Coronavirus symptoms and other clinical features of the infection are very variable. Because the young and immunocompetent patients may not present with any symptoms, the disease is likely to be missed. This could result in the rapid spread of the infection.

Because of the emerging cases of coronavirus infection in most parts of the world, the WHO has declared it as a public health emergency of international concern.

A recent article published the clinical characteristics of more than a thousand laboratory-confirmed cases of COVID-19 (Wuhan Coronavirus infection) [Ref].

This article is a simplified version of the above-cited article. The aim is to identify and diagnose patients with confirmed Coronavirus infection at the earliest so as to avoid its spread.

Demographics of the patients with Coronavirus infection:

Among all the diagnosed cases, 93.6% of the patients required hospitalization and the mortality rate was found to be 1.4% (death occurred in 15 patients).

Ages of the confirmed Coronavirus patients:

The median age of the patients was 47 years ranging from 35 to 58 years.

Most patients (55.1%) were between 14 and 49 years of age.

28.9% were 50 to 64 years of age.

15.1% were aged 65 years or more while only 0.9% of the patients were younger than 14 years of age.

Children younger than 14 years of age were least likely to get infected with Coronavirus

Gender of the patients:

41% of the patients infected with Coronavirus were females.

Exposure/ Possible mode of transmission during the last two weeks:

43.9% of the studied patients who were infected with COVID-19 infection were living in Wuhan.

31.3% were not living in Wuhan but had recently visited Wuhan.

72.3% had contact with residents of Wuhan

1.9% of the patients had contact with wildlife.

Most infections spread from the city of Wuhan

Incubation Period of Coronavirus:

The incubation period was defined as the interval between the possible earliest date of exposure to the source of infection and the onset of symptoms. Symptoms included fatigue, myalgia, fever, and fatigue.

The mean incubation period was 4 days ranging from 2 to 7 days.

Individuals who visit from an endemic area to a non-endemic area should be quarantined for a period of seven days.

Symptoms of Coronavirus infection among patients with the confirmed COVID-19 infection:

Fever in Coronavirus infection:

Fever was defined as an axillary temperature of 37.5 C or more.

43.8% of the patients had a fever on admission. 56.2% had a temperature of less than 37.5 C. 22% of the patients had a temperature of 37.5 C to 38 C. 18.2% had a temperature of 38.1 C to 39 C Only 3.9% of the confirmed cases had a temperature greater than 39 C.

88.7% of the patients were documented to have a fever during hospitalization 9.9% had a temperature of less than 37.5 C. 30.9% of the patients had a temperature of 37.5 C to 38 C. 46.9% had a temperature of 38.1 C to 39 C Only 12.3% of the confirmed cases had a temperature greater than 39 C.



Most patients develop a fever but high-grade fever is not a hallmark of Coronavirus infection.

Upper respiratory tract symptoms in Coronavirus infection:

Conjunctival congestion and red eyes were present in 0.9% of the patients.

of the patients. Nasal congestion was present in only 4.8% of the patients

of the patients A sore throat was present in 13.9% of the patients

Unlike most other viral infections, patients with Coronavirus infection infrequently have upper respiratory tract symptoms.

Lower Respiratory tract symptoms in Coronavirus infection:

67.8% of the patients had a cough

of the patients had a cough 33.7% had phlegm (sputum) production.

had phlegm (sputum) production. 18.7% of the patients developed shortness of breath.

of the patients developed shortness of breath. 0.9% of the patients had blood in the sputum (hemoptysis)

Lower respiratory tract symptoms are more common than upper respiratory tract symptoms in patients with Coronavirus infection.

Antimalarial drugs (Hydroxychloroquine and chloroquine) are thought to limit the disease to the upper respiratory tract and reduce the incidence of COVID-19 associated pneumonia.

Antimalarial drugs are thus used in the prevention of Coronavirus infection.

Gastrointestinal symptoms in Coronavirus infection:

Nausea and vomiting were found in 5% of the patients.

of the patients. Diarrhea was found in 3.8% of the patients.

Gastrointestinal symptoms are infrequent in Coronavirus infection

Musculoskeletal symptoms in Coronavirus infection:

13.6% of the patients had a headache

of the patients had a headache Fatigue was reported by 38.1% of the patients.

of the patients. 14.9% reported muscular pains and pain in the joints.

reported muscular pains and pain in the joints. 11.5% of the patients reported chills.

Fatigue and other skeletal manifestations are not very uncommon in Coronavirus infection

Clinical signs in Coronavirus infection:

Clinical signs were found infrequently.

1.7% of the patients had throat congestion

2.1% had swollen tonsils

0.2% of the patients had lymphadenopathy and a rash each.

Cough, Fever, Sputum production, Fatigue are the most common symptoms of Coronavirus infection.

Radiologic findings in Coronavirus infection:

The chest radiograph was abnormal in 59.1% of the confirmed cases.

Ground glass opacity was found in 20.1% of the radiographs

of the radiographs 28.1% of the radiographs had a local patchy shadowing

of the radiographs had a local patchy shadowing Bilateral patchy shadowing: 36.5%

Interstitial abnormalities: 4.4%

Chest CT was abnormal in 86.2% of the patients:

Ground glass opacity was found in 56.4% of the Chest CT scans

of the Chest CT scans 41.9% of the CT scans had a local patchy shadowing

of the CT scans had a local patchy shadowing Bilateral patchy shadowing: 51.8%

Interstitial abnormalities: 14.7%

Laboratory findings in Coronavirus infection:

White-cell count: mean count: 4700/ul less than 4000//ul: 33.7% of the patients more than 10000//ul: 5.9% of the patients



Lymphocyte count: Median: 1000//ul less than 1500/ul: 83.2% of the patients

Platelets count: Median: 168,000//ul less than 150,000/ul: 36.2% of the patients



Leukopenia and lymphopenia, in particular, along with thrombocytopenia were the predominant finding on blood CBC report of the patients

Median hemoglobin was 13.4 gm/dl

C-reactive protein ≥10 mg/liter: 60.7%

Procalcitonin ≥0.5 ng/ml: 5.5%

A positive C-reactive protein and a negative procalcitonin were found in most of the patients.

Lactate dehydrogenase ≥250 U/liter: 41%

Aspartate aminotransferase >40 U/liter: 22.2%

Alanine aminotransferase >40 U/liter: 21.3%

Total bilirubin >17.1 μmol/liter: 10.5%

Creatine kinase ≥200 U/liter: 13.7%

Creatinine ≥133 μmol/liter: 1.6%

d-dimer ≥0.5 mg/liter: 46.4%

LDH and D-dimers were elevated in almost half of the patients.

Complications of Coronavirus infection in the confirmed cases:

The most common complication that developed in patients with COVID-19 infection was pneumonia. Pneumonia developed in 91.1% of the patients and is the most dreaded of the complications as it may lead to ARDS.

Other complications were very rare. These included:

Septic shock in 1.1% of the patients

in 1.1% of the patients Acute respiratory distress syndrome in 3.4% of the patients

in 3.4% of the patients Acute renal failure in 0.5% of the patients

in 0.5% of the patients Disseminated intravascular coagulation in 0.1% of the patients

in 0.1% of the patients Rhabdomyolysis in 0.2% of the cases.

Most patients were treated with intravenous antibiotics and Oseltamivir. Oxygen inhalation was required in 41.3% of the patients.

18.6% were given glucocorticoids, 13% were given intravenous immunoglobulins, 5% required intensive care support while 2.3% required mechanical ventilation.

In Conclusion:

The clinical features of COVID-19 (Coronavirus infection) are very subtle. Most patients develop a low-grade fever, fatigue, and a dry cough. Leukopenia and lymphopenia, elevated CRP and low procalcitonin levels are the prominent laboratory features.

Most patients develop pneumonia as a complication that is evidenced by an abnormal chest radiograph or a CT scan of the chest. The calculated mortality in this cohort of patients is 1.4%.