WHAT IS CORONAVIRUS?

By: Colleen Doherty, MD 

 1/31/2020 UPDATE: The newest strain of coronavirus, called 2019-nCoV, surfaced in Wuhan, China, at the end of 2019. The Centers for Disease Control and Prevention (CDC) has confirmed six cases to date in the United States, but has only detected one instance of person-to-person spread in this country. Therefore, 2019-nCoV is not considered to be spreading among communities in the U.S. at this time. CDC monitoring is ongoing.

Coronavirus is a common family of viruses named for its appearance of having a crown (corona in Latin means “crown”). The crown is composed of a protein, called the spike protein, that sticks out from the virus’s surface.1

There are different types of coronaviruses, and while the majority typically cause mild cold symptoms (e.g., runny nose or sore throat), more dangerous types, like the coronaviruses that cause Middle East respiratory syndrome (MERS) or Severe Acute Respiratory Syndrome (SARS), may cause more severe disease, including pneumonia, and even death.

It is impossible to tell the difference between coronavirus infections and other illnesses based on symptoms alone. While doctors need to take a careful history and perform a physical exam, laboratory tests are needed to accurately diagnose coronavirus infections.

At this time, there are no medicines a person can take to prevent or treat the virus itself. Treatment for coronavirus infections is supportive, which means that the patient is supported while the infection runs its course and the body’s immune system clears the infection.

Types and Transmission:

Coronaviruses belong to the family Coronaviridae, and there are seven types that can infect humans.2

Types:

Four common types of human coronaviruses cause symptoms of the common cold.

These four coronaviruses—229E, NL63, OC43, HKU1—are often referred to as community-acquired coronaviruses because they are common and infect people all over the world.3

The other three coronaviruses are more worrisome because they have been linked to severe complications, like pneumonia and death.

These three coronaviruses include:

  • 2019 novel coronavirus (2019-nCoV)
  • Severe acute respiratory syndrome coronavirus (SARS-CoV)
  • Middle East respiratory syndrome (MERS-CoV)

Transmission:

In the United States, the coronavirus most commonly infects people in the fall and winter.4

Ways in which the virus can spread from person to person include the following forms of contact:

  • Droplets (after someone who has the virus coughs or sneezes)
  • Touch (e.g., shaking hands with an infected person or touching an object that contains the virus and then touching your mouth, eyes, or nose prior to washing your hands)
  • Feces (fecal-oral spread from infected patients; rare)

Symptoms:

The four community-acquired coronaviruses usually cause “cold” symptoms in the upper respiratory tract, such as:5

  • Runny nose
  • Cough
  • Sore throat
  • Fever
  • Headache
  • Malaise

Sometimes, the coronavirus can affect your respiratory system and complications, like pneumonia or bronchitis, may develop.

These complications are more common in babies and the elderly, as well as people with a suppressed immune system or an underlying heart or lung disease.

MERS-CoV and SARS-CoV:

These serious types of coronaviruses jumped from animals to humans, and are potentially life-threatening.2

According to the Centers for Disease Control and Prevention (CDC), MERS-CoV usually causes fever, cough, and trouble breathing, which often then leads to pneumonia. Thirty to 40 percent of people with MERS coronavirus have died.5

SARS-CoV causes a similar illness of fever, chills, body aches, and respiratory infection which can be fatal.

There are still cases of MERS, mostly in the Arabian peninsula. There have been no cases of SARS in the world since 2004.

2019 Novel Coronavirus (2019-nCoV):

At the end of 2019, a new coronavirus, called 2019-nCoV, surfaced in Wuhan, China. Similar to MERS and SARS, this coronavirus likely jumped from an animal (probably a bat, although scientists are not completely certain) to a human, perhaps via some other species. 6

It appears that the 2019-nCoV infection is causing a severe respiratory (lung) illness similar to SARS. Common initial symptoms of the infection include fever, cough, fatigue, and muscle aches.7 Available data suggests while the disease can be severe and even fatal, it may not have as high a mortality rate as MERS or SARS. The medical community is still trying to get accurate data early in this outbreak.

Diagnosis:

The diagnosis of a routine coronavirus infection (cold symptoms) involves a medical history, including travel history, and a physical examination. Most often, the patient will be diagnosed with a cold, and sent home.

If your symptoms are severe, your healthcare team may order tests to specifically check for the virus. This is done by taking a sample of your blood and/or a swab from your nose or throat.

With the new concern for 2019-nCoV infections, symptomatic patients and their doctors have to be careful to obtain a travel history to China or other infected regions, or a history of contacts with other people who may have been exposed. Laboratory testing for 2019-nCoV is currently being coordinated with public health offices and the CDC.

Treatment:

There is no vaccine or specific medicine to treat coronavirus. Instead, the treatment for mild coronavirus infections is supportive, which means doing things to ease your symptoms.8

These supportive measures may include:

  • Taking a medication, like Tylenol (acetaminophen), to reduce your fever
  • Using a cool-mist humidifier to help soothe your cough
  • Rest
  • Drinking fluids

Important Note:

Do not give your child or teenager aspirin or aspirin-containing products due to their risk of Reye syndrome, a potentially fatal condition.

SARS, MERS, and illnesses caused by 2019-nCoV also require supportive care, of a different type: hospitalization, oxygen, fluids, and other life-saving treatment may be necessary to support the patient while the immune system responds to, and clears, the infection.

Antiviral medicines shown to suppress or destroy coronaviruses are currently commercially available.  

Prevention:

You can reduce your risk of contracting human coronavirus by doing what you would do to protect yourself from getting the flu or common cold:8

  • Scrub your hands with soap and water for at least 20 seconds (try singing the Happy Birthday song twice for proper timing)
  • Avoid touching your eyes, nose, and mouth
  • Avoid being around people who are sick

If you are sick, you can protect others by staying home from work or school.

If you do cough or sneeze, be sure to cover your mouth and nose with a tissue, and then wash your hands after discarding the tissue. Alternatively, if you do not have a tissue available, sneeze or cough into the crook of your elbow.

A Word From Verywell:

Coronavirus is a common virus that infects people at least once over the course of their lifetime. The good news is that in most cases, it causes a mild, run-of-the-mill “cold.”

If your symptoms are severe or persistent, or if you have an underlying medical condition, be sure to see your doctor.

The 2019-nCoV coronavirus is concerning because of the potential for spreading globally, and because it can cause severe symptoms. As more information is gathered on this infection, we hope to remain a resource for you so you can get the information you need. If you are worried that you may have been exposed to this newly-described virus, it is a good idea to get medical care promptly.

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