COVID-19 signs, symptoms and severity of disease: A clinician guide
Last updated: June 1, 2022
The information below is based on currently available scientific evidence and informed by expert clinician opinion, and is subject to change as new information becomes available. This document is intended to provide clinicians with interim information on currently known clinical features of COVID-19, including signs and symptoms, incubation period, disease severity and risk factors for severe disease and SARS-CoV-2 variants of concern.
On this page
- Signs and symptoms
- Asymptomatic infection
- Incubation period
- Disease severity and risk factors for severe disease
- SARS-CoV-2 variants of concern (VOC)
- Acknowledgments
- Bibliography
Signs and symptoms
COVID-19 includes clinical features that present in varying ways with respect to frequency and severity and vary by age, vaccination status and variants of concern. Published reports often over-represent individuals who have more severe symptoms, and these may differ across care settings and between different age groups and vaccine statuses. Symptoms that are absent at the onset of illness may develop over time with disease progression. To date, there remains no comprehensive list of symptoms that has been validated to have high specificity or sensitivity for COVID-19. The ZOE COVID Study from the United Kingdom is a comprehensive system that tracks COVID-19 symptoms. This study found that symptom frequency and severity has varied by circulating variant and by vaccination status. During the Omicron wave that began in November 2021, those who have had at least 2 vaccinations reported milder symptoms; typical symptoms reported during the Omicron wave included runny nose, headache, sneezing, and sore throat. This response is different than the predominant symptoms earlier in the pandemic, which included fever, cough, chills and muscle pain. When fever occurred in Omicron cases, it was more frequently reported in unvaccinated than in vaccinated cases.
As new variants emerge and more of the population becomes vaccinated, there will be ongoing changes in the patterns of symptoms that individuals experience. With Omicron, clinical presumptive diagnosis should be considered with symptoms compatible with COVID-19 and a history of contact with known case(s). Testing may either not be available, or accurate, early in the course of illness. The patient however, should be advised to take a Point of Care antigen or NAAT test for SARS-CoV-2, when and where available, and follow local/regional public health authority recommendations for cases and contacts. Patients should always be encouraged to seek medical consultation if experiencing worsening symptoms of concern. Table 1 below outlines the common, less frequent, and rare symptoms reported by those with COVID-19 during the Omicron wave.
Common symptoms (>50%) |
Less frequent symptoms (≤ 50%) |
Rare symptoms (<10%) |
---|---|---|
|
|
|
Note: It is important to evaluate whether the patient's symptoms are new, worsening, or different from their baseline. |
With the Omicron variant, loss or altered sense of smell is less prevalent than with the Delta variant, and sore throat and hoarse voice were significantly more prevalent. Those infected during the Omicron wave are less likely to experience at least one out of the three classic COVID-19 symptoms (fever, loss of smell, and persistent cough) compared with individuals infected during the Delta wave. Duration of acute symptoms for those with the Delta variant was longer than those with the Omicron variant (mean duration 9 days vs. 7 days). Regardless of the variant, the duration of symptoms is shorter for those who received three doses of vaccines (Delta mean duration 8 vs. Omicron duration 4 days). Some people can present symptoms for weeks of months after their initial recovery. See long COVID for details on symptoms, mental health, prevention, diagnosis and treatment.
Clinicians should remain aware of signs and symptoms that warrant more urgent or emergency medical attention. Patients with mild disease should be informed to seek medical attention should they experience any of the following:
- trouble breathing or severe shortness of breath
- persistent pressure or pain in the chest
- new onset of confusion or altered level of consciousness
- inability to wake up or stay awake
- pale, gray, or blue-colored skin, lips, or nail beds
Multisystem inflammatory syndrome – children (MIS-C)
In early 2020, MIS-C was newly confirmed to be associated with to SARS-CoV-2 infection. It is characterized by hyperinflammation and multi-organ involvement, and presents with clinical features similar to Kawasaki disease and toxic shock syndrome. Symptoms typically occur around 2-6 weeks after the initial infection. In Canada, MIS-C is rare, with 269 cases reported to the Public Health Agency of Canada between March 11, 2020 and October 2, 2021. Cases have been reported in infants as young as one week to youth as old as 18 years, with a median age of six years. Cases were more likely to occur in males than females (58% vs 42%). Almost all MIS-C cases (99%) required hospitalization and 36% required intensive care unit admission. No deaths from MIS-C have been reported in Canada as of May 31, 2022.
Multisystem inflammatory syndrome – adults (MIS-A)
Multisystem inflammatory syndrome is a rare but severe complication of SARS-CoV-2 that may also occur in adults. Symptoms typically occur around 2-12 weeks after the initial infection. CDC has developed a working case definition for MIS-A.
In September 2021, a systematic review of all MIS-A publications reported a total of 221 cases, with a median age of 21 years and 70% of the cases being male. Most patients with MIS-A presented with fever (96%), hypotension (60%), cardiac dysfunction (54%), shortness of breath (52%), and/or diarrhea (52%). The median number of organ systems involved was 5. The median hospital stay was 8 days; and of those hospitalized, 57% were admitted to the intensive care unit (ICU). Of those admitted to the ICU, 47% required respiratory support and 7% died. Most patients had elevated markers of coagulopathy and/or inflammation (90%) and a positive SARS-CoV-2 serologic finding (72%).
Although rare, it is important to recognize the symptoms of MIS-A, as it is a serious hyperinflammatory condition associated with COVID-19 and can lead to multiorgan failure.
COVID-19 symptoms in children
In earlier waves of the pandemic, typical symptoms of COVID-19 in children were fever (46-64%) and cough (32-56%). However, many children were asymptomatic or only had a few symptoms. More recently, with the Omicron variant, symptoms have been shown to more likely be upper respiratory, as noted in Table 1 above. Young children are especially vulnerable to upper respiratory acute infection due to their small and relatively collapsible airways. This has resulted in some children experiencing laryngotracheobronchitis, or croup. Croup is classically characterized by a sudden onset "barking cough," inspiratory stridor, and respiratory distress. Some small case series of croup have been reported during the Omicron wave and have been associated with SARS-CoV-2 infection. It is still unknown if cases of croup are due to SARS-CoV-2 or a co-infection with another virus. Other than croup, children's symptoms mimic those of adults for Omicron, which are predominantly upper respiratory symptoms, including runny nose, sneezing and sore throat. Hospitalized children are more likely to have fever, abdominal symptoms like vomiting, and shortness of breath, along with cough and the other upper respiratory symptoms. Symptoms of COVID-19 may overlap with that of other viral infections, including influenza and other respiratory and enteric viral infections. The true incidence of asymptomatic COVID-19 infection is unknown. However, asymptomatic COVID-19 infection has been reported in up to 45% of children who had surveillance testing done at the time of hospitalization for a non-COVID indication.
A MMWR report on hospitalized children aged 5-11 years with SARS-CoV-2 infections in 14 U.S. states found that during the Omicron wave, unvaccinated children had double the rate of hospitalization compared to vaccinated children. Thirty percent (30%) of hospitalized children had no underlying medical conditions, and children with diabetes and obesity were more likely to develop severe COVID-19. Intensive care unit admission occurred in 19% of hospitalized cases. Increasing COVID-19 vaccination coverage among children aged 5–11 years, especially those at higher risk of severe disease, may help prevent hospitalizations and severe outcomes associated with COVID-19.
When assessing children, it is important to consider that the signs and symptoms of COVID-19 are similar to those of other infectious and non-infectious conditions, including influenza, other viral upper respiratory infections, streptococcal pharyngitis, asthma and allergies. The lack of specificity of signs or symptoms and the significant proportion of asymptomatic infections makes symptom-based screening for identification of SARS-CoV-2 in children difficult.
COVID-19 symptoms in older adults
Older adults may present with atypical symptoms due to age-related weakening of the immune system. Weakened immunity can also lead to increased risk of infection. Clinical presentation may differ in older adults, and COVID-19 symptoms may need to be evaluated using a slightly different approach in this patient population.
Symptoms that may present differently in older individuals include: fever (may present with lower temperatures), cough and shortness of breath (differentiate from chronic lung conditions), loss of taste or smell (differentiate if due to medications or neurodegenerative processes causing sensory impairment), and fatigue and body ache (common in older individuals). Sore throat, new-onset congestion, nausea, vomiting, or diarrhea may be more valuable as diagnostic criteria for SARS-CoV-2 infection in older individuals.
In a multicenter study of seven emergency departments in the US, delirium was one of the presenting symptoms in 226 (28%) of 817 patients with COVID-19 and exclusively the primary presenting complaint in 16% of patients with a mean age of 78 years. Estimates of falls and frailty, as a presenting symptom of COVID-19, ranged between 23.5% and 32%. In addition, dehydration in older adults should be considered as an important presentation of COVID-19. Therefore, it is important to ensure older adults receive their recommended vaccination series and boosters as they become available via regional/provincial/territorial public health authorities.
To review the most up-to-date information on Age groups by hospitalizations, ICU admissions and deaths see COVID-19 epidemiological summary.
Asymptomatic infection
A person who is asymptomatic is someone who has tested positive for SARS-CoV-2 test and has never developed any symptoms. During the Omicron wave, a large study in South Africa estimated that 31% of cases were asymptomatic (approximately 1 in 3 cases). This study also reported high viral loads in asymptomatic cases. The asymptomatic carriage rate was similar in SARS-CoV-2 seropositive and seronegative cases.
Incubation period
The pre-Omicron incubation period for COVID-19 had been estimated to range from 2 to 14 days, with a median of 4-7 days from exposure to symptom onset. Omicron has been found to have an incubation period of a median of 2-4 days, and its associated viral loads have been reported to peak in saliva 1-2 days before positive results can be seen in PCR or rapid antigen tests. Omicron has also been found to be more transmissible, have a higher attack rate and a higher basic reproduction number (R0) than other variants.
The world's first "human challenge" trial where volunteers were intentionally exposed to a challenge virus from the B1-lineage of SARS-CoV-2, which included the Alpha, Beta and Delta variants, found that the presence of symptoms did not change with viral load. The viral load in the airways in these infected patients was not related to whether the individual developed symptoms or the severity of illness. In infected individuals, the peak viral load occurred on day 5, with the virus first detected in the throat and then rising to significantly higher levels in the nose. The challenge study found that viral loads were detectable in the nose and throat within 24 hours of inoculation, although symptoms became apparent a little later, i.e., within 2-4 days.
It is now known that SARS-CoV-2 RNA can be detected in the upper or lower respiratory tract for weeks after illness onset. However, detection of viral RNA does not necessarily mean that a patient can transmit the virus. Evidence has shown that an individual may be infectious for up to 3 days prior to any presentation of symptoms. The levels of viral RNA from saliva, sputum, nasopharyngeal or other upper respiratory specimens, and stool samples appear to be highest soon after symptom onset.
Disease severity and risk factors for severe disease
There is a spectrum of COVID-19 disease severity, ranging from asymptomatic, mild, moderate, to severe and critical disease. Severe disease occurs more often in older age and in those with underlying medical conditions, and the risk increases with the number of underlying medical conditions.
The conditions identified below are those for which conclusive evidence is available.
Underlying medical conditions associated with more severe COVID-19 disease
- Cancer
- Cerebrovascular disease
- Chronic kidney disease
- Chronic liver diseases (limited to: cirrhosis, non-alcoholic fatty liver disease, alcoholic liver disease, and autoimmune hepatitis)
- Chronic lung diseases (limited to: bronchiectasis, chronic obstructive pulmonary disease, interstitial lung disease, pulmonary hypertension, pulmonary embolism)
- Cystic fibrosis
- Diabetes mellitus, type 1 and type 2
- Disabilities (e.g. Down syndrome, learning, intellectual, or developmental disabilities; ADHD; cerebral palsy; congenital disabilities; spinal cord injuries)
- Heart conditions (e.g., cardiomyopathies, coronary artery disease, heart failure, etc.)
- HIV infection
- Mental health disorders (limited to: mood disorders, including depression; schizophrenia spectrum disorders)
- Obesity
- Pregnancy and recent pregnancy
- Primary immunodeficiency diseases
- Smoking, current or former
- Solid organ or blood stem cell transplant
- Tuberculosis
- Use of corticosteroids or other immunosuppressive medication
Certain medical and/or social vulnerabilities, may make it more difficult for patients to recognize, clearly communicate, or act on symptoms' progression. Affected individuals may include: people experiencing intellectual, developmental, or cognitive disabilities; people who use substances regularly; people who live with mental health conditions; and persons experiencing homelessness or who are unhoused. These patients need closer attention and monitoring.
SARS-CoV-2 variants of concern (VOC)
The SARS-CoV-2 virus has naturally mutated or changed over time. Mutations may increase or decrease transmissibility or virulence, or lead to immune escape or reduced responses to therapeutics compared to non-variant viruses. Compared to the original strain of SARS-CoV-2, we have seen an increased transmissibility with Omicron. Over time, new variants will emerge, and the transmissibility and virulence will be expected to change.
Acknowledgements
Dr. Marianna Ofner, Dr. Marina Salvadori, Yung-En Chung, Dr. Michael Green, Aidan Pucchio, Denise Gravel-Tropper, Dr. Mireille Plamondon and Dr. Ewa Rajda.
Bibliography
Adamson B, Sikka R, Wyllie AL, Premsriut P. Discordant SARS-CoV-2 PCR and rapid antigen test results when infectious: a December 2021 occupational case series. (2022). medRxiv 22268770 [Preprint]. 2022 Jan 5.
Ahmada F., Ahmeda., A, Rajendraprasada S.S., Lorangera F., Guptaa S., Velagapudia M…Moore D. (2021). Multisystem inflammatory syndrome in adults: A rare sequela of SARS-CoV-2 infection. International Journal of Infectious Diseases, 2021-07-01, Volume 108, Pages 209-211.
Alene, M., Yismaw, L., Assemie, M.A., Ketema, D.B., Mengist, B., Kassie, B., & Birhan, T.Y. (2021). PLOS ONE Magnitude of asymptomatic COVID-19 cases throughout the course of infection: A systematic review and meta-analysis. https://doi.org/10.1371/journal.pone.0249090.
Argenziano M,G., Bruce S,L., Slater C.L., Tiao, J.R., Baldwin, M.R., Barr, R.G., Barr 4., …, Ruijun Chen. (2020). Characterization and Clinical Course of 1000 Patients with COVID-19 in New York: retrospective case series. BMJ 29(369),m1996. doi: 10.1136/bmj.m1996.
Auwaerter P.G. Coronavirus COVID-19 (SARS-CoV-2): Johns Hopkins ABX Guide. Coronavirus COVID-19 (SARS-CoV-2) | Johns Hopkins ABX Guide. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540747/all/Coronavirus_COVID_19__SARS_CoV_2_.
Bai, Y., Yao, L., Wei, T., Tian, F., Jin, D., Chen, L., & Wang, M. (2020). Presumed Asymptomatic Carrier Transmission of COVID-19. Jama 323(14):1406-1407. doi: 10.1001/jama.2020.2565.
Bullard, J., Dust, K., Funk, D., Strong, J.E., Alexander, D., Garnett, L., …Poliquin G. (2020). Predicting infectious SARS-CoV-2 from diagnostic samples. Clin Infect Dis 71(10):2663-2666. doi: 10.1093/cid/ciaa638.
Burke, R.M., Killerby, M.E., Newton, S., Ashworth; C.D., Berns, A.L., Brennan, S.,... Case Investigation Form Working Group. (2020). Symptom Profiles of a Convenience Sample of Patients with COVID-19 - United States, January-April 2020. MMWR Morb Mortal Wkly Rep, 69(28):904-908.doi: http://dx.doi.org/10.15585/mmwr.mm6928a2.
Cai, J., Xu, J., Lin, D., Zhi, Y., Lei, X., Zhenghai, Q., … Mei. Z. (2020). A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features. Clin Infect Dis. 71(6):1547--1551. doi:10.1093/cid/ciaa198.
Casey, M., Griffin, J., McAloon, C.G., Byrne, A.W., Madden, J.M., McEvoy, D.,... More, S.J. (2020). Estimating pre-symptomatic transmission of COVID-19: a secondary analysis using published data. https://www.medrxiv.org/content/10.1101/2020.05.08.20094870v1.full.pdf
Centers for Disease Control and Prevention. (2021). Multisystem Inflammatory Syndrome in Children (MIS-C): Information for Healthcare Providers About Talking with Families and Caregivers. Updated Dec. 14. https://www.cdc.gov/mis/mis-c/hcp/provider-families.html.
Centers for Disease Control and Prevention. (2022). CDC Science Brief: Evidence used to update the list of underlying medical conditions that increase a person's risk of severe illness from COVID-19. Updated Feb. 15. https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/underlying-evidence-table.html.
Chan, J.F., Yuan, S., Kok, K.H., To, K.K., Chu, H., Yang, J., …Hui, C.K. (2020). A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet, 395(10223):514-523. doi:https://doi.org/10.1016/S0140-6736(20)30154-9.
Chau, V.Q., Giustino, G., Mahmood, K.,Oliveros, E., Neibart, E., Oloomi, M., & Mancini, D.M. (2020). Cardiogenic shock and hyperinflammatory syndrome in young males with COVID-19. Circ Heart Fail, 13(10):e007485. doi: 10.1161/CIRCHEARTFAILURE.120.007485.
Centres for Effective Practice. COVID-19: Clinical Guidance for Primary Care Providers. https://tools.cep.health/tool/covid-19/#screening-covid19.
Cevik, M., Tate, M., Lloyd, O., Maraolo, A.E., Schafers, J., & Ho, A. (2021). SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis. The Lancet Microbe, 2(1), E13-E22. doi.org/10.1016/S2666-5247(20)30172-5.
Chen, N., Zhou, M., Dong, X., Qu. J., Gong, F., Han, Y., …Zhang, L. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet, 395(10223):507-513.
Chen, L., Deng, C., Chen, X., Zhang, X., Chen, B., Yu, H., …Sun X. (2020). Ocular manifestations and clinical characteristics of 534 cases of COVID-19 in China: A cross-sectional study. Acta Ophthalmologica 98(8): 951-959.
Clerkin, K.J., Fried, J.A., Raikhelkar, J., Sayer, G., Griffin, J.M., Masoumi, A., …Uriel, N. (2020). Coronavirus Disease 2019 (COVID-19) and cardiovascular disease. Circulation,141(20):1648-1655. doi: 10.1161/CIRCULATIONAHA.120.046941.
Coronavirus Disease 2019 in Children - United States, February 12-April 2, 2020. (2020). MMWR Morb Mortal Wkly Rep, 69:422-426. doi: http://dx.doi.org/10.15585/mmwr.mm6914e4.
Dadamo, H., Yoshikawa, T., & Ouslander, J.G. (2020). Coronavirus Disease 2019 in geriatrics and long-term care: The ABCDs of COVID-19. J Am Geriatr Soc, 68(5); 912-917. doi.org/10.1111/jgs.16445.
De Giorgi, F., Fabbian, F., Greco, S., Di Simone, E., De Giorgio, R., Passaro, A., …COMorbidity Evaluation of INTernal MEDicine COVID19 (OUTCOME-INTMED-COV19) Study Collaborators. (2020). Prediction of in-hospital mortality of patients with SARS-CoV-2 infection by comorbidity indexes: an Italian internal medicine single center study Eur Rev Med Pharmacol Sci., 24(19), 10258-10266.
Dominguez-Ramirez, L., Rodriguez-Perez, F., Sosa-Jurado, F., Santos-Lopez, G. & Cortes-Hernandez, P. (2020). The role of metabolic comorbidity in COVID-19 mortality of middle-aged adults. The case of Mexico. medRxiv 2020.12.15.20244160; doi: 10.1101/2020.12.15.20244160.
Dong, Y., Mo, X., Hu, Y., Qi, X., Jiang, F., Jiang, Z. & Tong, S. (2020). Epidemiology of COVID-19 Among Children in China. Pediatrics 145(6): e20200702.
Eliezer, M., Hautefort, C., Hamel, A., Verillaud, B., Herman, P., Houdart, E. & Eliot C. (2020). Sudden and complete olfactory loss function as a possible symptom of COVID-19. JAMA Otolaryngol Head Neck Surg, 146(7):674-675.
Ehrlich J.R., Ramke J., Macleod D., et al. (2021). Association between vision impairment and mortality: a systematic review and meta-analysis. Lancet Glob Health; 9(4):e418–e430.
Feldstein, L.R., Tenforde, M.W., Friedman, K.G., Newhams, M., Rose, E.B., Dapul, H., … for the Overcoming COVID-19 Investigators. (2021). Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome in Children (MIS-C) Compared With Severe Acute COVID-19. JAMA, 325(11):1074-1087. doi:10.1001/jama.2021.2091.
Flodgren, G.M. (2020). Immunity after SARS-CoV-2 infection, 1st update - a rapid review. Oslo: Norwegian Institute of Public Health, 2020. https://www.fhi.no/en/publ/2020/Immunity-after-SARS-CoV-2-infection-1st-update/.
Freedman, S.B., and Kellner, J.D. (2021). Protecting Canada's children from the consequences of the fourth wave of the COVID-19 pandemic. CMAJ September 27, 2021 193 (38) E1500-E1502; DOI: https://doi.org/10.1503/cmaj.211513.
Funk, A.L., Florin, T.A., Dalziel, S.R., et al. (2021). Prospective cohort study of children with suspected SARS-CoV-2 infection presenting to paediatric emergency departments: a Paediatric Emergency Research Networks (PERN) Study Protocol. BMJ Open;11:e042121. doi:10.1136/ bmjopen-2020-042121.
Fu, L., Bingyi, W., Yuan, T., Chen, X., Ao, Y. Fitzpatric, T.,... Zou, H. (2020). Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: a systematic review and meta-analysis. J Infect, 80(6):656-665.
Gates, M., Pillay, J., Wingert, A., Guitard, S., Rahman, S., Zakher, B.,... Hartling, L. (2021). Risk factors associated with severe outcomes of COVID-19: An updated rapid review to inform national guidance on vaccine prioritization in Canada. medRxiv. https://doi.org/10.1101/2021.04.23.21256014.
Garrett, N., Tapley, A., Andriessen, J., Seocharan, I., Fisher, L.H….Corey, L. (2022). High Rate of Asymptomatic Carriage Associated with Variant Strain Omicron. – medRxiv, Jan 14;2021.12.20.21268130. doi: 10.1101/2021.12.20.21268130. Preprint.
Gawronska, K., Lorkowski, J. (2021). Falls as one of the atypical presentations of COVID-19 in older population. Geriatr Orthop Surg Rehabil; 12:2151459321996619.
Gold, J.A.W., Wong, K.K., Szablewskiet, C.M., Patel, P.R., Rossaw, J., da Silva, J., …Jackson, B.R. (2020). Characteristics and Clinical Outcomes of Adult Patients Hospitalized with COVID-19 - Georgia, March 2020. MMWR Morb Mortal Wkly Rep. 2020. 69(18);545-550.
Götzinger, F., Santiago-García, B., Noguera-Julián, A., Lanaspa, M., Lancella, L., Carducci, F.I.C.,... ptbnet COVID-19 Study Group. (2020). COVID-19 in Children and Adolescents in Europe: A Multinational, Multicentre Cohort Study. Lancet Child Adolesc Health, 4(9):653-661. doi:10.1016/S2352-4642(20)30177-2.
Goyal, P., Choi, J.J., Pinheiro, L.C., Schenck, E.J., Chen, R., Jabri, A., …Safford, M.M. (2020). Clinical characteristics of Covid-19 in New York City. N Engl J Med, 382:2372-2374. doi: 10.1056/NEJMc2010419NEJMc2010419.
Grant, M.C., Geoghegan, L., Arbyn, M., Mohammed, A., McGuinness, L., Clarke, E.L., & Wade, R.G. (2020). PLOS ONE The prevalence of symptoms in 24,410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): A systematic review and meta-analysis of 148 studies from 9 countries. Published: June 23, 2020. https://doi.org/10.1371/journal.pone.0234765.
Grifoni, A., Weiskopf, D., Ramirez, S.I., Mateus, J., Dan, J.M., Rydyznski-Moderbacher, C., …Sette, A. (2020). Targets of T Cell Responses to SARS-CoV-2 Coronavirus in Humans with COVID-19 Disease and Unexposed Individuals. Cell, 181(7):1489-1501.e15. doi: 10.1016/j.cell.2020.05.015.
Guan, W.J., Ni, Z.Y., Hu, Y., Liang, W., Ou, C., He, J., …China Medical Treatment Expert Group for Covid-19. (2020). Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med, 382:1708-1720. doi: 10.1056/NEJMoa2002032.
Havers, F.P., Reed, C., Lim, T., Montgomery, J.M., Klena, J.D., Hall, A.J., … Krapiunaya, I. (2020). Seroprevalence of antibodies to SARS-CoV-2 in 10 sites in the United States, March 23-May 12, 2020. JAMA Intern Med, 180(12):1576-1586. doi:10.1001/jamainternmed.2020.4130.
Jansen, L., Tegomoh, B., Lange, K., et al. (2021). Investigation of a SARS-CoV-2 B.1.1.529 (Omicron) Variant Cluster – Nebraska, November-December 2021. MMWR Morb Mortal Wkly Rep; 70: 1782-1784.
He, X., Lau E.H.Y., Wu, P., Deng, X., Wang, J., Yiu, X.H., …Leung, G.M. (2020). Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med 26, 672-675. https://doi.org/10.1038/s41591-020-0869-5.
Hoehl, S., Rabenau, H., Berger, A., Kortenbusch, M., Cinatl, J., Bojkova, D., …Ciesek, S. (2020). Evidence of SARS-CoV-2 Infection in Returning Travelers from Wuhan, China. N Engl J Med, 382(13):1278-1280. doi: 10.1056/NEJMc2001899.
Hu, Z., Song, C., Xu, C., Jin, G,. Chen, Y., Xu, X., …, Shen, H. (2020). Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Sci China Life Sci, 63(5):706-711. doi: 10.1007/s11427-020-1661-4.
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., …Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5.
Irfan, O., Muttalib, F., Tang, K., Jiang, L., Lassi, Z.S., Bhutta, Z.,... Lassi, Z.S. (2021). Clinical characteristics, treatment and outcomes of paediatric COVID-19: a systematic review and meta-analysis. Arch Dis Child, 106(5):440-448. doi: 10.1136/archdischild-2020-321385.
Jarrett, P.G., Rockwood, K., Carver, D., Stolee, P., & Cosway, S. (2020). Illness presentation in elderly patients. Arch Intern Med,1995;155(10):1060-4.
Jones, T.C., Mühlemann, B., Veith, T., Biele, G., Zuchowski, M., Hofmann, J., … Drosten, C. (2021). An analysis of SARS-CoV-2 viral load by patient age. Science eabi5273. DOI: 10.1126/science.abi5273doi:10.1101/2020.06.08.20125484.
Jung, Y.J., Yoon, J.L., Kim, H.S., Lee, A.Y., Kim, M.Y., & Cho, J.J. (2017). Atypical clinical presentation of geriatric syndrome in elderly patients with pneumonia or coronary artery disease. Ann of Geri Med and Res, 21(4):158-63. 2.
Kam, K.Q., Yung, C.F., Cui, L., Lin, R.T.P., Mak, T.M., Maiwald, M., …Thoon, K.C. (20220). A Well Infant with Coronavirus Disease 2019 (COVID-19) with High Viral Load. Clin Infect Dis, 71(15):847-849. doi: 10.1093/cid/ciaa201.
Kennedy, M., Helfand, B.K.I., Gou, R.Y., et al. (2020) Delirium in older patients with COVID-19 presenting to the emergency department. JAMA Netw Open 2020; 3(11):e2029540.
Kumar, A., Arora, A., Sharma, P., Anikhindi, S. A., Bansal, N., Singla, V.,... Srivastava, A. (2020). Clinical features of covid-19 and factors associated with severe clinical course: A systematic review and meta-analysis. SSRN Electronic Journal. doi:10.2139/ssrn.3566166.
Lauer, S. A., Grantz, K. H., Bi, Q., Jones, F. K., Zheng, Q., Meredith, H. R.,... Lessler, J. (2020). The incubation period of Coronavirus DISEASE 2019 (COVID-19) from publicly REPORTED Confirmed Cases: Estimation and application. Annals of Internal Medicine, 172(9), 577-582. doi:10.7326/m20-0504.
Laverty, M., Salvadori, M.I., Squires, S.G., Ahmed, M.A., Eisenbeis, L., Lee, S.J., … Li, Y.A. (2021). Multisystem inflammatory syndrome in children in Canada. Can Commun Dis Rep 2021; 47 (11):461–5. https://doi.org/10.14745/ccdr.
Lechien, J.R., Chiesa-Estomba, C.M., Place, S., Laethem, Y.V., Cabaraux, P., Mat, Q.,... COVID-19 Task Force of YO-IFOS. (2020). Clinical and epidemiological characteristics of 1,420 European patients with mild-to-moderate coronavirus disease 2019. J Intern Med, 288(3):335-344. doi: 10.1111/joim.13089.
Li, L.Q., Huang, T., Wang, Y.Q., Wang, Z.P., Liang, Y., Huang, T.B.,... Wang, Y. (2020). COVID-19 novel coronavirus patients' clinical characteristics, discharge rate and fatality rate of meta-analysis. J Med Virol, 92(6):577-583.doi:10.1002/jmv.25757.
Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y.,... Feng, Z. (20220). Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med 2020; 382:1199-207.
Li, R., Pei, S., Chen, B., Song, Y., Zhang, T., Yang, W., & Shaman, J. (2020). Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science, 368(6490), 489-493. doi.org/10.1126/science.abb3221.
Lippi, G., & Plebani, M. (2020). Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med, 58(7):1131-1134. doi: 10.1515/cclm-2020-0198.
Liguoro, I., Pilotto, C., Bonanni. M., Ferrari, M.E., Pusiol, A., Nocerino, A., … Cogo, P. E., (2020). SARS-CoV-2 Infection in Children and Newborns: A Systematic Review. Eur J Pediatr, 1-18. doi: 10.1007/s00431-020-03684-7 2020. doi:10.21203/rs.3.rs-24629/v1.
Lovato, A.m & de Filippis, C. (2020). Clinical Presentation of COVID-19: A Systematic Review Focusing on Upper Airway Symptoms. Ear Nose Throat J, 99(9):569-576. doi: 10.1177/0145561320920762.
Lu, X., Zhang, L., Du, H., Zhang, J., Li, Y.Y., Qu, J.,... the Chinese Pediatric Novel Coronavirus Study Team. (20220.) SARS-CoV-2 Infection in Children. N Engl J Med, 23;382:1663-1665. doi:10.1056/NEJMc2005073.
Magro, C., Mulvey, J.J., Berlin, D., Nuovo, G., Salvatore, S., Harp.,... Laurence, J. (2020). Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Transl Res, 220:1-13. doi: 10.1016/j.trsl.2020.04.007.
Malone, M.L., Hogan, T.M., Perry, A., Biese, K., Bonner, A., Pagel, P., & Unroe, K.T. (2020). COVID-19 in older adults - Key points for emergency department providers. J of Geri Emerg Med, 1(4):1-11.
Mannheim, J., Gretsch, S., Layden, J.E., & Fricchione, M.J. (2020). Characteristics of Hospitalized Pediatric Coronavirus Disease 2019 Cases in Chicago, Illinois, March-April 2020. J Pediatric Infect Dis Soc, 9(5):519-522. doi:10.1093/jpids/piaa070.
McMichael, T.M., Clark, S., Pogosjans, S., Kay, M., Lewis, J., Baer, A.,... and CDC COVID-19 Investigation Team. (2020). COVID-19 in a Long-Term Care Facility - King County, Washington, February 27-March 9, 2020. MMWR Morbidity and mortality weekly report, 69(12):339-342.
Mizumoto, K., Kagaya, K., Zarebski, A., & Chowell, G. (2020). Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro surveillance: bulletin Europeen sur les maladies transmissibles - European communicable disease bulletin, 25(10).
Morris, S.B., Schwartz, N.G., Patel, P., Abbo, L., Beauchamps, L., Balan, S., & Godfred-Cato, S. (2020). Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection - United Kingdom and United States, March-August 2020. MMWR Weekly, 69(40);1450-1456. doi: dx.doi.org/10.15585/mmwr.mm6940e1.
National COVID-19 Clinical Evidence Taskforce. Caring for people with COVID-19. Supporting Australia's healthcare professionals with continually updated, evidence-based clinical guidelines. 10/06/21: Weekly Communique from the National Steering Committee. https://covid19evidence.net.au/.
Norman, D.C. (2000). Fever in the elderly. Clin Infect Dis 31(1):148–151.
O'Hanlon S.K.I,S. (2020). Delirium: a missing piece in the COVID-19 pandemic puzzle. Age Ageing 2020: 49(4):497–498.
Oran, D.P, & Topol, E.J. (2020). Prevalence of Asymptomatic SARS-CoV-2 Infection. Ann Intern Med, 173:362-367. doi:10.7326/M20-3012.
Oxley, T.J., Mocco, J., Majidi, S., Kellner, C.P., Shoirah, H., Singh, I.P.,... Fifi, J.T. (2020). Large-vessel stroke as a presenting feature of Covid-19 in the young. N Engl J Med, 382:e60. doi: 10.1056/NEJMc2009787.
Pan, L., Mu, M., Yang, P., Sun, Y., Wang, R., Yan, J.,... Tu, L. (2020). Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Am J Gastroenterol, 115(5): 766-773. doi: 10.14309/ajg.0000000000000620.
Pan, X., Chen, D., Xia, Y., Wu, X, Li, T., Ou, X.,... Liu, J. (2020). Asymptomatic cases in a family cluster with SARS-CoV-2 infection. Lancet Infect Dis, 20(4):410-411. doi:10.1016/S1473-3099(20)30114-6.
Patel, P., DeCuir, J., Abrams, J., Campbell, A., Godfred-Cata, S., Belay, E.D. (2021). Clinical Characteristics of Multisystem Inflammatory Syndrome in Adults A Systematic Review. JAMA Network Open. 2021;4(9):e2126456.doi:10.1001/jamanetworkopen.2021.26456.
Poline, J., Gaschignard, J., Leblanc, C., Madhi, F., Foucaud, E., Nattes, E.,... Ouldali, N. (2020). Systematic Severe Acute Respiratory Syndrome Coronavirus 2 Screening at Hospital Admission in Children: A French Prospective Multicenter Study. Clin Infect Dis, ciaa1044. doi: 10.1093/cid/ciaa1044.
Public Health Agency of Canada. (2022). COVID-19 daily epidemiology update. https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html#a9. Accessed May 10, 2022.
Qian G, Yang N, Ma AHY, Wang, L., Li, G., Chen, X., & Chen, X. (2020). A COVID-19 Transmission within a family cluster by presymptomatic infectors in China. Clin Infect Dis, 71(15):861-862. doi: 10.1093/cid/ciaa316.
Radia, T., Williams, N., Agrawal, P., Harman, K., Weale, J., Cook, J., Gupta, A. Multi-system inflammatory syndrome in children & adolescents (MIS-C): A systematic review of clinical features and presentation. (2021). Paediatr Respir Rev. Jun; 38:51-57. doi: 10.1016/j.prrv.2020.08.001. Epub 2020 Aug 11.
Riphagen, S., Gomez, X., Gonzalex-Martinez, C., Wilkinson, N., & Theocharis, P. (2020). Hyperinflammatory shock in children during COVID-19 pandemic Lancet, Volume 395, Issue 10237, P1607-1608, May 23, 2020. doi: https://doi.org/10.1016/S0140-6736(20)31094-1.
Rodriguez-Morales, A.J., Cardona-Ospina, J.A., Gutiérrez-Ocampo E, Villamizar-Peña, R., Holguin-Rivera, Y., Escalera-Antezana, J.P.,... Latin American Network of Coronavirus Disease 2019-COVID-19 Research (LANCOVID-19). (2020). Clinical, laboratory and imaging features of COVID-19: a systematic review and meta-analysis. Travel Med Inf Dis, 34:101623. doi: 10.1016/j.tmaid.2020.101623.
Rosenberg, E.S., Tesoriero, J.M., Rosenthal, E.M., Chung, R., Barranco, M.A., Styer, L.M.,... Zucker, H.A. (2020). (2020). Cumulative incidence and diagnosis of SARS-CoV-2 infection in New York. Ann Epidemiol., 48:23-29. doi:10.1016/j.annepidem.2020.06.004.
Rosenthal, N., Cao, Z., Gundrum, J., Sianis, J., & Safo, S. (2020). Risk Factors Associated with In-Hospital Mortality in a US National Sample of Patients With COVID-19. JAMA Netw Open, 3(12):e2029058. doi:10.1001/jamanetworkopen.2020.29058.
Rothe, C., Schunk, M., Sothmann, P., Bretzel, G., Froeschl, G., Wallrauch, C.,... Hoelscher, M. (2020). Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med, 382:970-971. doi: 10.1056/NEJMc2001468.
Roxby, A.C., Greninger, A.L., Hatfield, K.M., Lynch, J.B., Dellit, T.H., James, A.,... Neme, S. (2020). Detection of SARS-CoV-2 Among Residents and Staff Members of an Independent and Assisted Living Community for Older Adults -- Seattle, Washington, 2020. MMWR, 69(14):416-418. doi:10.15585/mmwr.mm6914e2.
Santos, M.O., Goncalves, L.C., Silva, P.A.G., Moreira, A.L.E., Ito, R.M, Peixoto, F.A.O…Avelino, M.A.G. (2021). Multisystem inflammatory syndrome (MIS-C): a systematic review and meta-analysis of clinical characteristics, treatment, and outcomes. J Pediatr (Rio J). 2021 Dec 3; S0021-7557(21)00148-0. doi: 10.1016/j.jped.2021.08.006.
Shekerdemian, L.S., Mahmood, N.R., Wolfe, K.K., Riggs, B.J., Ross, C.E., McKiernan, C.A.,... the International COVID-19 PICU Collaborative. (2020). Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units. JAMA Pediatr, 174(9):868-873. doi:10.1001/jamapediatrics.2020.1948.
Shi, H., Han, X., Jiang, N., Cao, Y., Alwalid, O., Gu, J., Fan, Y., & Zheng, C. (2020). Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis, 20(4):425-434.
Shi, D.S., Whitaker, M., Marks, K.J., et al. (2022). Hospitalizations of Children Aged 5-11 Years with Laboratory-Confirmed COVID-19 – COVID-NET, 14 States, March 2020-February 2022. MMWR Morb Mortal Wkly Rep. ePub: 19 April 2022.
Soresina, A., Moratto, D., Chiarini, M., Paolillo, C., Baresi, G., Focà, E.,... Badolato, R. (2020). Two X‐linked agammaglobulinemia patients develop pneumonia as COVID‐19 manifestation but recover. Pediatr Allergy Immunol, 31(5):565-569. doi: 10.1111/pai.13263.
Spinato, G., Fabbris, C., Polesel, J., Cazzador, D., Borsetto, D., Hopkins, C., & Boscolo-Rizzo, P. (2020). Alterations in Smell or Taste in Mildly Symptomatic Outpatients With SARS-CoV-2 Infection. JAMA, 323(20):2089-2090. doi:10.1001/jama.2020.6771.
Sun, L., Shen, L., Fan, J., Gu, F., Hu, M., An, Y.,... Bi, J. (2020). Clinical Features of Patients with Coronavirus Disease 2019 (COVID‐19) from a Designated Hospital in Beijing, China. J Med Virol, 92(10):2055-2066. doi: 10.1002/jmv.25966.
Teherani, M.F., Kao, C.M., Camacho-Gonzalez, A., Banskota, S., Shane, A.L., Linam, W.M., & Jaggi, P. (2020). Burden of Illness in Households With Severe Acute Respiratory Syndrome Coronavirus 2-Infected Children. J Pediatric Infect Dis Soc, 9(5):613-616. doi:10.1093/jpids/piaa097.
Tillett, R.L., Sevinsky, J.R., Hartley P.D., Kerwin, H., Crawford, N., Gorzalski, A.,... Pandori, M. (2021). Genomic Evidence for a Case of Reinfection with SARS-CoV-2 Lancet Infect Dis, 21: 52-55. doi.org/10.1016/S1473-3099(20)30764-7.
To, K. K., Hung, I. F., Ip, J. D., Chu, A. W., Chan, W., Tam, A. R.,... Yuen, K. (2020). Coronavirus Disease 2019 (COVID-19) Re-infection by a Phylogenetically Distinct Severe Acute Respiratory Syndrome Coronavirus 2 Strain Confirmed by Whole Genome Sequencing. Clinical Infectious Diseases. doi:10.1093/cid/ciaa1275.
To, K.K., Tsang, O.T., Leung, W.S., Tam, A.R., Wu, T., Lung, D.C.,... Yuen, K. (2020). Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis., 20(5):565-574. doi:10.1016/S1473-3099(20)30196-1.
Tong, Z.D., Tang, A., Li, K.F., Li, P., Wang, H., Yi, J.,... Yan, J. (2020). Potential Presymptomatic Transmission of SARS-CoV-2, Zhejiang Province, China, 2020. Emerg Infect Dis, 26(5):1052-1054. doi:10.3201/eid2605.200198.
Verdoni, L., Mazza, A., Gervasoni, A., Martelli, L., Ruggeri, M., Ciuffreda, M.,... D'Antiga, L; (2020.) An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet, 395(10239), 1771-1778. doi: https://doi.org/10.1016/S0140-6736(20)31103-X.
Viner, R.M., Ward, J.L., Hudson, L.D., Ashe, M., Patel, S.V., Hargreaves, D., & Whittaker, E. (2020). Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents. Arch Dis Child. archdischild-2020-320972. doi: 10.1136/archdischild-2020-320972.
Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J.,... Peng, Z. (2020). Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA, 323(11): 1061-1069. doi:10.1001/jama.2020.1585.
Wang, X., Zhou, Q., He, Y., Liu, L., Ma., X, Wei, X.,... Gao, Z. (2020). Nosocomial Outbreak of 2019 Novel Coronavirus Pneumonia in Wuhan, China. Eur Respir J, 55(6):2000544. doi: 10.1183/13993003.00544-2020.
Wang, Y., Liu, Y., Liu, L., Wang, X., Luo, N., & Ling, L. (2020). Clinical outcome of 55 asymptomatic cases at the time of hospital admission infected with SARS-Coronavirus-2 in Shenzhen, China. J Infect Dis, 221(11):1770-1774. doi: 10.1093/infdis/jiaa119.
Wei, M., Yuan, J., Liu, Y., Fu, T., Yu, X., & Zhang, Z.J. (2020). Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in China. JAMA, 323(13):1313-1314. doi:10.1001/jama.2020.2131.
Wei, W.E., Li, Z., Chiew, C.J., Yong, S.E., Toh, M.P., & Lee, V.J. (2020). Presymptomatic Transmission of SARS-CoV-2 - Singapore, January 23--March 16, 2020. MMWR, 69:411-5. doi:10.15585/mmwr.mm6914e1.
Williamson, E.J., Walker, A.J., Bhaskaran, K., Bacon, S., Bates, C., Morton, C.E.,... Goldacre, B. (2020). Factors associated with COVID-19-related death using OpenSAFELY. Nature, 584(7821):430-436. doi: 10.1038/s41586-020-2521-4.
Wölfel, R., Corman, V.M., Guggemos, W., Seilmaier, M., Zange, S., Müller, M.A.,... Wendtner, C. (2020). Virological assessment of hospitalized patients with COVID-2019. Nature, 581(7809):465-469. doi:10.1038/s41586-020-2196-x.
Wu, C., Chen, X., Cai, Y., Xia, J., Zhou, X., Xu, S.,... Song, Y. (2020). Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med., 2020 Mar 13; e200994.
Wu, Z., McGoogan, J.M. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA Intern Med, 180(7):934-943. doi:10.1001/jamainternmed.2020.0994.
Wu. L., Wang, N., Chang, Y., Tian, X., Na, D., Zhang.,... Liang, G. (2007). Duration of antibody responses after severe acute respiratory syndrome. Emerg Infect Dis. 2007;13(10):1562-1564. doi:10.3201/eid1310.070576.
Xu, X., Wu, X., Jiang, X., Xu, J., Ying, L., Ma, C.,... Li, L. (2020). Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ, 368:m606. doi: https://doi.org/10.1136/bmj.m606.
Yahav, D., Yelin, D., Eckerle, I., Eberjardt, C.S., Wang, J., Cao, B., & Kaiser, L. (2021). Definitions for coronavirus disease 2019 reinfection, relapse and PCR re-positivity. Clin Microbiol Infect, 27(3): 315-318. doi: 10.1016/j.cmi.2020.11.028.
Yang, J., Zheng, Y., Gou, X., Pu, K., Chen, Z., Guo, Q.,... Zhou, Y. (2020). Prevalence of Comorbidities and Its Effects in Patients Infected With SARS-CoV-2: A Systematic Review and Meta-Analysis. Int J Infect Dis, 94:91-95. doi: 10.1016/j.ijid.2020.03.017.
Yang, X., Yum Y., Xu, J., Shu, H., Xia, J., Liu, H.,... Shang, Y. (2020). Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine, 8(5):475-481. doi:https://doi.org/10.1016/S2213-2600(20)30079-5.
Yasuhara, J., Watanabe, K., Takagi, H., Sumitomo, & N., Kuno, T. (2020). COVID-19 and multisystem inflammatory syndrome in children: A systematic review and meta-analysis. Pediatr Pulmonol, 55(10):2565-2575. doi: 10.1002/ppul.24991.
Young, B.E., Ong, S.W.X., Kalimuddin, S., Low, J.G., Tan, S.Y., Loh, J.,... the Singapore 2019 Novel Coronavirus Outbreak Research Team. (2020). Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. JAMA, 323(15):1488-1494. doi:10.1001/jama.2020.3204.
Zhao, J., Yuan, Q., Wang, H., Liu, W., Liao, X., Su, Y.,... Zhang, Z. (2020). Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019. Clin Infect Dis, 71(16):2027-2034. doi: 10.1093/cid/ciaa344.
Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z.,... Cao, B. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet 395(10229):1054-1062. doi:10.1016/s0140-6736(20)30566-3.
Zhu, J., Pan., J., Pang, J., Zhong, Z., Li, H., He, C.,... Zhao, C. (2020). Clinical characteristics of 3,062 COVID-19 patients: a meta-analysis. J Med Virol, 92(10):1902-1914. doi: 10.1002/jmv.25884.
Zimmermann, P., & Curtis, N. (2020). COVID-19 in Children, Pregnancy and Neonates. The Pediatric Infectious Disease Journal, 39(6):469-477. doi:10.1097/inf.0000000000002700.
Zou, L., Ruan, F., Huang, M., Liang, L., Huang, H., Hong, Z.,... Wu, J. (2020). SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med, 382:1177-1179. doi: 10.1056/NEJMc2001737.
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