Novel 2019 Coronavirus SARS-CoV-2 (COVID-19): An Overview for Emergency Clinicians Abstract The novel coronavirus, SARS-CoV-2, and its infection, COVID-19, has quickly become a worldwide threat to health, travel, and commerce. It is essential for emergency clinicians to learn as much as possible about this pandemic to manage the unprecedented burdens on healthcare providers and hospital systems. This review analyzes information from worldwide research and experience on the epidemiology, prevention, and treatment of COVID-19, and offers links to the most reliable and trustworthy resources to help equip healthcare professionals in managing this public health challenge. As the pandemic sweeps the United States, lessons learned from early centers of infection, notably New York and Northern Italy, can help localities to prepare. Go online to www.ebmedicine.net/COVID-19 for more COVID-19 resources, podcasts, translations, and updates. Key Points • The current case fatality rate of COVID-19 is approximately 4%, though sampling error may be large. While this would make SARS-CoV-2 the least deadly of the 3 most pathogenic human coronaviruses, its relative virulence has shown an ability to overwhelm even relatively advanced healthcare infrastructures, as noted by a current case fatality rate in Italy of 8.37% as of March 18, 2020.1 • Based on data from China, 29% of the confirmed COVID-19 patients are healthcare professionals, and 12% are hospitalized patients, suggesting an alarming 41% rate of nosocomial spread.2 • Recent data from the CDC suggest younger patients (aged 20-44 years) are not as immune to significant disease as previously reported and have up to a 20% hospitalization rate; however, children aged < 18 years are generally spared from significant morbidity or mortality. • Gastrointestinal (GI) symptoms are less frequently discussed, but new data suggest almost half of patients in a Chinese study had diarrhea, and the presence of GI symptoms was associated with worse disease outcome. • In preparation for the arrival of patients suffering from COVID-19, emergency departments (EDs), hospitals, and healthcare systems should make immediate and necessary structural and process changes to prepare for high volumes of patients, primarily in respiratory distress, who will require mechanical support. May 2020 Volume 22, Number 5 E-published concurrently in Pediatric Emergency Medicine Practice May 2020 Volume 17, Number 5 Authors Al Giwa, LLB, MD, MBA, FACEP, FAAEM Associate Professor of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY Akash Desai, MD Icahn School of Medicine at Mount Sinai, New York, NY Andrea Duca, MD Attending Physician, Department of Emergency Medicine, Ospedale Papa Giovanni XXIII, Bergamo, Italy Peer Reviewers Andy Jagoda, MD, FACEP Professor and Chair Emeritus, Department of Emergency Medicine; Director, Center for Emergency Medicine Education and Research, Icahn School of Medicine at Mount Sinai, New York, NY Trevor Pour, MD, FACEP Assistant Professor, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY Marc A. Probst, MD, MS, FACEP Associate Professor, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY Prior to beginning this activity, see “CME Information” on the back page.
