IMMUNITY

Antibodies to the virus are induced in those who have become infected. Preliminary evidence suggests that some of these antibodies are protective, but this remains to be definitively established. Moreover, it is unknown whether all infected patients mount a protective immune response and how long any protective effect will last. Data on protective immunity following COVID-19 are emerging. The FDA has approved a test that qualitatively identifies immunoglobulin (Ig)M and IgG antibodies against SARS-CoV-2 in serum or plasma. Should evidence confirm that the presence of these antibodies reflects a protective immune response, serologic screening will be an important tool to understand population immunity and distinguish individuals who are at lower risk for reinfection.

Severe illness can occur in otherwise healthy individuals of any age, but it predominantly occurs in adults with advanced age or underlying medical conditions that have been associated with severe illness and mortality. 

• • • Cardiovascular disease
    • Diabetes mellitus
    • Hypertension
    • Chronic lung disease
    • Cancer
    • Chronic kidney disease

The United States Centers for Disease Control and Prevention (CDC) also includes immunocompromising conditions, severe obesity (body mass index ≥40), and liver disease as potential risk factors for severe illness, although specific data regarding risks associated with these conditions are limited.

Symptoms usually start 4 or 5 days after a person is infected with the virus. But in some people, it can take up to 2 weeks for symptoms to appear. Symptoms can include:

• • • Fever
    • Dry cough
    • Feeling tired
    • Muscle aches
    • Trouble breathing

Although less common, some people have other symptoms, such as headache, sore throat, runny nose, or problems with their sense of smell or taste. For most people, symptoms will get better within a few weeks. Some people even show no symptoms at all. But in others, COVID-19 can lead to serious problems.

TESTING

As of today, COVID-19 testing is not readily available — In some cases, testing for COVID-19 may not be accessible, particularly for individuals who have a compatible but mild illness that does not warrant hospitalization and do not have a known COVID-19 exposure or high-risk travel history.

In the United States, there is limited official guidance for this situation. If the clinician has sufficient concern for possible COVID-19, it is reasonable to assume the patient had COVID-19 and advise the patient to self-isolate at home (if hospitalization is not warranted) and alert the clinician about worsening symptoms.

TREATMENT

There is no known specific treatment for COVID-19. Many people will be able to stay home while they get better, but people with serious symptoms or other health problems might need to go to the hospital:

Mild illness – Mild illness means you might have symptoms like fever and cough, but you do not have trouble breathing. Most people with COVID-19 have mild illness and can rest at home until they get better. This usually takes about 2 weeks, but it’s not the same for everyone.

Severe illness – If you have more severe illness with trouble breathing, you might need to stay in the hospital, possibly in the intensive care unit (also called the “ICU”). While you are there, you will most likely be in a special isolation room. Only medical staff will be allowed in the room, and they will have to wear special gowns, gloves, masks, and eye protection.