19 by touching contaminated objects and then touching their own mouth, nose, or eyes. But the CDC says that the risk of this kind of transmission is low.Older Adults Are at Higher Risk for COVID-19
Older people who contract COVID-19 are at higher risk for developing a more severe case than younger people. As people age, their immune systems weaken. Older people are also more likely to have chronic conditions that can make it harder for them to recover from COVID-19, according to Johns Hopkins Medicine. More than 81 percent of COVID-19 deaths occur in people over age 65, says the CDC, adding that the number of deaths among seniors is 65 to 80 times higher than the number of deaths among people ages 18 to 29.Medical Conditions and COVID-19 Risk
Certain chronic diseases are known to increase the chances a person will have severe illness from COVID-19, leading to hospitalization, the need for a ventilator, or even death. According to the CDC, the conditions that demonstrably increase risk in adults of any age include: CancerChronic kidney diseaseChronic liver diseaseChronic lung disease, including asthma, COPD (chronic obstructive pulmonary disease), and cystic fibrosisDementia and other neurological conditionsDiabetes (type 1 or type 2)Down syndromeHeart conditions including heart failure, coronary artery disease, cardiomyopathies (diseases that affect the heart muscle), and possibly hypertension (high blood pressure)HIV infectionImmunocompromised state (weakened immune system)Mental health conditions, such as depression and schizophreniaObesity and overweightPregnancySickle cell disease or thalassemiaSmoking, either presently or in the pastSolid organ or blood stem cell transplantStroke or cerebrovascular diseaseSubstance use disordersTuberculosis Many people have multiple underlying conditions, such as obesity and diabetes. The more underlying conditions a person has, the higher their risk of severe COVID-19. While children are generally less affected by COVID-19 than adults, they can become infected with the virus, and some will develop serious illness. Children at increased risk of severe COVID-19 include those with complex medical problems; neurological, genetic, or metabolic conditions; congenital heart disease; or any of the conditions listed above, such as diabetes or obesity.Editor' s Picks
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How Contagious Is COVID-19
The virus that causes COVID-19 can spread more efficiently than the seasonal flu, says the CDC.In general, the closer and more prolonged an interaction with an infected person, the greater the likelihood of COVID-19 transmission, according to the CDC. The delta variant, which is currently the dominant variant, is more than twice as contagious as earlier forms of the coronavirus and causes more infections. Even so, COVID-19 vaccines continue to provide powerful protection against hospitalization and death.Person-to-Person Transmission
COVID-19 is primarily spread through respiratory droplets and aerosols produced when an infected person coughs, sneezes, or talks. Transmission can occur when these virus-laden droplets or aerosols land in someone else’s eyes, nose, or mouth or are inhaled, according to the CDC.The aerosols that are produced by a person with COVID-19 can remain suspended in the air, travel distances beyond six feet, and be breathed in by others, scientists have found. People can spread the virus without having symptoms. According to studies cited by the CDC in a brief on the effectiveness of mask wearing, it’s estimated that asymptomatic or presymptomatic cases are responsible for more than 50 percent of transmissions of the virus. While vaccines are helping guard against so-called superspreading events, in which one person infects a large number of others, individuals living in areas where immunization rates are low continue to be at risk, particularly in light of the ultracontagious delta variant. In July 2021, more than 125 campers and adults who attended a summer camp run by a South Texas church camp tested positive for COVID-19, CNN and other news media reported.What Is Community Spread
In the event that someone tests positive for COVID-19, health officials try to determine how the person contracted the disease. If the source of the illness is unknown, this is called community spread. The CDC first confirmed a possible instance of community spread in the United States on February 26, 2020.What Is Herd Immunity
Herd immunity, also known as population immunity, means that people in a community are largely protected from getting an infectious disease such as COVID-19 because enough of them have already had it or because they’ve received a vaccine. Achieving herd immunity is important because it means COVID-19 cannot spread readily, so even those who can’t be vaccinated, such as newborns, are protected. When SARS-CoV-2 first appeared, essentially no one was immune; the virus could spread quickly from person to person. According to many experts, achieving herd immunity against COVID-19 might require as much as 85 percent of the population to be vaccinated or develop natural immunity by becoming infected with the coronavirus.In an interview with CNBC News in September, Anthony Fauci, MD, the government’s top infectious disease expert, gave estimates of “75, 80, 85 percent” and “75 to 80-plus percent.”What Is the Incubation Period for COVID-19
The incubation period is the time from when a person was exposed to the virus until the first symptoms develop. The median incubation period for COVID-19 is four to five days from exposure; close to 98 percent of all people who develop symptoms do so within 11.5 days of the infection.New Coronavirus Variants
All viruses, including the virus that causes COVID-19, constantly change by mutating, creating new variants. These new variants can emerge and disappear or emerge and begin to spread. New variants of SARS-CoV-2, the virus that causes COVID-19, present a global threat. The current “variant of concern” is delta, which was first identified in India and which spreads much faster than other variants and may cause more severe cases. While the three COVID-19 vaccines available in the United States provide strong protection against serious illness and death caused by delta, so-called breakthrough infections do occur. One reason to immunize as many people as possible is to prevent new variants from emerging that might be more dangerous and better able to elude the current vaccines.How Long Does COVID-19 Last on Surfaces
It’s possible to get COVID-19 by touching a surface contaminated with the virus, then touching your mouth, nose, or eyes, but this isn’t the main way the coronavirus spreads, according to the CDC. In fact, the CDC says your odds of catching COVID-19 from a contaminated surface are less than 1 in 10,000. To reduce the risk of contracting COVID-19 from a surface, the CDC recommends that people practice frequent hand-washing with soap and water for at least 20 seconds. If soap and water aren’t available, hand sanitizer that contains at least 60 percent alcohol is the next best way to get rid of germs. And when it comes to cleaning at home, the CDC says that disinfecting to reduce the spread of COVID-19 is likely unnecessary unless someone living in your home has COVID-19, or someone who tested positive for COVID-19 was in your home within the past 24 hours.Can COVID-19 Be Spread Through Food and Groceries
Although surfaces may pose a COVID-19 risk, the CDC released a statement in May that the primary and most important way that the virus spreads is through close person-to-person contact. According to the shopping-for-food guidelines issued by the U.S. Food and Drug Administration (FDA), there is no evidence of food packaging being associated with the transmission of COVID-19.Testing for COVID-19 What Are the Types of COVID-19 Tests
The three types of tests for the novel coronavirus are molecular tests (also called PCR tests), antigen tests, and antibody tests.Molecular Tests
These tests are diagnostic or viral tests that are used to determine if someone is currently infected with COVID-19. A molecular test, such as a reverse transcription polymerase chain reaction (RT-PCR) test, detects the virus’s genetic material. Specimens can be collected with a nasal or throat swab or through a saliva sample.Antigen Tests
Antigen tests look for specific proteins from the virus. Although not as accurate at RT-PCR tests, they don’t require as much equipment and the results can usually be delivered faster. Both molecular and antigen tests for COVID-19 are available as at-home collection kits (usually with a doctor’s prescription) where a sample is collected at home and mailed to a lab for results.The FDA has also given the nod to several over-the-counter, at-home coronavirus testing kits that provide results in approximately 15 to 30 minutes.Antibody Tests
These tests use a finger prick or blood draw to look for antibodies — evidence that a person’s body has formed an immune response to the infection, which would indicate that a person had the virus and recovered. Antibody tests (also called serology tests) can be used to better determine the total number of cases of COVID-19 in a particular area.This test only shows if you’ve had the virus in the past — if you have the test when you first develop COVID-19, it might not detect antibodies, according to the FDA.How Reliable Are the Tests for COVID-19
There are hundreds of authorized diagnostic tests for COVID-19, all with different levels of accuracy. Additional factors can influence whether the results are correct, including the following: The quality of the specimen takenHow the specimen was stored before testingIf the person taking the test has symptomsHow much virus the person shedsPeople who are early or late in the course of their illness with COVID-19 In general, molecular tests using a nasal swab are the gold standard because they are the most accurate.Repeat testing with antigen kits can help compensate for their lower sensitivity; plus they are valuable when getting a speedy result is vital.Editor' s Picks
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When it comes to how long a person might feel sick with COVID-19, there is a broad spectrum. “Some people never feel sick or have symptoms — that’s one extreme,” says David Lee Thomas, MD, MPH, the director of the division of infectious diseases and a professor of medicine at Johns Hopkins Medicine in Baltimore. “On the other side, you have individuals who were infected with the virus over three months ago and have not stopped feeling sick.”People with a mild case of COVID-19 usually recover within one to two weeks, according to Johns Hopkins Medicine. For those with a severe case, the illness may last six weeks or longer, and could lead to lasting damage to the heart, kidney, lungs, and brain.COVID-19 Long-Haulers
Some people who become ill with COVID-19 continue to experience symptoms for weeks and even months after they are diagnosed, perplexing their doctors. Research published in JAMA Network Open in February 2021 found that as many as 1 in 3 COVID-19 outpatients in the study developed persistent symptoms after the initial infection, including extreme fatigue, loss of sense of smell or taste, and “brain fog.” There are at least two Facebook support groups and a Slack channel called Body Politic on which people with “long COVID” share their experiences and talk about techniques that have helped them cope.Vaccines and Treatments for COVID-19
Here’s a rundown of the different ways to fight COVID-19.COVID-19 Vaccine Update
In December 2020, the FDA issued emergency use authorizations (EUAs) for the Pfizer-BioNTech and Moderna vaccines. The Pfizer vaccine received full FDA approval in August 2021.Both companies completed large trials in which researchers gave the vaccine to tens of thousands of subjects and monitored how many people became infected with the virus compared with volunteers who received a placebo. The Pfizer-BioNTech vaccine was found to be 95 percent effective in preventing symptomatic COVID-19 among clinical trial participants. The vaccine developed by Moderna was found to be 94.5 percent effective.How Was the COVID-19 Vaccine Developed So Quickly
The Pfizer and Moderna vaccines both use a genetic molecule called messenger RNA (mRNA). The mRNA gives instructions to human cells to create a harmless piece of what is called a spike protein, similar to a protein on the surface of the coronavirus, according to the CDC. This triggers the immune system to create antibodies against the coronavirus. The Pfizer vaccine is approved for people ages 5 and older, and the Moderna vaccine is authorized for those 18 and older.The FDA issued an EUA for a third vaccine, by the Johnson & Johnson (J&J) subsidiary Janssen, in February 2021. The J&J vaccine involves a single jab, unlike the Pfizer and Moderna vaccines, which are administered in two doses spaced several weeks apart. The J&J vaccine was found to be 85 percent effective in preventing severe COVID-19 in international trials; in U.S. trials, it proved to be 72 percent effective at preventing mild to severe COVID-19.While the Pfizer and Moderna vaccines use mRNA, the J&J vaccine employs a genetically modified adenovirus — the type of virus that causes many common colds — to instruct cells to produce a piece of the spike protein. While the vaccines are somewhat less effective overall against the delta variant, they continue to provide strong protection against hospitalization and death.So-called “adverse effects” of COVID-19 vaccination are rare, and in the United States include: Anaphylaxis (severe allergic reaction), occurring in approximately 2 to 5 people per millionThrombosis with thrombocytopenia syndrome (blood clots with low platelets) after J&J vaccination, with 47 confirmed reports out of 15.3 million doses administered as of October 20, 2021Guillain-Barré syndrome after J&J vaccination, with 238 preliminary reports out of 15.3 million dosesMyocarditis and pericarditis (heart inflammation issues), with 963 confirmed reports out of 15.3 million dosesCOVID-19 Booster Shots
In September and October 2021 the U.S. government issued a set of recommendations for COVID-19 booster shots, to counter the waning effectiveness of the vaccines over time and the threat of the delta variant. For individuals immunized with the Pfizer or Moderna vaccine, the FDA and CDC recommend boosters for those who are 65 and older; those 18 and older with underlying health conditions that increase their risk of severe COVID-19; and those 18 and older who are at higher risk of exposure to COVID-19 because of their jobs or living situation. These people should get their booster no sooner than six months after completing their initial vaccination.Acknowledging that the one-shot Johnson & Johnson vaccine is less effective than the two-dose Pfizer or Moderna, the federal agencies recommend boosters for everyone age 18 and older who received a J&J vaccine more than two months prior.COVID-19 Vaccines and Boosters for People Who Are Moderately to Severely Immunocompromised
Individuals who are moderately to severely immunocompromised are at particular risk from COVID-19 because they may not be able to develop strong immunity in response to vaccination. Based on CDC guidelines, those 18 and over are eligible for a third shot of either a Pfizer of Moderna vaccine at least 28 days after completing their initial two-dose regimen and may opt to get a fourth shot at least six months later.The CDC recommends that individuals in this moderately to severely immunocompromised group who initially received a Johnson & Johnson vaccine get a second shot at least two months after receiving their primary dose. People in this highly vulnerable group, age 18 and up, include those who have: Been receiving active cancer treatment for tumors or cancers of the bloodReceived an organ transplant and are taking medicine to suppress the immune systemModerate to severe primary immunodeficiency (such as DiGeorge syndrome)Advanced or untreated HIV infectionActive treatment with high-dose corticosteroids or other drugs that may suppress the immune responseMedications for COVID-19
Medications for COVID-19 work in one of three ways: They keep the virus from entering cells, prevent the virus from replicating in cells, or minimize the damage the virus inflicts on the organs. “There are quite a variety of compounds currently under investigation,” says Rama Mallampalli, MD, the chair of the department of internal medicine at the Ohio State University College of Medicine in Columbus. “Many anti-inflammatory and antiviral medications that have been approved by the FDA in the past for other illnesses are being redeployed for COVID-19.”Currently there is one FDA-approved medication for COVID-19 and several drugs, biological products, and combination therapies that are authorized by the FDA for emergency use, with varying levels of effectiveness and safety. These include: Remdesivir This antiviral medication became the first FDA-approved treatment for COVID-19 in October 2020. It is used to treat adults and children over the age of 12 who are hospitalized due to COVID-19.Monoclonal Antibodies These laboratory-produced molecules act as supplemental antibodies.COVID-19 Convalescent Plasma Antibody-rich plasma from people who have recovered from COVID-19 can help currently infected people mount an immune response.Baricitinib (Olumiant) in Combination With Remdesivir Olumiant is an immune modulator used in rheumatoid arthritis.Remdesivir and Other Antivirals
Antivirals kill or prevent the growth of viruses by targeting a specific part of the life cycle that is necessary for them to reproduce, according to Harvard Medical School. Drugs that were designed to treat other viral infections (such as different types of hepatitis or HIV) are being studied to see if they can help fight the coronavirus. As of October 2021, close to 600 studies are underway to evaluate antivirals’ efficacy against the infection that causes COVID-19. One key trial, published in The New England Journal of Medicine on November 5, 2020, found that the antiviral remdesivir was superior to placebo in shortening recovery time for adults hospitalized with COVID-19 who had lower respiratory tract infection. Expectations are high for an antiviral pill called molnupiravir, which drug companies Merck and Ridgeback say can cut the risk of hospitalization or death from COVID-19 in half for adults with mild or moderate disease who are at high risk for developing severe illness. The FDA will meet on November 30 to discuss emergency use authorization.Meanwhile, Pfizer has been developing its own protease-inhibitor antiviral called Paxlovid. In clinical trials results released on November 5, 2021, the new drug reduced hospitalizations by 89 percent compared to placebo and completely prevented death. Unlike Merck's molnupiravir, however, Paxlovid must be given with a booster drug called ritonavir to prevent the body from breaking down the antiviral too quickly.Corticosteroids
Steroids, which are commonly prescribed for allergies or asthma, have been successfully used in treating hospitalized people with COVID-19, says Dr. Mallampalli. “Steroids have been shown to help people who were on oxygen to not get worse and have to go on respirators, and they helped prevent death in people who were already on respirators,” he says.The synthetic steroid dexamethasone reduced the death of COVID-19 patients on ventilators by one-third in the University of Oxford’s RECOVERY study, according to a report by the investigators published in February 2021 in The New England Journal of Medicine.Monoclonal Antibodies
Monoclonal antibodies are laboratory-made molecules designed to serve as substitute antibodies that can restore, enhance, or imitate the immune system’s attack against certain diseases, including COVID-19. These treatments work by helping the body’s natural immune defense against COVID-19.Several monoclonal antibody treatments are authorized for people with mild or moderate COVID-19 who are at high risk for developing severe disease. These treatments include the combination of bamlanivimab and etesevimab; the combination of casirivimab and imdevimab (REGEN-COV2); and the monoclonal antibody sotrovimab (Xevudy).Convalescent Plasma
“The use of convalescent plasma is not a new idea — it’s been around for about 100 years. It’s been used for other coronaviruses, such as severe acute respiratory syndrome (SARS) and Middle East respiratory virus (MERS),” says Mallampalli. This method works by taking plasma from people who have recovered from infection and giving it to people who are critically ill, explains Mallampalli. “At first, this therapy was reserved for the most severely ill patients, but now inventory of the plasma is higher,” he says.The FDA issued an emergency use authorization for convalescent plasma in August 2020 based on evidence that it “may be effective in lessening the severity or shortening the length of COVID-19 illness in some hospitalized patients,” according to an FDA statement.Immune Modulators and Cytokine Storms
In an acute reaction to the COVID-19 infection, the body produces different substances, including compounds called cytokines. Although cytokines play an important role in normal immune responses, some people make them in very large amounts, a phenomenon called a cytokine storm. This extreme immune response can be a life-threatening complication of COVID-19.Scientists are testing certain immune modulators to find out if they decrease the production of inflammation without interfering with other important immune functions, according to a study published in May 2020 in Lancet Rheumatology.So far one of these medications has been granted EUA use for COVID-19, baricitinib. It blocks the activity of one or more of a specific family of enzymes, thus interfering with the pathway that leads to inflammation. The drug is sold under the name Olumiant and is FDA-approved for the treatment of rheumatoid arthritis. It is approved for use in COVID-19 only when combined with remdesivir.The combination of the two drugs was shown to reduce recovery time within 29 days compared with remdesivir alone. Immunomodulators are still actively being evaluated for their benefit in the treatment of COVID-19.