The Experts Group of Tongji Hospital, Tongji Medical College of HUST has made a detailed interpretation of the symptoms and signs of COVID-19 in the Rapid Guidelines for Diagnosis and Treatment of COVID-19. Tencent Medpedia has obtained the authorization from the Experts Team, and hereby shares the information at first time.

Begin with fever as the main manifestation

In clinical manifestations, COVID-19 mainly begins with fever, and may combine with symptoms such as mild dry cough, fatigue, breathing discomforts, and diarrhea. Symptoms such as running nose and productive cough are less frequent.

Half of patients may develop dyspnea after one week. Severe patients may rapidly progress to acute respiratory distress syndrome, septic shock, refractory metabolic acidosis and bleeding and coagulation dysfunction.

Some patients are mild and free of clinical symptoms such as fever, and will mostly recover in a week. Most patients have a favorable prognosis. Few patients have severe cases or even may die of the disease.

Images may show multiple small patchy shadows and interstitial changes with significant peripheral distribution in the early stage. Then the condition may develop to the involvement of multiple ground glass-opacities and infiltrates in two lungs. Severe patients may have lung consolidation. Pleural effusion is less frequent.

In addition to the imaging manifestations, patients in the early onset may have normal or decreased total white blood cells and decreased lymphocytes. Some patients may have increased liver enzymes, creatase and myoglobin.

Most patients have increased C-reactive proteins and erythrocyte sedimentation rate, but normal procalcitonin. Severe patients may have increased D-D dimer and progressive decrease of lymphocytes.

With what concomitant symptoms fever patients are suspected of being infected

Can a COVID-19 case be confirmed if one suffers the above symptoms? Of course not.

COVID-19 is a brand new coronavirus pneumonia. The population generally lacks immunity to the virus and is of susceptibility. If patients are exposed to a large amount of virus or have relatively poor immune function, they are highly susceptible to infection.

Based on the previous diagnosis and treatment experience, the suspected COVID-19 case is a person who has traveled to or lived in Wuhan within 2 weeks before onset; or has been exposed to patients with fever and respiratory symptoms or with cluster onset of COVID-19 from Wuhan within 14 days before onset; the patient has fever also with imaging characteristics of pneumonia; and in the early stage with normal or decreased total white blood cells or decreased lymphocytes.

After meeting the criteria for a suspected case, the case would be confirmed once the samples from such as sputum, throat swab and lower respiratory tract secretions were tested positive for nucleic acid of 2019-nCoV by real-time fluorescence RT-PCR.

Medical quarantine should be practiced for all suspected cases; quarantine at the clinic and home for observation may be performed for mild patients. All patients under observation at home must get back to the designated hospital immediately for centralized treatment once they had presented any deterioration of the condition. Severe and critically ill patients should be hospitalized.

What to do if you have fever and cough and are worried that you may have COVID-19? Learn more from this medical guideline!