При отслеживании тенденций COVID-19, госпитализации в различных географических регионах Соединенных Штатов — это критически важные данные для мониторинга. Также важно следить за посещениями скорой помощи, связанными с COVID-19, поскольку они могут служить ранними индикаторами распространения вируса.
Коронавирусы и их воздействие
COVID-19 у врачей
Прогноз
Смертность и диабет
Информация о госпитализации и кардиометаболических состояниях
Вирусология
Как уже упоминалось, вирусы, такие как SARS-CoV-2, постоянно изменяются. Среди сотен обнаруженных вариантов в первый год пандемии, наиболее обеспокоены так называемые варианты интереса (VOCs). Исследователи постоянно изучают, как варианты могут изменять или не изменять степень защиты с использованием доступных вакцин и антитело-направленной терапии. На январь 2023 года нет активных EUA для моноклональных антител, направленных на SARS-CoV-2 из-за текущих циркулирующих вариантов, которые не поддаются.
Вариант Омикрон (B.1.1.529), инициально обнаруженный в Южной Африке, был объявлен вариантом интереса в Соединенных Штатах CDC 30 ноября 2021 года. Этот VOC содержит несколько десятков мутаций, включая большое количество в спайковом гене, больше чем у предыдущих VOCs. Эти мутации включают несколько, связанных с увеличением передачи. Вариант Омикрон быстро стал доминирующим в Соединенных Штатах. На 8 января 2022 года он составлял более 98% циркулирующего вируса, по сравнению с менее чем 8% 11 декабря 2021 года.
Эффективность противовирусных средств
Старые Варианты, Мониторинг в Соединенных Штатах
Центр по контролю и профилактике заболеваний отслеживает долю вариантов, циркулирующих в Соединенных Штатах и оценивает, что вариант B.1.1.7 (Альфа), который впервые был обнаружен в Великобритании, составил более 44% случаев с 2 января по 27 марта 2021 года. 7 апреля 2021 года CDC объявил, что B.1.1.7 был доминирующим штаммом, циркулирующим в Соединенных Штатах. Это был доминирующий штамм, пока Delta-вариант не стал доминирующим.
VOCs B.1.427 (Эпсилон) и B.1.429 (Эпсилон) появились в Калифорнии. Эти варианты составили 2,9% и 6,9% циркулирующих вариантов в Соединенных Штатах с 2 января по 27 марта 2021 года. Наблюдается примерно 20% увеличение передачи с этим вариантом.
David J Cennimo, MD, FAAP, FACP, FIDSA, AAHIVS Профессор медицины и педиатрии, Инфекционные заболевания у взрослых и детей, Медицинская школа Нью-Джерси Ратгерс
Отчет: Ничего не обнаружено.
Scott J Bergman, PharmD, FCCP, FIDSA, BCPS, BCIDP Координатор программы антимикробной стойкости, Руководитель программы резидентуры по инфекционным заболеваниям, Отдел фармацевтического и пищевого обеспечения, Дивизион инфекционных заболеваний Nebraska Medicine; Клинический ассоциированный профессор, Отдел фармацевтической практики, Фармацевтический колледж, Медицинский университет Небраска
Отчет: Получено исследовательское грант от: Merck & Co., Inc.
Keith M Olsen, PharmD, FCCP, FCCM Декан и профессор, Фармацевтический колледж, Медицинский университет Небраска
Специализированный редакторский совет
Mary L Windle, PharmD Член преподавательского состава, Фармацевтический колледж Университета Небраска; Главный редактор, Справочник по лекарствам Medscape
Характеристика коронавирусной болезни (COVID-19)
Коронавирусная болезнь 2019 (COVID-19) вызвана вирусом, который называется тяжелым острым респираторным синдромом коронавируса 2, или, более широко известным, как SARS-CoV-2. Распространение началось в конце 2019 года и стало пандемическим заболеванием в 2020 году.
Вирус, вызывающий COVID-19, распространяется в основном через воздух в мельчайших каплях жидкости между людьми вблизи друг от друга. Многие люди с COVID-19 не имеют симптомов или имеют легкое заболевание. Но для пожилых людей и людей с определенными медицинскими состояниями COVID-19 может привести к необходимости госпитализации или смерти.
Быть в курсе вашей вакцинации против COVID-19 помогает предотвратить тяжелое заболевание, необходимость госпитализации из-за COVID-19 и смерть от COVID-19. Другие способы, которые могут помочь предотвратить распространение этого коронавируса, включают хорошую вентиляцию в помещениях, физическое дистанцирование, ношение маски в соответствующей обстановке и хорошую гигиену.
Медицина может смягчить тяжесть вирусной инфекции. Большинство людей восстанавливаются без долгосрочных последствий, но у некоторых людей симптомы продолжаются в течение месяцев.
Симптомы
Типичные симптомы COVID-19 часто проявляются через 2—14 дней после контакта с вирусом.
Симптомы могут включать в себя:
- Высокая температура или озноб
- Кашель
- Утомляемость
- Боли в мышцах или теле
- Головная боль
- Потеря вкуса или обоняния
- Горло
- Редко наблюдаются рвота, диарея или сыпь на коже
Люди могут иметь лишь несколько симптомов или совсем не иметь их. Люди, у которых нет симптомов, но положительный результат теста на COVID-19, называются асимптоматическими. Например, многие дети, у которых положительный результат теста, не имеют симптомов заболевания COVID-19. Люди, у которых впоследствии появляются симптомы, считаются предсимптоматическими. Обе группы все еще могут распространять COVID-19 на других.
У некоторых людей могут возникнуть симптомы, которые ухудшаются примерно через 7—14 дней после начала симптомов.
У большинства людей с COVID-19 наблюдаются легкие или умеренные симптомы. Но COVID-19 может вызвать серьезные осложнения и привести к смерти. Пожилые люди или люди, у которых уже есть медицинские проблемы, находятся в большем риске серьезного заболевания.
COVID-19 может быть легким, умеренным, тяжелым или критическим заболеванием.
Редко люди, которые заражаются коронавирусом, могут развить группу симптомов, связанных с воспаленными органами или тканями. Это заболевание называется мультиорганного воспалительным синдромом. Когда дети болеют этим заболеванием, его называют мультиорганным воспалительным синдромом у детей, а для взрослых — MIS-A.
Когда обратиться к врачу
Свяжитесь с медицинским работником, если результат вашего теста на COVID-19 положителен. Если у вас есть симптомы и вы должны пройти тест на COVID-19, или вы были в контакте с кем-то, кто заразился COVID-19, медицинский работник может помочь.
Немедленно обратитесь за неотложной помощью в случае любого из этих симптомов:
- Трудности с дыханием
- Боли или давление в грудной клетке
- Новые осложнения коронавируса
This list doesn’t include every emergency symptom. If you or a person you’re taking care of has symptoms that worry you, get help. Let the healthcare team know about a positive test for COVID-19 or symptoms of the illness.
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Causes
COVID-19 is caused by infection with the severe acute respiratory syndrome coronavirus 2, also called SARS-CoV-2.
The coronavirus spreads mainly from person to person, even from someone who is infected but has no symptoms. When people with COVID-19 cough, sneeze, breathe, sing or talk, their breath may be infected with the COVID-19 virus.
The coronavirus carried by a person’s breath can land directly on the face of a nearby person, after a sneeze or cough, for example. The droplets or particles the infected person breathes out could possibly be breathed in by other people if they are close together or in areas with low air flow. And a person may touch a surface that has respiratory droplets and then touch their face with hands that have the coronavirus on them.
It’s possible to get COVID-19 more than once.
The virus that causes COVID-19 can infect some pets. Cats, dogs, hamsters and ferrets have caught this coronavirus and had symptoms. It’s rare for a person to get COVID-19 from a pet.
Risk factors
The main risk factors for COVID-19 are:
Many factors affect your risk of catching the virus that causes COVID-19. How long you are in contact, if the space has good air flow and your activities all affect the risk. Also, if you or others wear masks, if someone has COVID-19 symptoms and how close you are affects your risk. Close contact includes sitting and talking next to one another, for example, or sharing a car or bedroom.
It seems to be rare for people to catch the virus that causes COVID-19 from an infected surface. While the virus is shed in waste, called stool, COVID-19 infection from places such as a public bathroom is not common.
Serious COVID-19 illness risk factors
Some people are at a higher risk of serious COVID-19 illness than others. This includes people age 65 and older as well as babies younger than 6 months. Those age groups have the highest risk of needing hospital care for COVID-19.
Not every risk factor for serious COVID-19 illness is known. People of all ages who have no other medical issues have needed hospital care for COVID-19.
Known risk factors for serious illness include people who have not gotten a COVID-19 vaccine. Serious illness also is a higher risk for people who have:
People with dementia or Alzheimer’s also are at higher risk, as are people with brain and nervous system conditions such as stroke. Smoking increases the risk of serious COVID-19 illness. And people with a body mass index in the overweight category or obese category may have a higher risk as well.
Other medical conditions that may raise the risk of serious illness from COVID-19 include:
This list is not complete. Factors linked to a health issue may raise the risk of serious COVID-19 illness too. Examples are a medical condition where people live in a group home, or lack of access to medical care. Also, people with more than one health issue, or people of older age who also have health issues have a higher chance of severe illness.
Complications
Complications of COVID-19 include long-term loss of taste and smell, skin rashes, and sores. The illness can cause trouble breathing or pneumonia. Medical issues a person already manages may get worse.
Complications of severe COVID-19 illness can include:
Post-COVID-19 Syndrome
After a COVID-19 infection, some people report that symptoms continue for months, or they develop new symptoms. This syndrome has often been called long COVID, or post-COVID-19. You might hear it called long haul COVID-19, post-COVID conditions or PASC. That’s short for post-acute sequelae of SARS-CoV-2.
Other infections, such as the flu and polio, can lead to long-term illness. But the virus that causes COVID-19 has only been studied since it began to spread in 2019. So, research into the specific effects of long-term COVID-19 symptoms continues.
Researchers do think that post-COVID-19 syndrome can happen after an illness of any severity.
Getting a COVID-19 vaccine may help prevent post-COVID-19 syndrome.
Prevention
The Centers for Disease Control and Prevention (CDC) recommends a COVID-19 vaccine for everyone age 6 months and older. The COVID-19 vaccine can lower the risk of death or serious illness caused by COVID-19. It lowers your risk and lowers the risk that you may spread it to people around you.
The COVID-19 vaccines available in the United States are:
In general, people age 5 and older with typical immune systems can get any vaccine approved or authorized for their age. They usually don’t need to get the same vaccine each time.
Some people should get all their vaccine doses from the same vaccine maker, including:
Talk to your healthcare professional if you have any questions about the vaccines for you or your child. Your healthcare team can help you if:
People with weakened immune systems
Your health care team may suggest added doses of COVID-19 vaccine if you have a moderately or severely weakened immune system.
Control the spread of infection
In addition to vaccination, there are other ways to stop the spread of the virus that causes COVID-19.
If you are at a higher risk of serious illness, talk to your healthcare professional about how best to protect yourself. Know what to do if you get sick so you can quickly start treatment.
If you feel ill or have COVID-19, stay home and away from others, including pets, if possible. Avoid sharing household items such as dishes or towels if you’re sick.
In general, make it a habit to:
Try to spread out in crowded public areas, especially in places with poor airflow. This is important if you have a higher risk of serious illness.
The CDC recommends that people wear a mask in indoor public spaces if you’re in an area with a high number of people with COVID-19 in the hospital. They suggest wearing the most protective mask possible that you’ll wear regularly, that fits well and is comfortable.
Travel and COVID-19
Travel brings people together from areas where illnesses may be at higher levels. Masks can help slow the spread of respiratory diseases in general, including COVID-19. Masks help the most in places with low air flow and where you are in close contact with other people. Also, masks can help if the places you travel to or through have a high level of illness.
Masking is especially important if you or a companion have a high risk of serious illness from COVID-19.
More Information
Feb. 21, 2024
In 2019, a new coronavirus called ‘SARS-CoV-2’ quickly spread worldwide. Infection by this virus causes the disease known as COVID-19. COVID-19 primarily targets the respiratory system, but it also affects the nervous system and other organs. Most cases of COVID-19 are mild, especially in those who have been vaccinated, and go away within a couple of weeks. However, severe cases of COVID-19 can damage a person’s organs. When COVID-19 affects the lungs, it prevents the body from getting enough oxygen, which can lead to disability or death.
Some people have symptoms of COVID-19 that last for weeks, months, or even years after their initial infection. Some may develop new symptoms after an initial recovery or after mild initial COVID 19. These prolonged symptoms are known as “Long COVID,” which can affect many parts of the body, particularly the brain and nervous system. Medical and research communities are studying how COVID-19 might cause or contribute to the neurological symptoms of Long COVID. Researchers hope to better understand this connection to support diagnosis and develop effective treatments for people experiencing Long COVID.
Read below to understand what we know about COVID-19’s effects on the brain and nervous system, and promising avenues of study to understand and treat Long COVID.
What do we know about the effects of SARS-CoV-2 and COVID-19 on the nervous system?
After the initial infection, during what’s known as the subacute phase, people who have had COVID-19 may develop a variety of inflammatory syndromes affecting the brain, spinal cord, or nerves.
In children, the inflammatory process can affect multiple organ systems and is called multi-inflammatory syndrome in children (MIS-C). It is important to recognize these syndromes early in the course of the illness since they can be treated with drugs that target inflammation.
Scientists are still learning how COVID-19 affects the nervous system. You can read the NINDS Director’s Message on Understanding neurological complications of COVID-19 to learn about research is supporting to better understand this connection.
Funding opportunities include new analyses of large brain COVID-19 datasets, how COVID-19 affects pre-existing neurological conditions, and how COVID-19 affects nervous systems and mood disorders in different stages of the disease.
NINDS COVID-19 Funding
NINDS has open funding opportunities that seek to improve our understanding of the effects of COVID-19 on the nervous system.
Am I at a higher risk if I currently have a neurological disorder?
COVID-19 is a new disease, so researchers are still studying the risks for people already living with a neurological disorder. According to the Centers for Disease Control and Prevention (CDC), people living with dementia or Alzheimer’s disease, or who have had a stroke, are at higher risk for severe COVID-19.
What are possible long-term neurological complications of COVID-19?
COVID-19 can affect many parts of the body. Researchers are learning more about the long-term effects of COVID-19 on the brain and nervous system and whether those who have experienced COVID 19 are at greater risk for other diseases. Those who experience severe COVID-19 or are hospitalized are more likely to have symptoms that last beyond their initial infection. However, those with mild cases may also develop new or worsening Long COVID symptoms.
How Long COVID changes over time varies from person to person. Some people improve within weeks, while others may still have symptoms for years after their initial infection. Sometimes Long COVID symptoms come back after they have gone away or get worse over time. Researchers may use the term “post-acute sequelae of SARS-CoV-2,” or PASC, in studies exploring the potential long-term consequences of COVID-19.
Long COVID is a “diagnosis of exclusion,” meaning it is diagnosed only after a doctor has ruled out other possible causes for symptoms. It is also possible that Long COVID or COVID-19 can help uncover diseases that a person did not know they had. While there is currently no standard treatment for Long COVID, the symptoms of Long COVID can be treated. Individuals with Long COVID should talk with their doctor about what treatments work best for managing their symptoms.
The most common neurological symptoms of Long COVID include:
Cognitive symptoms of Long COVID
People with COVID-19 may experience new or increased difficulty concentrating, processing information, and remembering things. This is sometimes called “brain fog” and can last for weeks or months after infection.
Sleep disturbances
Approximately 40% of people with Long COVID report major changes to their sleep after COVID-19 . Sleep is important for the brain, and sleep disorders can contribute to fatigue and cognitive difficulties.
Anxiety, depression, and stress
Many diseases from viral infections, like COVID-19, can cause feelings of exhaustion or exercise intolerance. Both during a COVID-19 and with Long COVID, people may feel they have less of an energy reserve. This fatigue is often severe enough to interfere with a person’s daily life.
Post-exertional malaise
Some people who have recovered from COVID-19 describe feeling very tired or a worsening of symptoms after only a little bit of physical, cognitive, emotional, or social activity. This is called post-exertional malaise, or PEM, and is a common symptom of Long COVID.
Pain, Sensitivity, and Movement Symptoms of Long COVID
People with Long COVID may experience new pain or loss ofsensitivity to touch. They also may experience tingling or burning sensations. These changes tend to be worse in the limbs, particularly in the hands, and/or feet. This is because COVID-19 is thought to affect the nerves that send signals like touch, pressure, heat/cold, and pain to the brain.
Headache
Headaches can accompany COVID-19. Some people with Long COVID continue to have mild to severe headaches. These headaches may feel different from a migraine. The frequency of headaches varies by individual. In some individuals, the headaches may be related to blood clots that have formed in the vessels surrounding the brain (known as venous sinuses).
Dizziness/Fainting
For some people with Long COVID, the part of the nervous system that regulates involuntary things like heart rate and blood pressure may not function as well. This is called dysautonomia and can lead to increased heart rate and dizziness or fainting when standing up from a lying down or sitting position. This type of dizziness/fainting is called postural orthostatic tachycardia syndrome (POTS).
Trouble with Movement
Since COVID-19 can affect the nervous system, it can also affect how the brain sends signals to the muscles of the body to coordinate movement. Some people with Long COVID have trouble with coordination (ataxia), loss of movement (bradykinesia), tremor, or sudden muscle twitching or jerking (myoclonus).
How are Long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) related?
is funding cutting-edge research to explore potential connections between the effects of COVID-19 on blood vessels in the brain and similar effects on the lining of the intestines, and whether this damage may relate to chronic cognitive symptoms of Long COVID. Read the most recent finding from this study.
is also investing in new tools to understand the biological effects of COVID-19. This includes research to define the biological basis of Long COVID symptoms using MRI and blood biomarkers. The institute is also funding research to evaluate the neurological complications of COVID-19 using neuroimaging, neuropsychiatric examination, and cognitive testing. This research also aims to further explore how different characteristics such as sex, BMI, race/ethnicity, and socioeconomic status, play a role in neurocognitive changes.
’s Researching COVID to Enhance Recovery (RECOVER)) Initiative is a national, patient-centered effort to understand the causes of Long COVID and advance discovery of treatments for Long COVID. is a leading partner in this effort. RECOVER seeks to identify treatments for all individuals affected by Long COVID, including those disproportionately affected by COVID-19. RECOVER is leading observational studies to track Long COVID symptoms and outcomes over time, as well as clinical trials to test potential treatments, and pathobiology studies to understand the biological causes of Long COVID. One example of a clinical trial is RECOVER-NEURO, which seeks to advance our understanding of how COVID-19 affects the brain and identify potential treatments for symptoms like brain fog. Learn how people with Long COVID, their family members, and healthy volunteers can participate in RECOVER.
and are part of the US Department of Health and Human Services (), which is coordinating a whole-of-government approach to respond to the longer-term impacts of COVID-19 through the Office of Long COVID Research and Practice. You can sign up for updates on this office and its work at their website.
What can I do to reduce my risk for COVID-19 and Long COVID?
See more information on Long COVID from the NIH and from the CDC.
NINDS news on COVID-19
You can also read news articles from NINDS on COVID-19 and Long COVID research in neuroscience.
2023 Aug 18
Free Books & Documents
Features, Evaluation, and Treatment of Coronavirus (COVID-19)
Coronavirus disease 2019 (COVID-19) is a highly contagious viral illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has had a catastrophic effect on the world, resulting in more than 6 million deaths worldwide. After the first cases of this predominantly respiratory viral illness were reported in Wuhan, Hubei Province, China, in late December 2019, SARS-CoV-2 rapidly disseminated worldwide. This compelled the World Health Organization (WHO) to declare it a global pandemic on March 11, 2020.
Even though substantial progress in clinical research has led to a better understanding of SARS-CoV-2, many countries continue to have outbreaks of this viral illness. These outbreaks are primarily attributed to the emergence of mutant variants of the virus. Like other RNA viruses, SARS-CoV-2 adapts with genetic evolution and developing mutations. This results in mutant variants that may have different characteristics than their ancestral strains. Several variants of SARS-CoV-2 have been described during the course of this pandemic, among which only a few are considered variants of concern (VOCs). Based on the epidemiological update by the WHO, 5 SARS-CoV-2 VOCs have been identified since the beginning of the pandemic:
Alpha (B.1.1.7): First variant of concern, which was described in the United Kingdom (UK) in late December 2020
Beta (B.1.351): First reported in South Africa in December 2020
Gamma (P.1): First reported in Brazil in early January 2021
Delta (B.1.617.2): First reported in India in December 2020
Omicron (B.1.1.529): First reported in South Africa in November 2021
Despite the unprecedented speed of vaccine development against the prevention of COVID-19 and robust global mass vaccination efforts, the emergence of new SARS-CoV-2 variants threatens to overturn the progress made in limiting the spread of this disease. This review aims to comprehensively describe the etiology, epidemiology, pathophysiology, and clinical features of COVID-19. This review also provides an overview of the different variants of SARS-CoV-2 and the guideline-recommended treatment (as of January 2023) for managing this disease.
Conflict of interest statement
Disclosure: Marco Cascella declares no relevant financial relationships with ineligible companies.
Disclosure: Michael Rajnik declares no relevant financial relationships with ineligible companies.
Disclosure: Abdul Aleem declares no relevant financial relationships with ineligible companies.
Disclosure: Scott Dulebohn declares no relevant financial relationships with ineligible companies.
Disclosure: Raffaela Di Napoli declares no relevant financial relationships with ineligible companies.
Sections
По состоянию на 23 мая 2022: 100 и более случаев на 1000 жителей от 30 до 100 случаев на 1000 жителей от 10 до 30 случаев на 1000 жителей от 3 до 10 случаев на 1000 жителей от 1 до 3 случаев на 1000 жителей от 0,3 до 1 случая на 1000 жителей от 0 до 0,3 случаев на 1000 жителей Нет зарегистрированных случаев, нет населения или нет данных
По состоянию на 24 мая 2022: 10 000 000 и более подтверждённых случаев от 1 000 000 до 9 999 999 подтверждённых случаев от 100 000 до 999 999 подтверждённых случаев от 10 000 до 99 999 подтверждённых случаев от 1000 до 9999 подтверждённых случаев от 100 до 999 подтверждённых случаев от 1 до 99 подтверждённых случаев нет подтверждённых случаев
По состоянию на 15 июля 2022: 100 и более смертей на миллион жителей от 10 до 100 смертей на миллион жителей от 1 до 10 смертей на миллион жителей от 0,1 до 1 смертей на миллион жителей от 0 до 0,1 смертей на миллион жителей Нет смертей от COVID-19
Место начала Ухань, Хубэй, Китай
Медиафайлы на Викискладе
Вспышка COVID-19 в Китае и последующее введение карантина на границах с Китаем
Расписка Ли Вэньляна о том, что он предупреждён о недопустимости распространения ложных слухов, взятая полицией Уханя
Распространение COVID-19 в Китае с 22 января по 7 марта 2020 года
Первый случай за пределами Китая стал известен 13 января. Это была 61-летняя женщина, которая прилетела из Уханя 8 января в Бангкок (Таиланд). К 18 января количество случаев за пределами Китая увеличилось до трёх случаев (два в Таиланде, один в Японии).
Из того факта, что за пределами Китая были зарегистрированы несколько случаев заболевания, эпидемиологи пришли к выводу, что число людей, инфицированных в Ухане, должно быть значительно больше (на 1—2 порядка), чем официально объявленные 41 случай. По оценкам, высказываемым экспертами-вирусологами, число людей, инфицированных в Ухане, на 17 января составило до 1700 человек.
Тот факт, что несколько сотрудников больницы, которые занимались лечением больных, также заболели, ясно показал, что вирус может передаваться от человека к человеку.
20 января китайские власти сообщили о резком увеличении числа новых случаев заболевания, вызванного коронавирусной инфекцией COVID-19, сразу на 140 новых пациентов; некоторые из них оказались за пределами Уханя — в Шэньчжэне и Пекине. Также сообщалось о ещё одной смерти, вызванной вирусом, и о первом случае заболевания в Южной Корее. Китайские власти официально подтвердили, что имели место случаи передачи инфекции от человека к человеку. 21 января у американца, который вернулся из Уханя в Сиэтл (США) 15 января, была диагностирована первая инфекция COVID-19 года за пределами Азии. Были высказаны серьёзные опасения, что предстоящий китайский Новый год может значительно способствовать распространению вируса. Сотни миллионов китайцев традиционно посещают этот праздник в Китае и за его пределами, чтобы отдохнуть, отпраздновать и посетить своих родственников.