Coronavirus Disease 2019 (COVID-19)

What is Coronavirus Disease 2019 (COVID-19)?

Coronavirus Disease 2019, commonly known as COVID-19 or COVID, is a respiratory infection caused by the coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). SARS-CoV-2 and COVID-19 were first identified in the Wuhan Province in China in December 2019. Since then, the virus has spread rapidly around the world, causing a pandemic and hundreds of millions of infections.

Coronaviruses are a large family of viruses that can infect and cause disease in humans and animals. There are currently seven known types of coronaviruses that infect humans. Four of these are common and cause mild respiratory infections like the common cold. The remaining three types, which include SARS-CoV-2, cause more severe respiratory infections.

Who gets COVID-19?

The virus is highly contagious and anyone exposed can develop COVID-19 infection. Older adults and people who have certain underlying medical conditions, such as heart or lung disease or diabetes, are at increased risk for severe COVID-19 illness.

How does COVID-19 spread?

COVID-19 spreads when an infected person breathes out droplets or small particles that contain the virus. This can happen while breathing, speaking, singing, or exercising. These droplets and particles can then be breathed in by another person, or they can land on their eyes, nose, or mouth. Sometimes, the infected person may contaminate surfaces they touch and others will become infected by touching their eyes, nose, or mouth with contaminated hands. People who are closer than six feet from an infected person are most likely to get infected.

What are the symptoms of COVID-19 infection?

Illness from COVID-19 infection can range from no symptoms or very mild symptoms to severe illness that can result in hospitalization, intensive care, or death. The more common symptoms include:

Fever or chills
Cough
Shortness of breath
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

While anyone can have symptoms, older adults and people with certain underlying medical conditions (e.g., heart disease, lung disease, diabetes, and weakened immune systems) have a higher risk for severe COVID-19 illness. Symptoms of serious illness include:

Trouble breathing
Persistent pain or pressure in the chest
New confusion
Inability to wake or stay awake
Pale, gray, or blue-colored skin, lips, or nail beds

How soon after exposure do symptoms occur?

Symptoms may appear 2-14 days after exposure to the virus.

How are COVID-19 infections diagnosed?

Two types of viral tests are used to diagnose a current COVID-19 infection. A molecular test (also called RT-PCR) is used to detect the genetic material that makes up the virus. An antigen test is used to find specific proteins that are found on the surface of the virus. Both types of tests can determine if you have an active COVID-19 infection. Molecular and antigen tests are usually performed by taking samples from the nose using long swabs. Your healthcare provider may determine whether to conduct tests for the virus based on your signs and symptoms, whether you have had close contact with an infected person, if you have a condition that puts you at higher risk for severe illness, or if you are going to have a medical procedure. Tests can be performed in a laboratory, at a testing site, or in your own home.

What treatments are available for COVID-19?

Currently, three medications are either authorized or approved by the U.S. Food and Drug Administration (FDA) for the treatment of COVID-19. People who have been diagnosed with mild to moderate COVID-19 and are at higher risk for severe illness should contact their healthcare provider right away to see if they are eligible for treatment. Treatment must be started within the first few days of illness to be effective.

According to the National Institutes of Health (NIH) COVID-19 Treatment Panel, the oral antiviral drug nirmatrelvir combined with ritonavir (Paxlovid; Pfizer) is the first-choice treatment for COVID-19. Paxlovid currently has FDA Emergency Use Authorization and is available for patients who are 12 years of age and older, weigh at least 40 kg, and are at high risk for severe illness due to COVID-19. Paxlovid must be started within 5 days of COVID-19 symptom onset.

According to the NIH Treatment Panel, remdesivir (Veklury; Gilead Sciences) is the second-choice treatment option for COVID-19. Veklury is FDA approved and is the only current therapy that can be used in people less than 12 years of age. Veklury must be started within 7 days of symptom onset, can be used in either the outpatient or inpatient setting, and is given as an intravenous (IV) infusion on three consecutive days. The federal government has a COVID-19 Therapeutics Locator website where the public or healthcare providers can search for sites that can provide IV Veklury.

Per the NIH Treatment Panel, molnupiravir (Lagevrio; Merck) is considered the third-choice medication for treatment of COVID-19. Lagevrio is an oral antiviral drug that is currently under an FDA EUA. The drug is available for patients 18 years of age and older and must be started within 5 days of symptom onset.

How can COVID-19 infection be prevented?

There are several strategies that should be followed to slow the spread of COVID-19.

Stay up to date on your COVID-19 vaccines to have the best protection.
- People who have a medical condition or are taking medications that weaken their immune system may not be fully protected even if they are up to date on their vaccines. They should talk to their healthcare provider about steps to take to protect themselves.
You should always wear a mask if you have COVID-19 (or symptoms) and need to be around others or if you are caring for someone who has COVID-19. You may choose to wear a mask after an exposure to someone with COVID-19, and are around other people, particularly those who are more likely to get very sick from COVID-19. You may also choose to mask indoors in public if the COVID-19 hospital admission level is high, regardless of your vaccination status. People at higher risk for severe illness and people who live or spend time with someone at higher risk can consider wearing a high-quality mask if the COVID-19 hospital admission level is medium.
- Some people should never wear a mask. These include children under the age of 2 years; any child when the child is sleeping; people who have trouble breathing, are incapacitated, or who are otherwise unable to remove the mask without help; people with a disability who cannot wear a mask, or cannot safely wear a mask, for reasons related to the disability.
Avoid indoor areas that have poor airflow (ventilation) and crowds. This is especially important for people who are at higher risk for severe illness.
Get tested if you have COVID-19 symptoms or have been exposed to someone with COVID-19.
Stay home if you are sick or have a positive COVID-19 test.
Wash your hands often with soap and water for at least 20 seconds. If water is not available, use an alcohol-based hand sanitizer containing at least 60% alcohol.
Avoid contact with people who are sick.
Clean surfaces that are touched often using household cleaners, such as soap or detergent.

How can I learn more about COVID-19?

If you have concerns about COVID-19, contact your healthcare provider.
Contact your local health department. A directory of local health departments is located at https://www.vdh.virginia.gov/local-health-districts/.
Visit the Centers for Disease Control and Prevention (CDC) website at https://www.cdc.gov/coronavirus/2019-ncov/index.html.

May 2023