FAQs

Coronavirus and COVID-19 are not the same thing, but sometimes these terms are used interchangeably. Coronaviruses are a family of viruses that have crown-like spikes on their surface. The scientific name for the new coronavirus that emerged from China in December 2019 is SARS-CoV-2, which stands for severe acute respiratory syndrome coronavirus 2.

COVID-19 is the disease caused by the new SARS-CoV-2 virus and stands for coronavirus disease 2019.

Fever, aches, and a cough are symptoms commonly found in patients with either COVID-19 or the flu. Both diseases can range in severity from mild to severe and may lead to the development of pneumonia. Although both viruses may be fatal, COVID-19 is associated with a significantly higher mortality rate than the flu. Estimates vary, but approximately 1% to 3% of people with COVID-19 will die from the disease.

There are several reasons why the coronavirus is more dangerous than the flu:

  • Coronavirus is twice as contagious as the flu. Research indicates that a person with the flu infects an average of 1.28 other people. However, a person with coronavirus can infect between 2 to 3 other people.
  • Coronavirus has a longer incubation period. The incubation period is the time between exposure to the virus and the onset of symptoms. People with coronavirus might not have symptoms for up to 14 days, and some may not develop symptoms at all. People with the flu usually develop symptoms within 2 days of infection. Since coronavirus has a significantly longer incubation period, infected individuals may unknowingly spread the virus for a longer period of time.
  • There is an effective vaccine available for the flu. There is no vaccine available for COVID-19, but development and testing are in progress.

Based on currently available information, people aged 65 years and older and people of any age with serious underlying medical conditions may be at higher risk of severe illness from COVID-19. Preexisting medical conditions that increase the risk of serious illness include:

  • Chronic lung disease or moderate-to-severe asthma
  • Cardiovascular disease, hypertension (high blood pressure), and serious heart conditions
  • Diabetes
  • Liver disease
  • Cancer
  • Chronic kidney disease and dialysis
  • Severe obesity (body mass index [BMI] of 40 or more)
  • Immunosuppression (bone marrow or organ transplantation, immune deficiencies, autoimmune diseases, poorly controlled HIV or AIDS, or long-term use of corticosteroids)

People who are at high risk of serious illness with COVID-19 should practice good hand hygiene and social distancing to minimize their chance of contracting the new coronavirus.

The new coronavirus is spread through respiratory droplets released into the air when an infected person coughs, sneezes, or talks. These droplets generally do not travel more than a few feet before falling to the ground. If you are in close proximity to someone who is infected, you may inhale the virus.

Coronavirus can also be transmitted from objects and surfaces that are contaminated with the virus. Studies suggest that the virus can live on surfaces for a few hours or up to several days, depending on the surface and environmental factors. A small amount of virus can be found on plastic for up to 3 days, on stainless steel for up to 2 days, and for up to one day on cardboard. It is important to practice good hand hygiene to minimize the risk of infection. It is recommended that you wash your hands for 20 seconds with soap and water or use an alcohol-based hand sanitizer that contains at least 60% alcohol to prevent the spread of the virus.

Symptoms could appear as soon as 2 days or as late as 14 days after exposure to the virus. The median time for symptoms to develop is about 5 days. If you believe you have been exposed to the new coronavirus, it is important to quarantine for 14 days to prevent the spread of the virus to others.

It is estimated that on average people with COVID-19 first develop symptoms approximately 5 days after exposure to the virus. However, symptoms may develop between 2 and 14 days after exposure. One study found that people with COVID-19 were contagious approximately 2 to 3 days before symptom onset and were most infectious the day before symptoms appeared.

People infected with the new coronavirus can be contagious without symptoms. It is estimated that up to 50% of people infected with coronavirus remain asymptomatic. However, these people are still contagious. One study found that people with no symptoms were the source of 44% of diagnosed COVID-19 cases.

A serologic test is a blood test that identifies antibodies against SARS-CoV-2, the virus that causes COVID-19. Antibodies are proteins created by your immune system to fight infections. Since it takes your body 5 to 10 days to produce enough antibodies to be detected in a test, serologic tests cannot be used to diagnose an active COVID-19 infection, even in patients with severe disease.

Serologic tests can be used to identify people who have been infected with the new coronavirus during the course of the pandemic. However, since the coronavirus that causes COVID-19 is new, there is still much we do not know about it. Scientists are working to determine if antibodies against SARS-CoV-2 provide protection against future infections by this virus. If antibodies do provide immunity, we do not know what amount, or titer, of antibodies would provide protection or for how long this protection would last.

Yes, several treatments are currently available for COVID-19. Your healthcare provider might recommend one or more of the following treatments if you become ill with COVID-19:

  • Remdesivir is an antiviral drug approved by the US Food and Drug Administration (FDA) for the treatment of hospitalized patients with COVID-19. Remdesivir is given by intravenous injection, and it is recommended for use in hospitalized patients who require supplemental oxygen.
  • Monoclonal antibodies for COVID-19 are proteins specifically designed to neutralize the virus. Several monoclonal antibodies (bamlanivimab, casirivimab plus imdevimab, and bamlanivimab plus etesevimab) are authorized by the FDA for emergency use in patients with mild-to-moderate COVID-19 who are at high risk for progressing to severe disease and/or hospitalization. Patients at high risk are those older than 65 years or who have certain chronic medical conditions. Monoclonal antibodies are given by intravenous infusion outside the hospital. Monoclonal antibodies should be administered as soon as possible after testing positive for COVID-19 and within 10 days of symptom onset.
  • Dexamethasone is a steroid medication that reduces the body’s exaggerated immune response to the virus. Dexamethasone is recommended for hospitalized patients with COVID-19 who require supplemental oxygen, especially those with a critical illness that requires mechanical ventilation. Dexamethasone is given orally or intravenously.
  • Barcitinib is an oral anti-inflammatory drug. Baricitinib in combination with remdesivir is authorized by the FDA for emergency use in hospitalized patients with COVID-19 who require supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).

Some doctors in France advise people against using ibuprofen (i.e., Advil®, Motrin®) to manage the symptoms of COVID-19. There were several reports of healthy patients with COVID-19 who were taking ibuprofen and developed severe disease, particularly pneumonia. However, there were no scientific studies to support this advice.

The World Health Organization (WHO) initially recommended using acetaminophen (i.e., Tylenol®) instead of ibuprofen to reduce the fever, aches, and pains related to coronavirus infection. However, the WHO now states that either acetaminophen or ibuprofen can be used. It is important to make sure that you do not exceed the maximum daily dose of 3,000 milligrams of acetaminophen per day.

References

Centers for Disease Control and Prevention. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19). Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html

Centers for Disease Control and Prevention. Treatments Your Healthcare Provider Might Recommend if You Are Sick. Available at https://www.cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.html. Accessed 2/11/2021.

Food and Drug Administration (FDA). Emergency Use Authorization (EUA) of Bamlanivimab. Fact Sheet for Healthcare Providers. Available at https://www.fda.gov/media/143603/download. Accessed 2/11/2021.

Food and Drug Administration (FDA). Emergency Use Authorization (EUA) of Bamlanivimab and Etesevimab. Fact Sheet for Healthcare Providers. Available at https://www.fda.gov/media/145802/download. Accessed 2/11/2021.

Food and Drug Administration (FDA). Emergency Use Authorization (EUA) of Casirivimab and Imdevimab. Fact Sheet for Health Care Providers. Available at https://www.fda.gov/media/143892/download. Accessed 2/11/2021.

He X, Lau EHY, Wu P, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nature Med. 2020;26:675.

Geleris J, Sun Y, Platt J, et al. Observational study of hydroxychloroquine in hospitalized patients with COVID-19. N Engl J Med. 2020;May 7: Epub ahead of print.

 

Infectious Disease Society of America (IDSA). IDSA COVID-19 Antibody Testing Primer. Available at https://www.idsociety.org/globalassets/idsa/public-health/covid-19/idsa-covid-19-antibody-testing-primer.pdf

National Institutes of Health. COVID-19 Treatment Guidelines. Therapeutic Management of Patients with COVID-19. Available at https://www.covid19treatmentguidelines.nih.gov/therapeutic-management/. Accessed 2/11/2021

Silva Borba MG, Almeida Val FF, Souza Sampaio V, et al. Effect of high vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Infection: a randomized clinical trial. JAMA Netw Open. 2020;3:e208857.  

 

World Health Organization (WHO). The use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with COVID-19. Available at https://www.who.int/news-room/commentaries/detail/the-use-of-non-steroidal-anti-inflammatory-drugs-(nsaids)-in-patients-with-covid-19

Copyright © 2020 | COVID Frontline | All Rights Reserved | Website by Divigner

Patient Toolkit

The COVID FRONTLINE Patient Toolkit is a resource center for patients who have been diagnosed with or who are interested in learning about COVID-19. Choose from the options below to learn more.

Clinical Toolkit

The COVID-19 Clinical Toolkit is an online tool that aims to provide clinicians with up-to-date information on the presentation, prognosis, pathophysiology, and treatment strategies for COVID-19. Click on one of the options below to learn more.

This activity is provided by Med Learning Group. This activity is co-provided by Ultimate Medical Academy/CCM.
This activity is supported by educational grants from AbbVie, Astellas, Genentech, Merck & Co., Inc., and Pfizer.

Copyright © 2019 | COVID Frontline | All Rights Reserved | Website by Divigner

Updates in the Treatment and Prevention of COVID-19​

Emergency use authorization for BNT162b2 for the prevention of COVID-19

BNT162b2 (Pfizer-BioNTech COVID-19 Vaccine) is a messenger RNA (mRNA) vaccine delivered in a lipid nanoparticle to express the spike protein of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2).1 On December 11, 2020, the US Food and Drug Administration (FDA) granted an emergency use authorization (EUA) for BNT162b2 for the prevention of coronavirus disease 2019 (COVID-19) in individuals 16 years of age and older.2, 3

Authorization is based on data from an ongoing phase 3 trial (NCT04368728), which showed that BNT162b2 was 95% effective in preventing symptomatic COVID-19 infections.1 With a median follow-up of 2 months after vaccination, there were 170 COVID-19 cases among study participants (8/21,720 in the vaccine group versus 162/21,728 in the placebo group) reported at or after 7 days following the second dose. Similar vaccine efficacy was reported across subgroups defined by age, sex, race, ethnicity, BMI, and coexisting conditions. Nine of the 10 severe COVID-19 cases reported in the trial occurred in the placebo group. The safety profile of BNT162b2 was characterized by local and systemic reactions (pain at the injection site, fatigue, headache, fever, chills), which were mostly short-term and mild-to-moderate. Reactions were relatively more common after the second dose in younger participants. Rare cases of anaphylaxis and Bell’s palsy were also reported in the trial.

Emergency use authorization for mRNA-1273 for the prevention of COVID-19

mRNA-1273 (Moderna COVID-19 Vaccine) is an mRNA vaccine delivered in a lipid nanoparticle to express the spike protein of SARS-CoV-2.4 On December 18, 2020, the FDA granted an EUA for mRNA-1273 for the prevention of COVID-19 in individuals 18 years of age and older.5, 6

Authorization is based on data from an ongoing phase 3 trial (NCT04470427), which showed that mRNA-1273 was 94.1% effective in preventing symptomatic COVID-19 infections.4 With a median follow-up of 2 months after vaccination, there were 196 COVID-19 cases among study participants (11/15,210 in the vaccine group versus 185/15,210 in the placebo group) reported at or after 14 days following the second dose. Vaccine efficacy was similar across key secondary subgroup analyses. All 30 severe COVID-19 cases reported in the trial (including 1 fatality) occurred in the placebo group. Mild-to-moderate, transient local and systemic reactions (pain at the injection site, fatigue, headache, myalgia, arthralgia) after vaccination were reported. Reactions were relatively more common after the second dose in younger participants. Rare cases of anaphylaxis and Bell’s palsy were also reported after vaccination.

Emergency use authorization for bamlanivimab for outpatients with mild-to-moderate COVID-19

Bamlanivimab (also known as LY-CoV555 and LY3819253) is a neutralizing monoclonal antibody against the spike protein of SARS-CoV-2.7 On November 9, 2020, the FDA granted an EUA for bamlanivimab for the treatment of mild-to-moderate COVID-19 in adult and pediatric patients (≥12 years of age and ≥40 kg) who test positive for SARS-CoV-2 and are at high risk for progressing to severe COVID-19 and/or hospitalization.8 High risk is defined as patients who are ≥65 years of age or have certain chronic medical conditions. Treatment with bamlanivimab should be administered as soon as possible after a positive viral test for SARS-CoV-2 and within 10 days of symptom onset.9 Bamlanivimab is not authorized for patients who are hospitalized due to COVID-19 or require oxygen therapy due to COVID-19.8

Authorization is based on data from the ongoing phase 2/3 BLAZE-1 trial (NCT04427501) in which nonhospitalized participants with recently diagnosed mild or moderate COVID-19 were randomly assigned to receive placebo or bamlanivimab.7 Compared with placebo, treatment with bamlanivimab was associated with a reduction in SARS-CoV-2 viral load at day 11. Furthermore, the percentage of participants who had a COVID-19-related hospitalization or visit to an emergency department within 28 days was lower in the bamlanivimab group compared to the placebo group (1.6% versus 6.3%). Nausea and infusion-related reactions to bamlanivimab were reported but were generally uncommon.9

Emergency use authorization for bamlanivimab plus etesevimab for outpatients with mild-to-moderate COVID-19

Bamlanivimab (LY3819253 or LY-CoV555) and etesevimab (LY3832479 or LY-CoV016) are neutralizing monoclonal antibodies that bind to different epitopes of the spike protein of SARS-CoV-2.10 On February 09, 2021, the FDA granted an EUA for bamlanivimab plus etesevimab for the treatment of mild-to-moderate COVID-19 in adult and pediatric patients (≥12 years of age and ≥40 kg) who test positive for SARS-CoV-2 and are at high risk for progressing to severe COVID-19 and/or hospitalization.11 High risk is defined as patients who are ≥65 years of age or have certain chronic medical conditions. Treatment with bamlanivimab plus etesevimab should be administered as soon as possible after a positive viral test for SARS-CoV-2 and within 10 days of symptom onset.12 Bamlanivimab and etesevimab are not authorized for patients who are hospitalized due to COVID-19 or require oxygen therapy due to COVID-19.11

Authorization is based on data from the ongoing phase 2/3 BLAZE-1 (NCT04427501) and phase 2 BLAZE-4 (NCT04634409) trials.10-12 Among nonhospitalized adults with mild-to-moderate COVID-19 who were at high risk for progressing to severe COVID-19, hospitalization or death occurred in 7% of participants who received placebo compared to 2% of those who received bamlanivimab plus etesevimab.11 All-cause death was also significantly lower in the bamlanivimab plus etesevimab group compared to the placebo group. Possible adverse effects of bamlanivimab plus etesevimab include nausea, dizziness, pruritus, and rash.

Emergency use authorization for casirivimab plus imdevimab for outpatients with mild-to-moderate COVID-19

Casirivimab (REGN10933) and imdevimab (REGN10987) are neutralizing monoclonal antibodies that bind to different epitopes of the spike protein of SARS-CoV-2.13 The combination of casirivimab and imdevimab (previously known as REGN-COV2) has been authorized for emergency use for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients (≥12 years of age and ≥40 kg) who are at high risk for progressing to severe COVID-19 or hospitalization.14 High risk is defined as patients who are ≥65 years of age or have certain chronic medical conditions. Treatment with casirivimab plus imdevimab should be administered as soon as possible after a positive viral test for SARS-CoV-2 and within 10 days of symptom onset. Casirivimab plus imdevimab are not authorized for patients who are hospitalized due to COVID-19 or require oxygen therapy due to COVID-19.14

Interim results from 275 nonhospitalized patients in a placebo-controlled trial (NCT04425629) of casirivimab plus imdevimab found that the combination therapy reduced viral load, with a greater effect in patients whose immune response had not yet been initiated or who had a high viral load at baseline. Patients who received casirivimab plus imdevimab required fewer medical visits for COVID-19 than patients who received placebo (3% vs 6%, respectively). Among patients who were serum antibody-negative at baseline, 15% in the placebo group and 6% in the treatment group required COVID-19-related medical care.13 Infrequent infusion-related reactions to treatment with casirivimab plus imdevimab were reported.14

Baricitinib in combination with remdesivir authorized for emergency use in hospitalized patients with COVID-19

Baricitinib is an oral Janus kinase (JAK) inhibitor with anti-inflammatory as well as potential antiviral activity.15 Baricitinib, in combination with remdesivir, is authorized for emergency use in adult and pediatric patients ≥2 years of age hospitalized for COVID-19 who require supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).16

A recent trial (NCT04401579) of 1033 patients hospitalized for COVID-19 found that baricitinib plus remdesivir was superior to remdesivir alone in reducing recovery time (7 days vs 8 days, respectively; P= .03). Patients receiving high-flow oxygen or noninvasive ventilation at enrollment had a time to recovery of 10 days with combination therapy and 18 days with the control (rate ratio for recovery, 1.51). The addition of baricitinib to remdesivir was associated with 30% higher odds of improvement in clinical status at day 15 compared with remdesivir alone.15 Known adverse effects of baricitinib include serious venous thrombosis, such as pulmonary embolism, and serious infections.16

 

References 

  1. Polack FP, Thomas SJ, Kitchin N, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020;383(27):2603-2615.
  2. FDA. Pfizer-BioNTech COVID-19 Vaccine. Available at https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/pfizer-biontech-covid-19-vaccine. Accessed 2/10/2021.
  3. FDA. Emergency Use Authorization (EUA) of the Pfizer-BioNTech COVID-19 Vaccine to Prevent Coronavirus Disease 2019 (COVID-19). Fact Sheet for Healthcare Providers Administering Vaccine. Available at https://www.fda.gov/media/144413/download. Accessed 2/10/2021.
  4. Baden LR, El Sahly HM, Essink B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med. 2021;384(5):403-416.
  5. FDA. FDA Takes Additional Action in Fight Against COVID-19 By Issuing Emergency Use Authorization for Second COVID-19 Vaccine. Available at https://www.fda.gov/news-events/press-announcements/fda-takes-additional-action-fight-against-covid-19-issuing-emergency-use-authorization-second-covid. Accessed 2/10/2021.
  6. FDA. Emergency Use Authorization (EUA) of the Moderna COVID-19 Vaccine to Prevent Coronavirus Disease 2019 (COVID-19). Factsheet for Healthcare Providers Administering Vaccine. Available at https://www.fda.gov/media/144637/download?utm_medium=email&utm_source=govdelivery. Accessed 2/10/2021.
  7. Chen P, Nirula A, Heller B, et al. SARS-CoV-2 neutralizing antibody LY-CoV555 in outpatients with Covid-19. N Engl J Med. 2021;384(3):229-237.
  8. FDA. Coronavirus (COVID-19) Update: FDA Authorizes Monoclonal Antibody for Treatment of COVID-19. Available at https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-monoclonal-antibody-treatment-covid-19?utm_medium=email&utm_source=govdelivery. Accessed 2/10/2021.
  9. FDA. Emergency Use Authorization (EUA) of Bamlanivimab. Fact Sheet for Healthcare Providers. Available at https://www.fda.gov/media/143603/download. Accessed 2/10/2021.
  10. Gottlieb RL, Nirula A, Chen P, et al. Effect of bamlanivimab as monotherapy or in combination with etesevimab on viral load in patients with mild to moderate COVID-19: a randomized clinical trial. JAMA. 2021;e210202.
  11. FDA. Coronavirus (COVID-19) Update: FDA Authorizes Monoclonal Antibodies for Treatment of COVID-19. Available at https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-monoclonal-antibodies-treatment-covid-19-0. Accessed 2/10/2021.
  12. FDA. Emergency Use Authorization (EUA) of Bamlanivimab and Etesevimab. Fact Sheet for Healthcare Providers. Available at https://www.fda.gov/media/145802/download. Accessed 2/10/2021.
  13. Weinreich DM, Sivapalasingam S, Norton T, et al. REGN-COV2, a neutralizing antibody cocktail, in outpatients with Covid-19. N Engl J Med. 2021;384(3):238-251.
  14. FDA. Emergency Use Authorization (EUA) of Casirivimab and Imdevimab. Fact Sheet for Health Care Providers. Available at https://www.fda.gov/media/143892/download. Accessed 12/23/2020.
  15. Kalil AC, Patterson TF, Mehta AK, et al. Baricitinib plus remdesivir for hospitalized adults with Covid-19. N Engl J Med. 2020;NEJMoa2031994.
  16. Emergency Use Authorization (EUA) of Baricitinib. Fact Sheet for Healthcare Providers. Available at https://www.fda.gov/media/143823/download. Accessed 12/23/2020.