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Abstract
COVID-19 infection has a broad spectrum of severity ranging from an asymptomatic form to a severe acute respiratory syndrome that requires mechanical ventilation. Starting with the description of our case series, we evaluated the clinical presentation and evolution of COVID-19. This article is addressed particularly to physicians caring for patients with COVID-19 in their clinical practice. The intent is to identify the subjects in whom the infection is most likely to evolve and the best methods of management in the early phase of infection to determine which patients should be hospitalized and which could be monitored at home. Asymptomatic patients should be followed to evaluate the appearance of symptoms. Patients with mild symptoms lasting more than a week, and without evidence of pneumonia, can be managed at home. Patients with evidence of pulmonary involvement, especially in patients over 60 years of age, and/or with a comorbidity, and/or with the presence of severe extrapulmonary manifestations, should be admitted to a hospital for careful clinical-laboratory monitoring.
Highlights
Coronaviruses are enveloped viruses with a positive-sense single-stranded RNA genome belonging to the Coronaviridae family, the Nidovirales order, and broadly distributed in humans and other mammals [1]
Since December 2019, a new zoonotic beta-corona virus (SARS-CoV-2) has spread all over the world from Wuhan, China [4], causing a disease known as coronavirus disease (COVID-19)
COVID-19 infection has a broad spectrum of severity ranging from an asymptomatic form to a severe acute respiratory syndrome that requires mechanical ventilation
Summary
Coronaviruses are enveloped viruses with a positive-sense single-stranded RNA genome belonging to the Coronaviridae family, the Nidovirales order, and broadly distributed in humans and other mammals [1]. Most human coronavirus infections are mild, the epidemics of the two beta-coronaviruses, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) [2], caused more than 10,000 cumulative cases in the past two decades, respectively in 2002 and 2012, with mortality rates of 10% for SARS-CoV and 37%. Since December 2019, a new zoonotic beta-corona virus (SARS-CoV-2) has spread all over the world from Wuhan, China [4], causing a disease known as coronavirus disease (COVID-19). SARS-CoV-2 is able to enter host cells through the binding between the viral structural spike (S). Once binding between the S protein and receptor is established, the virus particles enter the host cell through membrane fusion and endocytosis. Starting from the description of our case series, we evaluated the clinical presentation and evolution of COVID-19. The intent is to identify the subjects in whom the infection is most likely to evolve and the best methods of management in the early phase of infection to determine which patients should be hospitalized and which could be monitored at home
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