មើលកូដរបស់ ជំងឺកូរ៉ូណាវីរុស២០១៩

{{short description|Infectious respiratory disease caused by SARS coronavirus 2}}
{{About|ជំងឺ|វីរុស|កូរ៉ូណាវីរុសសមាការផ្លូវដង្ហើមស្រួចស្រាវធ្ងន់ធ្ងរ២|រោគរាតត្បាត|រោគរាតត្បាតកូវីដ-១៩}}
{{Notkhmer}}
{{Update}}
{{pp-protected|small=yes}}
{{Use dmy dates|date=March 2020}}
{{Infobox medical condition
| name = ជំងឺកូរ៉ូណាវីរុស២០១៩ (កូវីដ-១៩)
| synonyms = * កូរ៉ូណាវីរុស
* កូវីដ
* ជំងឺផ្លូវដង្ហើមស្រួចស្រាវ ២០១៩-នកូវ
* ជំងឺសួតកូរ៉ូណាវីរុសថ្មី<ref name="chinamortality" /><ref>{{cite journal|vauthors=Han X, Cao Y, Jiang N, Chen Y, Alwalid O, Zhang X, Gu J, Dai M, Liu J, Zhu W, Zheng C, Shi H | display-authors=6 |title=Novel Coronavirus Pneumonia (COVID-19) Progression Course in 17 Discharged Patients: Comparison of Clinical and Thin-Section CT Features During Recovery|journal=Clinical Infectious Diseases|date=March 2020|doi=10.1093/cid/ciaa271|pmid=32227091 | pmc=7184369 | doi-access=free }}</ref>
| image = Symptoms of coronavirus disease 2019 4.0.svg
| caption = រោគសញ្ញាកូវីដ-១៩
| specialty = [[ជំងឺបង្ករោគ (ឯកទេសវេជ្ជសាស្រ្ត)|ជំងឺបង្ករោគ]]
| symptoms = ឡើងកម្តៅ, ក្អក, ពិបាកដកដង្ហើម, បាត់បង់ឃានវិញ្ញាណ (ក្លិន)<ref name="CDC Interim Guidance" /><ref name=CDC2020Sym/><ref name=WHO2020QA/>
| complications = [[រោគរលាកសួតបណ្តាលមកពីវីរុស|រោគរលាកសួត]], [[ពិសឈាមវិសាណូ|ពិសឈាមវីរុសviral sepsis]], [[acute respiratory distress syndrome]], [[កំហូចតំរងនោមស្រួចស្រាវAcute kidney injury|ការខ្សោយតំរងនោមkidney failure]], [[សមាការព្រលែងកោសិការចលកម្មcytokine release syndrome]]
| onset = ២–១៤ ថ្ងៃ (ជាធម្មតា ៥) ពីការឆ្លង 
| duration = 
| types = 
| cause = [[កូរ៉ូណាវីរុសសមាការផ្លូវដង្ហើមស្រួចស្រាវធ្ងន់ធ្ងរ២]] (សារស៍-កូវ-២)
| risks = ធ្វើដំណើរ, ទៅកន្លែងណាដែលងាយប្រថុយនឹងវីរុស
| diagnosis = [[ប្រតិកម្មច្រវាក់ពហុមែរ៉ាសចំលងក្រមបញ្ច្រាសReverse transcription polymerase chain reaction|សំណាក rRT-PCR testing]], [[ការឆ្លុះCT scan]]
| differential = 
| prevention = [[ការលាងដៃ]], បិទមុខ, [[ចត្តាឡីស័ក]] (នៅដោយឡែក)<ref name=Quar2020>{{cite journal |last1=Nussbaumer-Streit |first1=B |last2=Mayr |first2=V |last3=Dobrescu |first3=AI |last4=Chapman |first4=A |last5=Persad |first5=E |last6=Klerings |first6=I |last7=Wagner |first7=G |last8=Siebert |first8=U |last9=Christof |first9=C |last10=Zachariah |first10=C |last11=Gartlehner |first11=G |title=Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review. |journal=The Cochrane Database of Systematic Reviews |date=8 April 2020 |volume=4 |pages=CD013574 |doi=10.1002/14651858.CD013574 |pmid=32267544|pmc=7141753 }}</ref>
| treatment = [[ការព្យាបាលតាមរោគសញ្ញាSymptomatic treatment|តាមរោគសញ្ញាSymptomatic]] និងand [[ការព្យាបាលឧបត្ថម្ភsupportive treatment|ឧបត្ថម្ភsupportive]]
| medication = 
| prognosis = 
| frequency = {{Cases in 2019–20 coronavirus pandemic|confirmed|editlink=|ref=yes}} confirmed cases
| deaths = {{Cases in 2019–20 coronavirus pandemic|deaths|editlink=|ref=no}} ({{Cases in 2019–20 coronavirus pandemic|ratio|editlink=|ref=no}} of confirmed cases){{Cases in 2019–20 coronavirus pandemic|ref=yes}}
}}
[[File:Stop the Spread of Germs updated (Khmer).pdf|thumb|បញ្ឈប់ការរីករាលដាលនៃមេរោគ]]

<!-- 1) Definition and epidemiology -->
'''ជំងឺវីរុសកូរ៉ូណាឆ្នាំ២០១៩''' ('''កូវីដ-១៩''') គឺជា[[ជំងឺបង្ករោគ|ជំងឺឆ្លង]]ដែលបង្កដោយ[[កូរ៉ូណាវីរុសសមាការផ្លូវដង្ហើមស្រួចស្រាវធ្ងន់ធ្ងរ២]] (សារ្ស-កូវ-២).<ref>{{cite web|url=https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963|title=Coronavirus disease 2019 (COVID-19)—Symptoms and causes|website=Mayo Clinic|access-date=2020-04-14}}</ref> កូវីដ-១៩ ត្រូវបានគេរកឃើញដំបូងក្នុងខែធ្នូ ឆ្នាំ២០១៩ នៅក្នុង[[អ៊ូហាន|ទីក្រុងអ៊ូហាន]], រដ្ឋធានីនៃខេត្ត[[ហ៊ូប៉ី]]របស់ប្រទេសចិនហើយចាប់តាំងពីពេលនោះមកវាបានរីករាលដាលទៅជុំវិញពិភពលោកហើយបន្តក្លាយជា[[ជំងឺរាតត្បាតសកលកូវីដ-១៩|ជំងឺរាតត្បាតសកល]]។<ref name="Hui14Jan2020" /><ref name="WHOPandemic">{{cite press release | title=WHO Director-General's opening remarks at the media briefing on COVID-19 | website=[[World Health Organization]] (WHO) | date=11 March 2020 | url=https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020 |access-date=12 March 2020 | url-status=live | archive-url=https://web.archive.org/web/20200311212521/https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020 | archive-date=11 March 2020 }}</ref> គិតត្រឹមថ្ងៃ {{Cases in 2019–20 coronavirus pandemic|date|editlink=|ref=no}}, [[ករណីជំងឺរាតត្បាតកូវីដ-១៩|ករណីប្រមាណ {{Cases in 2019–20 coronavirus pandemic|conround|editlink=|ref=no}} ករណី]]ត្រូវបានគេរកឃើញនៅតាមប្រទេសនិងដែនដីចំនួន {{Cases in 2019–20 coronavirus pandemic|territories|ref=no}} ដែលជាលទ្ធផល[[មរណភាពដោយជំងឺរាតត្បាតកូវីដ-១៩|មនុស្សប្រមាណជាង {{Cases in 2019–20 coronavirus pandemic|dround|editlink=|ref=no}} នាក់ត្រូវបានបាត់បង់ជីវិត]]។ ចំណែកឯអ្នកជាសះស្បើយមានចំនួនជាង {{Cases in 2019–20 coronavirus pandemic|recround|editlink=|ref=no}} នាក់។{{Cases in 2019–20 coronavirus pandemic|ref=yes}}

<!-- 2) Symptoms -->
រោគសញ្ញាទូទៅរួមមាន[[គ្រុនក្តៅ]]កំដៅចាប់ពី ៣៧,៥ុអង្សារឡើងទៅ, [[ក្អក]],ឈឺបំពង់ក, ឆាប់អស់កម្លាំង, [[ការពិបាកដកដង្ហើម]], និង[[អាណូស្មៀរ|បាត់បង់ឃាណវិញ្ញាណ]] និងជីវ្ហាវិញ្ញាណ។<ref name="CDC2020Sym" /><ref name="whoqa">{{cite web|url=https://www.who.int/news-room/q-a-detail/q-a-coronaviruses|title=Q&A on coronaviruses (COVID-19)|url-status=live|access-date=11 March 2020|publisher=[[World Health Organization]] (WHO)|archive-url=https://web.archive.org/web/20200120174649/https://www.who.int/news-room/q-a-detail/q-a-coronaviruses|archive-date=20 January 2020}}</ref><ref name="entuk-anosmia" /> រោគសញ្ញានៃករណីកូវីដ-១៩ ភាគច្រើនគឺបែបលក្ខណៈធន់ស្រាល, ប៉ុន្តែខ្លះអាចវិវត្តទៅជា[[រោគរលាកសួតបណ្តាលមកពីវីរុស|រោគរលាកសួត]], [[រោគសញ្ញាជំងឺនៃសរីរាង្គមួយចំនួន|សរីរាង្គមួយចំនួនឈប់ដំណើរការ]], ឫ[[កកសរសៃឈាម]]ជាដើម។<ref name="Hui14Jan2020" /><ref name="tocil-8" /><ref name="WHO-q-a">{{cite web |url=https://www.who.int/news-room/q-a-detail/q-a-coronaviruses |title=Q&A on coronaviruses |website=[[World Health Organization]] (WHO) |url-status=live |archive-url=https://web.archive.org/web/20200120174649/https://www.who.int/news-room/q-a-detail/q-a-coronaviruses |archive-date=20 January 2020 |access-date=27 January 2020| name-list-format = vanc}}</ref> [[រយៈពេលបង្ករោគ|រយៈវេលានៃរោគសញ្ញា]]នឹងចាប់ផ្តើមមាននៅថ្ងៃទីប្រាំបន្ទាប់ពីបានប៉ះជាមួយនឹងវីរុសប៉ុន្តែពេលខ្លះវានឹងចំណាយពេលចាប់ពី ២ ថ្ងៃរហូតដល់ទៅ ១៤ ថ្ងៃឯណោះ។<ref name="CDC2020Sym" /><ref>{{cite journal|author-last1=Velavan |author-first1=T. P. |author-last2=Meyer |author-first2=C. G. |title=The COVID-19 epidemic|journal=Tropical Medicine & International Health|volume=n/a|issue=n/a|pages=278–80|doi=10.1111/tmi.13383 |doi-access=free |pmid=32052514|date=March 2020 |pmc=7169770 }}</ref>

<!-- 3) Spread and diagnosis -->
<!-- DO NOT INTERFERE WITH THE SECTION BEGIN/END TAGS, AS IT WILL BREAK THE PANDEMIC ARTICLE --><section begin="Spread">វីរុស អាចចម្លងពីមនុស្សម្នាក់ ទៅមនុស្សម្នាក់ទៀតតាមរយៈការនៅជិតគ្នា ។</section>The virus is primarily [[Transmission (medicine)|spread]] between people during close contact,{{efn|Close contact is defined as one metre (three feet) by the WHO<ref name="WHO2020QA">{{cite web|url=https://www.who.int/news-room/q-a-detail/q-a-coronaviruses|title=Q&A on coronaviruses|date=8 April 2020|work=[[World Health Organization]]|url-status=live|archive-url=https://web.archive.org/web/20200120174649/https://www.who.int/news-room/q-a-detail/q-a-coronaviruses|archive-date=20 January 2020|access-date=30 April 2020}}</ref> and two metres (six feet) by the CDC.<ref name="CDCTrans">{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html |title=How COVID-19 Spreads |date=2 April 2020|website=[[Centers for Disease Control and Prevention]] (CDC) |url-status=live|archive-url=https://web.archive.org/web/20200403001235/https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmission.html|archive-date=April 3, 2020|access-date=April 3, 2020}}</ref>}} often via [[Respiratory droplet|small droplets]] produced by coughing,{{efn|An uncovered cough can travel up to {{convert|8.2|m|ft|abbr=off}}.<ref name="Bourouiba, JAMA, 26 March">{{Cite journal| doi = 10.1001/jama.2020.4756| vauthors=Bourouiba L | title = Turbulent Gas Clouds and Respiratory Pathogen Emissions: Potential Implications for Reducing Transmission of COVID-19| journal = JAMA | date = March 2020| pmid = 32215590 | doi-access = free}}</ref>}} sneezing, and talking.<ref name=WHO2020QA/><ref name=CDCTrans/><ref name="ECDCQA">{{cite web|url=https://www.ecdc.europa.eu/en/covid-19/questions-answers|title=Q & A on COVID-19|website=European Centre for Disease Prevention and Control|access-date=30 April 2020}}</ref> The droplets usually fall to the ground or onto surfaces rather than [[airborne disease|remaining in the air]] over long distances.<ref name=WHO2020QA/><!--These droplets are relatively heavy, do not travel far and quickly sink to the ground. --> People may also become infected by touching a contaminated surface and then touching their face.<ref name=WHO2020QA/><!-- These droplets land on objects and surfaces around the person. Other people then catch COVID-19 by touching these objects or surfaces, then touching their eyes, nose or mouth. --><ref name=CDCTrans/><!-- The virus is thought to spread mainly from person-to-person [...] Between people who are in close contact with one another --> On surfaces, the amount of virus declines over time until it is insufficient to remain infectious, but it may be detected for hours or days.<ref name=WHO2020QA/><ref name="ECDCQA" /><!-- Quote:A recent study published by The New England Journal of Medicine (NEJM) reported that the causal agent of COVID-19 (SARS-CoV-2) is able to persist for up to 24 hours on cardboard, in experimental settings (e.g. controlled relative humidity and temperature). In practice however there is no evidence of the infection ever being transmitted through contaminated packages that are exposed to different environmental conditions and temperatures. --><ref name="StableNIH">{{cite web|url=https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours-surfaces|title=New coronavirus stable for hours on surfaces|date=17 March 2020|publisher=[[National Institutes of Health]]|url-status=live|archive-url=https://web.archive.org/web/20200323032520/https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours-surfaces|archive-date=23 March 2020|access-date=30 April 2020}}</ref><!-- Quote: The scientists found that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detectable in aerosols for up to three hours, up to four hours on copper, up to twenty-four hours on cardboard and up to two to three days on plastic and stainless steel. --> It is most contagious during the first three days after the onset of symptoms, although spread may be possible before symptoms appear and in later stages of the disease.<!-- Quote: "People are thought to be most contagious when they are most symptomatic (the sickest) [...] Some spread might be possible before people show symptoms" --><ref name=":22">{{cite web|url=https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf?sfvrsn=5ae25bc7_4|title=Coronavirus disease 2019 (COVID-19) Situation Report—73|last=|first=|date=2 April 2020|website=World Health Organization|url-status=live|archive-url=|archive-date=|access-date=3 April 2020}}</ref><!-- Quote: shedding of the COVID-19 virus is highest in upper respiratory tract (nose and throat) early in the course of the disease.8-11 That is, within the first three days from onset of symptoms.10-11 Preliminary data suggests people may be more contagious around the time of symptom onset as compared to later on in the disease. --><!-- DO NOT REMOVE THE FOLLOWING TAG --><section end="Spread"/> The standard method of [[diagnosis]] is by [[real-time reverse transcription polymerase chain reaction]] (rRT-PCR) from a [[nasopharyngeal swab]].<ref name="CDC2020Testing">{{cite web |title=Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Persons for Coronavirus Disease 2019 (COVID-19)|url=https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.html |website=[[Centers for Disease Control and Prevention]] (CDC) |access-date=26 March 2020 |date=11 February 2020 |archive-url=https://web.archive.org/web/20200304165907/https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html |archive-date=4 March 2020 |url-status=live }}</ref> [[Chest CT]] imaging may also be helpful for diagnosis in individuals where there is a high suspicion of infection based on symptoms and risk factors; however, guidelines do not recommend using it for routine screening.<ref name=":0">{{cite journal|vauthors=Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A |date=March 2020 |title=Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients |journal=American Journal of Roentgenology|pages=1–7|doi=10.2214/AJR.20.23034|pmid=32174129 | doi-access=free}}</ref><ref name="acr.org">{{cite web|url=https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/Recommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-Infection|title=ACR Recommendations for the use of Chest Radiography and Computed Tomography (CT) for Suspected COVID-19 Infection|last=|first=|date=2020-03-22|website=American College of Radiology|url-status=dead|archive-url=https://web.archive.org/web/20200328055813/https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/Recommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-Infection|archive-date=28 March 2020|access-date=|archivedate=28 មីនា 2020|archiveurl=https://web.archive.org/web/20200328055813/https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/Recommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-Infection}}</ref>

<!-- 4) Prevention -->
Recommended measures to prevent infection include frequent [[hand washing]], [[social distancing|maintaining physical distance from others]] (especially from those with symptoms), [[quarantine]], covering coughs, and keeping unwashed hands away from the face.<ref name="Advice for public">{{cite web|url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public|title=Advice for public|website=[[World Health Organization]] (WHO)|access-date=25 February 2020|archive-url=https://web.archive.org/web/20200126025750/https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public|archive-date=26 January 2020|url-status=live| name-list-format = vanc}}</ref><ref>{{cite web|url=https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults|title=Guidance on social distancing for everyone in the UK|website=GOV.UK|access-date=25 March 2020|archive-url=https://web.archive.org/web/20200324214400/https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults|archive-date=24 March 2020|url-status=live}}</ref><ref name=Quar2020/> In addition, the use of a face covering is recommended for those who suspect they have the virus and their caregivers.<ref name="CDC2020IfSick">{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html |title=What to Do if You Are Sick |vauthors=((Centers for Disease Control and Prevention)) |date=5 April 2020|website=[[Centers for Disease Control and Prevention]] (CDC)|url-status=live|archive-url=https://web.archive.org/web/20200214153016/https://www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html|archive-date=14 February 2020|access-date=24 April 2020 }}</ref><ref name=WHO2020masks>{{cite web |title=When and how to use masks |url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks |website=[[World Health Organization]] (WHO) |access-date=24 April 2020 |archive-url=https://web.archive.org/web/20200307013848/https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks |archive-date=7 March 2020 |url-status=live }}</ref><!-- Quote: "If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection." --> Recommendations for face covering use by the general public vary, with some authorities recommending, some recommending against, and others requiring their use.<ref name=WHO2020masks/><ref>{{cite journal|vauthors=Feng S, Shen C, Xia N, Song W, Fan M, Cowling BJ |date=March 2020|title=Rational use of face masks in the COVID-19 pandemic|journal=Lancet Respiratory Medicine|volume=0|issue=5|pages=434–436|doi=10.1016/S2213-2600(20)30134-X|pmid=32203710|pmc=7118603 | doi-access=free }}</ref><ref>{{cite news|last=Tait|first=Robert|url=https://www.theguardian.com/world/2020/mar/30/czechs-get-to-work-making-masks-after-government-decree-coronavirus|title=Czechs get to work making masks after government decree|date=2020-03-30|work=The Guardian|access-date=2020-03-31|issn=0261-3077|archive-url=https://web.archive.org/web/20200330235911/https://www.theguardian.com/world/2020/mar/30/czechs-get-to-work-making-masks-after-government-decree-coronavirus|archive-date=30 March 2020|url-status=live}}</ref> There is limited evidence for or against the use of masks (medical or other) in healthy individuals in the wider community.<ref name=WHO2020QA/><!-- Quote: Currently, there is not enough evidence for or against the use of masks (medical or other) in healthy individuals in the wider community. -->

<!-- 5) Management and history -->
According to the World Health Organization, there are no available [[COVID-19 vaccine|vaccine]]s nor [[COVID-19 drug development|specific]] [[antiviral treatment]]s for COVID-19.<ref name=WHO2020QA/><!-- To date, there is no vaccine and no specific antiviral medicine to prevent or treat COVID-2019. --> On 1 May 2020, the United States gave [[Emergency Use Authorization]] to the antiviral [[remdesivir]] for people hospitalized with severe COVID-19.<ref name=fda20200501 /> Management involves the [[Palliative care|treatment of symptoms]], [[supportive care]], [[isolation (health care)|isolation]], and [[Medical research|experimental measures]].<ref name="cdc21Jan20202">{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html |title=How to Protect Yourself & Others |date=8 April 2020|publisher=[[Centers for Disease Control and Prevention]] (CDC)|url-status=live|archive-url=https://web.archive.org/web/20200226145347/https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html|archive-date=26 February 2020|access-date=9 April 2020 }}</ref> The [[World Health Organization]] (WHO) declared the COVID-19 [[outbreak]] a [[Public Health Emergency of International Concern]] (PHEIC)<ref>{{cite web|url=https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)|title=Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)|website=[[World Health Organization]] (WHO)|access-date=11 February 2020|archive-url=https://web.archive.org/web/20200131005904/https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)|archive-date=31 January 2020|url-status=live| name-list-format = vanc}}</ref><ref>{{cite news | author-last1=Mahtani |author-first1=S. |author-last2=Berger |author-first2=M. |author-last3=O'Grady |author-first3=S. |author-last4=Iati |author-first4=M. | url = https://www.washingtonpost.com/world/asia_pacific/coronavirus-china-live-updates/2020/02/05/114ced8a-479c-11ea-bc78-8a18f7afcee7_story.html |title = Hundreds of evacuees to be held on bases in California; Hong Kong and Taiwan restrict travel from mainland China | work = [[The Washington Post]] | date = 6 February 2020 | access-date = 11 February 2020 | archive-url = https://web.archive.org/web/20200207134650/https://www.washingtonpost.com/world/asia_pacific/coronavirus-china-live-updates/2020/02/05/114ced8a-479c-11ea-bc78-8a18f7afcee7_story.html | archive-date = 7 February 2020 | url-status = live | name-list-format = vanc}}</ref> on 30 January 2020 and a [[pandemic]] on 11 March 2020.<ref name="WHOPandemic" /> [[Local transmission]] of the disease has occurred in most countries across all six [[WHO regions]].<ref>{{cite web|url=https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200416-sitrep-87-covid-19.pdf?sfvrsn=9523115a_2|title=WHO Situation Report #87|last=|first=|date=16 April 2020|website=WHO|url-status=live|archive-url=|archive-date=|access-date=}}</ref>
[[File:En.Wikipedia-VideoWiki-Coronavirus disease 2019.webm|thumb|thumbtime=0:02|upright=1.4|Video summary ([[Wikipedia:VideoWiki/Coronavirus disease 2019|script]])]]
{{TOC limit}}

==អាការៈ និង រោគសញ្ញា==

{| class="wikitable" style = "float:right; margin-left:1em; text-align:center"
|+ Symptoms of COVID-19<ref name="CDC Interim Guidance" />
|-
! scope="col" | Symptom
! scope="col" | Range
|-
|Fever
|83–99%
|-
|Cough
|59–82%
|-
|Loss of appetite 
|40–84%
|-
|Fatigue
|44–70%
|-
|Shortness of breath
|31–40%
|-
|Coughing up sputum
|28–33%
|-
|Muscle aches and pains
|11–35%
|}
[[Fever]] is the most common symptom, although some older people and those with other health problems experience fever later in the disease.<ref name="CDC Interim Guidance" /><ref>{{cite journal |quote=...{{nbsp}}52 critically ill adult patients{{nbsp}}... fever (98%){{nbsp}}... [of which] fever was not detected at the onset of illness in six (11·5%){{nbsp}}...|display-authors=etal|last1=Yang|first1=Xiaobo|last2=Yu|first2=Yuan|last3=Xu|first3=Jiqian|title=Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study |journal=Lancet |date=24 February 2020 |volume=8|issue=5|pages=475–481|doi=10.1016/S2213-2600(20)30079-5 |pmid=32105632|pmc=7102538<!-- Let's hold this number in reserve: |pmid=32105632 -->}}</ref> In one study, 44% of people had fever when they presented to the hospital, while 89% went on to develop fever at some point during their hospitalization.<ref name="CDC Interim Guidance" /><ref name="Guan Ni Hu Liang p."/>

Other common symptoms include [[cough]], [[Anorexia (symptom)|loss of appetite]], [[fatigue]], [[Dyspnea|shortness of breath]], [[sputum|sputum production]], and [[Myalgia|muscle]] and [[Arthralgia|joint pains]].<ref name="CDC Interim Guidance" /><ref name="CDC2020Sym"><!-- KEEP THIS NAMED REFERENCE -->{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html |title=Symptoms of Coronavirus |date=20 March 2020|website=U.S. [[Centers for Disease Control and Prevention]] (CDC) |url-status=live|archive-url=https://web.archive.org/web/20200130202038/https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html|archive-date=30 January 2020|access-date=}}</ref><ref name="chinamortality" /><ref name="Hessen27Jan2020">{{cite web |url=https://www.elsevier.com/connect/coronavirus-information-center |title=Novel Coronavirus Information Center: Expert guidance and commentary |last=Hessen |first=Margaret Trexler | name-list-format = vanc |date=27 January 2020 |website=Elsevier Connect |url-status=live |access-date=31 January 2020 |archive-url=https://web.archive.org/web/20200130171622/https://www.elsevier.com/connect/coronavirus-information-center |archive-date=30 January 2020 }}</ref> Symptoms such as [[nausea]], [[vomiting]], and [[diarrhoea]] have been observed in varying percentages.<ref name=":10">{{cite news|title=Clinical Characteristics of SARS-CoV-2 Infected Pneumonia with Diarrhea|first1=Xiao-Shan|last1=Wei|first2=Xuan|last2=Wang|first3=Yi-Ran|last3=Niu|first4=Lin-Lin|last4=Ye|first5=Wen-Bei|last5=Peng|first6=Zi-Hao|last6=Wang|first7=Wei-Bing|last7=Yang|first8=Bo-Han|last8=Yang|first9=Jian-Chu|last9=Zhang|first10=Wan-Li|last10=Ma|first11=Xiao-Rong|last11=Wang|first12=Qiong|last12=Zhou|date=26 February 2020|doi=10.2139/ssrn.3546120|ssrn = }}</ref><ref name="Huang24Jan2020">{{cite journal | vauthors = Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B | display-authors = 6 | title = Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China | journal = Lancet | volume = 395 | issue = 10223 | pages = 497–506 | date = February 2020 | pmid = 31986264 | doi = 10.1016/S0140-6736(20)30183-5 | pmc = 7159299 | doi-access = free }}</ref><ref>{{cite journal|last1=Lai|first1=Chih-Cheng|last2=Shih|first2=Tzu-Ping|last3=Ko|first3=Wen-Chien|last4=Tang|first4=Hung-Jen|last5=Hsueh|first5=Po-Ren|date=1 March 2020|title=Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges|journal=International Journal of Antimicrobial Agents|volume=55|issue=3|page=105924|doi=10.1016/j.ijantimicag.2020.105924|pmid=32081636|issn=0924-8579|pmc=7127800}}</ref> Less common symptoms include sneezing, runny nose, or sore throat.<ref name="WHOReport24Feb2020"/>

Some cases in China initially presented with only [[chest pain|chest tightness]] and [[palpitations]].<ref name="Zheng Ma Zhang Xie p.">{{cite journal | vauthors = Zheng YY, Ma YT, Zhang JY, Xie X | title = COVID-19 and the cardiovascular system | journal = Nature Reviews. Cardiology | date = March 2020 | volume = 17 | issue = 5 | pages = 259–260 | pmid = 32139904 | doi = 10.1038/s41569-020-0360-5 | pmc = 7095524 | doi-access = free }}</ref>

A decreased sense of smell or disturbances in taste may occur.<ref name="LancetIDSmell">{{cite journal |vauthors=Xydakis MS, Dehgani-Mobaraki P, Holbrook EH, Geisthoff UW, Bauer C, Hautefort C, Herman P, Manley GT, Lyon DM, Hopkins C |display-authors=6 |title=Smell and taste dysfunction in patients with COVID-19 |journal=Lancet Infectious Diseases |date=April 15, 2020 |doi=10.1016/S1473-3099(20)30293-0 |pmid=32304629 |url=https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30293-0/fulltext#%20 |accessdate=21 April 2020|pmc=7159875 }}</ref><ref>{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html|title=Symptoms of Coronavirus|last=|first=|date=27 April 2020|website=|publisher=Centers for Disease Control and Prevention|url-status=live|archive-url=|archive-date=|access-date=28 April 2020}}</ref><!-- Even though loss of smell as a symptom was first hyped and then fell back down to Earth, and even though other upper respiratory infections can cause loss of smell, I thought I'd keep some of technical terms which were here still available: anosmia means loss of smell, hyposmia means partial loss of smell, and dysgeusia means disturbance in taste. --> [[anosmia|Loss of smell]] was a presenting symptom in 30% of confirmed cases in South Korea.<ref name="entuk-anosmia">{{cite web|url=https://www.entuk.org/loss-sense-smell-marker-covid-19-infection|title=Loss of sense of smell as marker of COVID-19 infection|last=Hopkins|first=Claire|date=|website=Ear, Nose and Throat surgery body of United Kingdom|access-date=2020-03-28|archive-date=27 ឧសភា 2020|archive-url=https://web.archive.org/web/20200527203954/https://www.entuk.org/sites/default/files/files/Loss%20of%20sense%20of%20smell%20as%20marker%20of%20COVID.pdf|url-status=dead|archivedate=27 ឧសភា 2020|archiveurl=https://web.archive.org/web/20200527203954/https://www.entuk.org/sites/default/files/files/Loss%20of%20sense%20of%20smell%20as%20marker%20of%20COVID.pdf}}</ref><ref name="Iacobucci2020">{{cite journal|last1=Iacobucci|first1=Gareth|title=Sixty seconds on ... anosmia|journal=BMJ|year=2020|volume=368|pages=m1202|issn=1756-1833|doi=10.1136/bmj.m1202|pmid=32209546|doi-access=free}}</ref>

As is common with infections, there is a delay between the moment a person is first infected and the time he or she develops symptoms. This is called the [[incubation period]]. The incubation period for COVID‑19 is typically five to six days but may range from two to 14 days,<ref>{{cite document | vauthors=((World Health Organization)) |title=Coronavirus disease 2019 (COVID-19): situation report, 29 |date=19 February 2020|website=[[World Health Organization]] (WHO) | hdl=10665/331118 | hdl-access=free }}</ref><ref>{{cite web|url=https://www.who.int/news-room/q-a-detail/q-a-coronaviruses|title=Q&A on coronaviruses (COVID-19): How long is the incubation period for COVID-19?|date=|website=[[World Health Organization]] (WHO)|url-status=live|archive-url=https://web.archive.org/web/20200120174649/https://www.who.int/news-room/q-a-detail/q-a-coronaviruses|archive-date=20 January 2020|access-date=26 February 2020| name-list-format = vanc}}</ref> although 97.5% of people who develop symptoms will do so within 11.5 days of infection.<ref>{{cite journal|last1=Lauer|first1=Stephen A.|last2=Grantz|first2=Kyra H.|last3=Bi|first3=Qifang|last4=Jones|first4=Forrest K.|last5=Zheng|first5=Qulu|last6=Meredith|first6=Hannah R.|last7=Azman|first7=Andrew S.|last8=Reich|first8=Nicholas G.|last9=Lessler|first9=Justin|date=10 March 2020|title=The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application|journal=Annals of Internal Medicine|volume=172|issue=9|page=577|doi=10.7326/M20-0504|pmid=32150748|pmc=7081172|issn=0003-4819}}</ref>

A minority of cases do not develop noticeable symptoms at any point in time.<ref name=Imperial>{{cite journal|publisher=Imperial College COVID-19 Response Team|title=Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand|date=March 16, 2020|url=https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf|accessdate=April 21, 2020}}</ref><ref name=MizumotoEtAl>{{cite journal |last1=Mizumoto |first1=Kenji |last2=Kagaya |first2=Katsushi |last3=Zarebski |first3=Alexander |last4=Chowell |first4=Gerardo |title=Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020 |journal=Euro Surveillance |date=2020 |volume=25 |issue=10 |doi=10.2807/1560-7917.ES.2020.25.10.2000180 |pmid=32183930 |pmc=7078829 |url=http://med.stanford.edu/content/dam/sm/id/documents/COVID/AsymptCOVID_TransmissionShip.pdf |accessdate=April 21, 2020}}</ref> These asymptomatic carriers tend not to get tested, and their role in transmission is not yet fully known.<ref>{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html|title=Clinical Questions about COVID-19: Questions and Answers |last=|date=2020-02-11|website=Centers for Disease Control and Prevention|access-date=2020-03-31|archive-url=https://web.archive.org/web/20200214023335/https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html|archive-date=14 February 2020|url-status=live}}</ref><ref>{{cite journal |last1=Lai |first1=Chich-Cheng |last2=Liu |first2=Yen Hung |last3=Wang |first3=Cheng-Yi |last4=Wang |first4=Ya-Hui |last5=Hsueh |first5=Shun-Chung |last6=Yen |first6=Muh-Yen |last7=Ko |first7=Wen-Chien |last8=Hsueh |first8=Po-Ren |title=Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): Facts and myths |journal=Journal of Microbiology, Immunology, and Infection |date=March 4, 2020 |doi=10.1016/j.jmii.2020.02.012 |pmid=32173241 |pmc=7128959 }}</ref> However, preliminary evidence suggests they may contribute to the spread of the disease.<ref>{{cite journal|last=Bai|first=Yan|last2=Yao|first2=Lingsheng|last3=Wei|first3=Tao|last4=Tian|first4=Fei|last5=Jin|first5=Dong-Yan|last6=Chen|first6=Lijuan|last7=Wang|first7=Meiyun|date=2020-02-21|title=Presumed Asymptomatic Carrier Transmission of COVID-19|journal=JAMA|volume=323|issue=14|page=1406|doi=10.1001/jama.2020.2565|issn=0098-7484|pmc=7042844|pmid=32083643}}</ref><ref name=":1">{{cite web|url=https://www.bloomberg.com/news/articles/2020-03-31/china-reveals-1-541-symptom-free-virus-cases-under-pressure|title=China Reveals 1,541 Symptom-Free Virus Cases Under Pressure|last=|first=|date=31 March 2020|website=www.bloomberg.com|url-status=live|archive-url=|archive-date=|access-date=2020-03-31}}</ref> In March 2020, the [[Korea Centers for Disease Control and Prevention]] (KCDC) reported that 20% of confirmed cases remained asymptomatic during their hospital stay.<ref name=":1" /><ref>{{cite web|url=http://www.ktv.go.kr/program/home/PG1110921D/content/595426|title=코로나19 국내 발생현황 브리핑 (20. 03. 16. 14시)|website=ktv.go.kr|language=ko|access-date=2020-03-31}}</ref>

===Complications===

In some, the disease may progress to [[pneumonia]], [[Multiple organ dysfunction syndrome|multi-organ failure]], and [[death]].<ref name="Hui14Jan2020">{{cite journal|display-authors=6|vauthors=Hui DS, I Azhar E, Madani TA, Ntoumi F, Kock R, Dar O, Ippolito G, Mchugh TD, Memish ZA, Drosten C, Zumla A, Petersen E|date=February 2020|title=The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - The latest 2019 novel coronavirus outbreak in Wuhan, China |journal=Int J Infect Dis|volume=91|issue=|pages=264–66|doi=10.1016/j.ijid.2020.01.009|pmc=7128332|pmid=31953166|doi-access=free }}</ref> Neurological manifestations include [kikilu[seizures]], [[stroke]], [[encephalitis]], and [[Guillain–Barré syndrome]].<ref>{{cite journal|last1=Carod-Artal|first1=FJ|date=1 May 2020|title=Neurological complications of coronavirus and COVID-19.|journal=Revista de neurologia|volume=70|issue=9|pages=311–322|doi=10.33588/rn.7009.2020179|pmid=32329044}}</ref> Cardiovascular-related complications may include [[heart failure]], [[Arrhythmia|irregular electrical activity]], [[Venous thromboembolism|blood clots]], and [[Myocarditis|heart inflammation]].<ref>{{cite journal|last1=Long|first1=B|last2=Brady|first2=WJ|last3=Koyfman|first3=A|last4=Gottlieb|first4=M|date=18 April 2020|title=Cardiovascular complications in COVID-19.|journal=The American Journal of Emergency Medicine|doi=10.1016/j.ajem.2020.04.048|pmc=7165109|pmid=32317203}}</ref>

In some people, COVID‑19 may affect the lungs causing [[pneumonia]]. In those most severely affected, COVID-19 may rapidly progress to [[acute respiratory distress syndrome]] (ARDS) causing respiratory failure, [[septic shock]], or multi-organ failure.<ref name="Heymann Shindo 2020 pp. 542–5452">{{cite journal|vauthors=Heymann DL, Shindo N|date=February 2020|title=COVID-19: what is next for public health?|journal=Lancet|publisher=Elsevier BV|volume=395|issue=10224|pages=542–545|doi=10.1016/s0140-6736(20)30374-3|pmc=7138015|pmid=32061313|collaboration=WHO Scientific and Technical Advisory Group for Infectious Hazards}}</ref><ref>{{cite book|title=StatPearls|vauthors=Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R|date=2020|publisher=StatPearls Publishing|location=Treasure Island (FL)|chapter=Features, Evaluation and Treatment Coronavirus (COVID-19)|pmid=32150360|access-date=18 March 2020|chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK554776/}}</ref> Complications associated with COVID‑19 include [[sepsis]], [[Coagulopathy|abnormal clotting]], and damage to the heart, kidneys, and liver. Clotting abnormalities, specifically an increase in [[prothrombin time]], have been described in 6% of those admitted to hospital with COVID-19, while abnormal kidney function is seen in 4% of this group.<ref name="Zhou Yu Du Fan 2020 p.2">{{cite journal|display-authors=6|vauthors=Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L|date=2020|title=Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study|journal=The Lancet|publisher=Elsevier BV|volume=395|issue=10229|pages=1054–1062|doi=10.1016/s0140-6736(20)30566-3|issn=0140-6736|pmid=32171076|doi-access=free}}</ref> Approximately 20-30% of people who present with COVID‑19 demonstrate elevated liver enzymes ([[transaminase]]s).<ref name="Sanders20202">{{cite journal|last1=Sanders|first1=JM|last2=Monogue|first2=ML|last3=Jodlowski|first3=TZ|last4=Cutrell|first4=JB|date=April 13, 2020|title=Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review|journal=JAMA|doi=10.1001/jama.2020.6019|pmid=32282022|doi-access=free}}</ref> Liver injury as shown by blood markers of liver damage is frequently seen in severe cases.<ref>{{cite journal|vauthors=Xu L, Liu J, Lu M, Yang D, Zheng X|date=March 2020|title=Liver injury during highly pathogenic human coronavirus infections|journal=Liver International|volume=40|issue=5|pages=998–1004|doi=10.1111/liv.14435|pmid=32170806|doi-access=free}}</ref>

==Cause==

{{See also|Severe acute respiratory syndrome coronavirus 2}}

===ការចំលង===

<!-- DO NOT INTERFERE WITH THE SECTION BEGIN/END TAGS, AS IT WILL BREAK THE PANDEMIC ARTICLE --><section begin="Transmission"/>[[File:Sneeze.JPG|alt=Cough/sneeze droplets visualised in dark background using Tyndall scattering|thumb|Respiratory droplets produced when a man [[sneeze]]s, visualised using [[Tyndall scattering]]]]
[[File:COVID19 in numbers- R0, the case fatality rate and why we need to flatten the curve.webm|thumb|thumbtime=4:02|A video discussing the [[basic reproduction number]] and [[case fatality rate]] in the context of the pandemic]]

COVID-19 is a new disease, and the ways it spreads between people are under investigation, including: the role of small droplets, the extent and how it may be transmitted through air, and how long the virus remains infectious on surfaces.<ref name="WHO2020QA" /><ref name="CDCTrans" /><ref name=ECDCQA/> The disease is spread during close contact, often by small droplets produced during coughing, sneezing, or talking.<ref name="WHO2020QA" /><ref name=ECDCQA/> During close contact, (1 to 2 metres, 3 to 6 feet), people catch the disease after [[inhaling|breathing in]] contaminated droplets that were [[exhaled]] by infected people. However, the droplets are relatively heavy and usually fall to the ground or surfaces, as opposed to being infectious over large distances.<ref name="WHO2020QA" /><ref name=ECDCQA/>

After the droplets fall to floors or surfaces, they still can infect other people, if they touch contaminated surfaces and then their eyes, nose or mouth with unwashed hands.<ref name="WHO2020QA" /> On surfaces the amount of active virus decreases over time until it can no longer cause infection.<ref name=ECDCQA/> However, experimentally, the virus can survive on various surfaces for some time, (for example copper or cardboard for a few hours, and plastic or steel for a few days).<ref name=ECDCQA/><ref name="Doremalen">{{cite journal|vauthors=van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, Tamin A, Harcourt JL, Thornburg NJ, Gerber SI, Lloyd-Smith JO, de Wit E, Munster VJ | display-authors=6 |date=March 2020 |title=Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1|journal=New England Journal of Medicine| volume=382 | issue=16|pages=1564–7|doi=10.1056/NEJMc2004973|issn=0028-4793|pmc=7121658|pmid=32182409 |doi-access=free }}</ref> Surfaces are easily decontaminated with household disinfectants which kill the virus outside the human body or on the hands.<ref name="WHO2020QA" /> Disinfectants or bleach are not a treatment for COVID-19, and cause health problems when not used properly, such as inside the human body.<ref>{{cite web|title=Household cleaners and disinfectants can cause health problems when not used properly. Follow the instructions on the product label to ensure safe and effective use. Learn more about cleaning and disinfecting your home: <nowiki>https://bit.ly/2S2a9yc .pic.twitter.com/rdcR9QJNIR</nowiki>|url=https://twitter.com/cdcgov/status/1253742258853199872?lang=en|last=CDC|date=2020-04-24|website=@cdcgov|language=en|access-date=2020-05-06}}</ref>

[[Sputum]] and [[saliva]] carry large amounts of virus.<ref name="Saliva2020"/><ref name="WHO2020QA" /><ref name="CDCTrans" /><ref name=ECDCQA/> Some medical procedures may result in the virus being transmitted easier than normal for such small droplets, known as [[airborne transmission]].<ref name="WHO2020QA" /><ref name=ECDCQA/>

The virus is most contagious during the first three days after onset of symptoms, although spread is known to occur up to two days before symptoms appear (presymptomatic transmission) and in later stages of the disease.<ref name="CDCTrans" /><ref name=ECDCQA/><ref name="who20200402">{{cite web |url=https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf?sfvrsn=5ae25bc7_4 |title=Coronavirus disease 2019 (COVID-19) Situation Report—73 |date=2 April 2020 |website=World Health Organization|url-status=live|access-date=3 April 2020}}</ref><ref name=ECDC23April2020>[https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-rapid-risk-assessment-coronavirus-disease-2019-ninth-update-23-april-2020.pdf Coronavirus disease 2019 (COVID-19) in the EU/EEA and the UK – ninth update], 23 April 2020. Stockholm: ECDC, p.8-9.</ref> Some people have been infected and recovered without showing symptoms, but uncertainties remain in terms of asymptomatic transmission.<ref name=ECDCQA/>

Although COVID-19 is not a [[sexually transmitted infection]], kissing, intimate contact, and faecal oral routes are suspected to transmit the virus.<ref>{{cite web|url=https://www.acon.org.au/what-we-are-here-for/covid19/ |title=COVID-19 and Our Communities -ACON – We are a New South Wales based health promotion organisation specialising in HIV prevention, HIV support and lesbian, gay, bisexual, transgender and intersex (LGBTI) health |publisher=Acon.org.au |date= |accessdate=2020-04-29}}</ref><ref>{{cite web|url=https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-sex-guidance.pdf|title=Sex and Coronavirus Disease 2019 (COVID-19)|last=|first=|date=27 March 2020|website=nyc.gov|url-status=live|archive-url=|archive-date=|access-date=29 April 2020}}</ref><!-- DO NOT REMOVE THE FOLLOWING TAG --><section end="Transmission"/>

===វីរុសវិទ្យា===

{{Main|Severe acute respiratory syndrome coronavirus 2}}
[[File:Coronavirus virion structure.svg|thumb|Illustration of [[SARSr-CoV]] virion]]

Severe acute respiratory syndrome coronavirus{{nbsp}}2 (SARS-CoV-2) is a [[novel virus|novel]] severe acute respiratory syndrome coronavirus, first isolated from three people with pneumonia connected to the [[Disease cluster|cluster]] of acute respiratory illness cases in Wuhan.<ref name="ECDC risk assessment">{{cite web |url=https://www.ecdc.europa.eu/sites/default/files/documents/SARS-CoV-2-risk-assessment-14-feb-2020.pdf |title=Outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): increased transmission beyond China—fourth update |publisher=European Centre for Disease Prevention and Control |date=14 February 2020 |access-date=8 March 2020}}</ref> All features of the novel SARS-CoV-2 virus occur in related coronaviruses in nature.<ref name="NM-20200317" />
Outside the human body, the virus is killed by household [[soap]], which bursts its [[Viral envelope|protective bubble]].<ref name=":0"/>

SARS-CoV-2 is closely related to the original [[SARS-CoV]].<ref name="Zhu24Jan2020">{{cite journal |vauthors=Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W |display-authors=6 |title=A Novel Coronavirus from Patients with Pneumonia in China, 2019 |journal=[[The New England Journal of Medicine]] |volume=382 |issue=8 |pages=727–733 |date=February 2020 |pmid=31978945 |doi=10.1056/NEJMoa2001017|pmc=7092803 }}</ref> It is thought to have a [[Zoonosis|zoonotic]] origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus ''[[Betacoronavirus]]'', in subgenus [[Severe acute respiratory syndrome-related coronavirus|''Sarbecovirus'']] (lineage B) together with two [[bat]]-derived strains. It is 96% identical at the whole [[genome]] level to other bat coronavirus samples (BatCov RaTG13).<ref name="WHOReport24Feb2020" /> In February 2020, Chinese researchers found that there is only one [[amino acid]] difference in the binding domain of the [[Peplomer|S protein]] between the coronaviruses from [[pangolins]] and those from humans; however, whole-genome comparison to date found that at most 92% of genetic material was shared between pangolin coronavirus and SARS-CoV-2, which is insufficient to prove pangolins to be the [[intermediate host]].<ref name="Cyranoski26Feb2020">{{cite journal |title=Mystery deepens over animal source of coronavirus |journal=Nature |volume=579 |pages=18–19 |date=26 February 2020 |doi=10.1038/d41586-020-00548-w |pmid=32127703 |vauthors=Cyranoski D |issue=7797 |bibcode=2020Natur.579...18C|doi-access=free }}</ref>

==Pathophysiology==

The lungs are the organs most affected by COVID‑19 because the virus accesses host cells via the enzyme [[angiotensin-converting enzyme 2]] (ACE2), which is most abundant in [[Type II cell|type II alveolar cells]] of the lungs. The virus uses a special surface glycoprotein called a "spike" ([[peplomer]]) to connect to ACE2 and enter the host cell.<ref name="Nature Microbiology">{{cite journal | title=Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses | journal=Nature Microbiology | doi=10.1038/s41564-020-0688-y | doi-access=free | pmid=32094589 | date=2020 | vauthors=Letko M, Marzi A, Munster V | volume=5 | issue=4 | pages=562–569 | pmc=7095430 }}</ref> The density of ACE2 in each tissue correlates with the severity of the disease in that tissue and some have suggested that decreasing ACE2 activity might be protective,<ref name="Zhang Penninger Li Zhong p.">{{cite journal | vauthors=Zhang H, Penninger JM, Li Y, Zhong N, Slutsky AS | title=Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target | journal=Intensive Care Medicine | date=March 2020 | volume=46 | issue=4 | pages=586–590 |doi=10.1007/s00134-020-05985-9 | doi-access=free | pmid=32125455 | pmc=7079879 }}</ref><ref name="Xu Zhong Deng Peng p.">{{cite journal | vauthors=Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, Li T, Chen Q | display-authors=6 | title=High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa | journal=International Journal of Oral Science | volume=12 | issue=1 | page=8 | date=February 2020 | doi=10.1038/s41368-020-0074-x |doi-access=free | pmid=32094336 | pmc=7039956 }}</ref> though another view is that increasing ACE2 using [[angiotensin II receptor blocker]] medications could be protective and these hypotheses need to be tested.<ref>{{cite journal | vauthors=Gurwitz D | title=Angiotensin receptor blockers as tentative SARS‐CoV‐2 therapeutics | journal=Drug Development Research | doi=10.1002/ddr.21656 | doi-access=free | pmid=32129518 | date=March 2020 }}</ref> As the alveolar disease progresses, respiratory failure might develop and death may follow.<ref name="Xu Zhong Deng Peng p." />

SARS-CoV-2 may also cause respiratory failure through affecting the brainstem as other coronaviruses have been found to invade the [[Central nervous system|central nervous system (CNS)]]. While virus has been detected in cerebrospinal fluid of autopsies, the exact mechanism by which it invades the CNS remains unclear and may first involve invasion of peripheral nerves given the low levels of ACE2 in the brain.<ref>{{Cite journal|last=Li|first=Yan-Chao|last2=Bai|first2=Wan-Zhu|last3=Hashikawa|first3=Tsutomu|date=2020|title=The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients|journal=Journal of Medical Virology|language=en|volume=92|issue=6|pages=552–555|doi=10.1002/jmv.25728|pmid=32104915|issn=1096-9071|doi-access=free}}</ref><ref>{{Cite journal|last=Baig|first=Abdul Mannan|last2=Khaleeq|first2=Areeba|last3=Ali|first3=Usman|last4=Syeda|first4=Hira|date=March 2020|title=Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host–Virus Interaction, and Proposed Neurotropic Mechanisms|journal=ACS Chemical Neuroscience|volume=11|issue=7|pages=995–998|doi=10.1021/acschemneuro.0c00122|pmid=32167747|pmc=7094171|issn=1948-7193}}</ref>

The virus also affects gastrointestinal organs as ACE2 is abundantly expressed in the [[gland]]ular cells of [[Stomach|gastric]], [[Duodenum|duodenal]] and [[Rectum|rectal]] [[epithelium]]<ref name=":11">{{cite journal|last1=Gu|first1=Jinyang|last2=Han|first2=Bing|last3=Wang|first3=Jian|date=27 February 2020|title=COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission|journal=Gastroenterology|volume=158|issue=6|pages=1518–1519|doi=10.1053/j.gastro.2020.02.054|pmid=32142785|issn=0016-5085|pmc=7130192}}</ref> as well as [[Endothelium|endothelial]] cells and [[enterocyte]]s of the [[small intestine]].<ref>{{cite journal|last1=Hamming|first1=I.|last2=Timens|first2=W.|last3=Bulthuis|first3=M. L. C.|last4=Lely|first4=A. T.|last5=Navis|first5=G. J.|last6=Goor|first6=H. van|date=2004|title=Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis|journal=The Journal of Pathology|volume=203|issue=2|pages=631–637|doi=10.1002/path.1570|pmid=15141377|issn=1096-9896|pmc=7167720}}</ref>

The virus can cause [[Myocardial infarction|acute myocardial injury]] and chronic damage to the [[Circulatory system|cardiovascular system]].<ref name=":3">{{cite journal|last=Zheng|first=Ying-Ying|last2=Ma|first2=Yi-Tong|last3=Zhang|first3=Jin-Ying|last4=Xie|first4=Xiang|date=March 2020|title=COVID-19 and the cardiovascular system|journal=Nature Reviews Cardiology|volume=17|issue=5|pages=259–260|doi=10.1038/s41569-020-0360-5|pmid=32139904|issn=1759-5010|pmc=7095524}}</ref> An acute cardiac injury was found in 12% of infected people admitted to the hospital in Wuhan, China,<ref name="Huang24Jan2020"/> and is more frequent in severe disease.<ref>{{cite journal|last=Wang|first=Dawei|last2=Hu|first2=Bo|last3=Hu|first3=Chang|last4=Zhu|first4=Fangfang|last5=Liu|first5=Xing|last6=Zhang|first6=Jing|last7=Wang|first7=Binbin|last8=Xiang|first8=Hui|last9=Cheng|first9=Zhenshun|last10=Xiong|first10=Yong|last11=Zhao|first11=Yan|date=March 2020|title=Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China|journal=JAMA|volume=323|issue=11|pages=1061–1069|doi=10.1001/jama.2020.1585|issn=0098-7484|pmc=7042881|pmid=32031570}}</ref> Rates of cardiovascular symptoms are high, owing to the systemic inflammatory response and immune system disorders during disease progression, but acute myocardial injuries may also be related to ACE2 receptors in the heart.<ref name=":3" /> ACE2 receptors are highly expressed in the heart and are involved in heart function.<ref name=":3" /><ref>{{cite journal|last=Turner|first=Anthony J.|last2=Hiscox|first2=Julian A.|last3=Hooper|first3=Nigel M.|date=2004-06-01|title=ACE2: from vasopeptidase to SARS virus receptor|url=https://www.cell.com/trends/pharmacological-sciences/abstract/S0165-6147(04)00097-5|journal=Trends in Pharmacological Sciences|volume=25|issue=6|pages=291–294|doi=10.1016/j.tips.2004.04.001|issn=0165-6147|pmc=7119032|pmid=15165741}}</ref> A high incidence of [[thrombosis]] (31%) and [[venous thromboembolism]] (25%) have been found in ICU patients with COVID‑19 infections and may be related to poor prognosis.<ref name=":4">{{cite journal|last=Klok|first=F.A.|last2=Kruip|first2=M.J.H.A.|last3=van der Meer|first3=N.J.M.|last4=Arbous|first4=M.S.|last5=Gommers|first5=D.A.M.P.J.|last6=Kant|first6=K.M.|last7=Kaptein|first7=F.H.J.|last8=van Paassen|first8=J.|last9=Stals|first9=M.A.M.|last10=Huisman|first10=M.V.|last11=Endeman|first11=H.|date=April 2020|title=Incidence of thrombotic complications in critically ill ICU patients with COVID-19|journal=Thrombosis Research|doi=10.1016/j.thromres.2020.04.013|pmid=32291094|issn=0049-3848|pmc=7146714}}</ref><ref>{{cite journal|last=Cui|first=Songping|last2=Chen|first2=Shuo|last3=Li|first3=Xiunan|last4=Liu|first4=Shi|last5=Wang|first5=Feng|date=2020-04-09|title=Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia|journal=Journal of Thrombosis and Haemostasis|doi=10.1111/jth.14830|pmid=32271988|doi-access=free}}</ref> Blood vessel dysfunction and clot formation (as suggested by high D-dimer levels) are thought to play a significant role in mortality, incidences of clots leading to [[pulmonary embolism]]s, and [[stroke|ischaemic events]] within the brain have been noted as complications leading to death in patients infected with SARS-CoV-2. Infection appears to set off a chain of [[vasoconstriction|vasoconstrictive responses]] within the body, constriction of blood vessels within the [[pulmonary circulation]] has also been posited as a mechanism in which oxygenation decreases alongside the presentation of viral pneumonia.<ref name="Science">{{cite journal | last=Wadman | first=Meredith |doi=10.1126/science.abc3208 |title= How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes | journal=Science |date=April 2020 |doi-access=free }}</ref>

Another common cause of death is complications related to the [[kidney]]s<ref name="Science"/>—SARS-CoV-2 directly infects kidney cells, as confirmed in post-mortem studies. [[Acute kidney injury]] is a common complication and cause of death; this is more significant in patients with already compromised kidney function, especially in people with pre-existing chronic conditions such as hypertension and diabetes which specifically cause [[nephropathy]] in the long run.<ref>{{cite journal|url=https://www.medrxiv.org/content/10.1101/2020.03.04.20031120v4|title=Human Kidney is a Target for Novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection|first1=Bo|last1=Diao|first2=Chenhui|last2=Wang|first3=Rongshuai|last3=Wang|first4=Zeqing|last4=Feng|first5=Yingjun|last5=Tan|first6=Huiming|last6=Wang|first7=Changsong|last7=Wang|first8=Liang|last8=Liu|first9=Ying|last9=Liu|first10=Yueping|last10=Liu|first11=Gang|last11=Wang|first12=Zilin|last12=Yuan|first13=Liang|last13=Ren|first14=Yuzhang|last14=Wu|first15=Yongwen|last15=Chen|date=10 April 2020|journal=MedRxiv|pages=2020.03.04.20031120|via=www.medrxiv.org|doi=10.1101/2020.03.04.20031120}}</ref>

Autopsies of people who died of COVID‑19 have found diffuse alveolar damage (DAD), and lymphocyte-containing inflammatory infiltrates within the lung.<ref name="AJCPCOVID">{{cite journal|vauthors=Barton L, Duval E, Stroberg E, Ghosh S, Mukhopadhyay S|title=COVID-19 autopsies, Oklahoma, USA|journal=American Journal of Clinical Pathology|date=April 2020|volume=153|issue=6|pages=725–733|doi= 10.1093/ajcp/aqaa062 |pmid=32275742|pmc=7184436}}</ref>

===Immunopathology===

Although SARS-COV-2 has a tropism for ACE2-expressing epithelial cells of the respiratory tract, patients with severe COVID‑19 have symptoms of systemic hyperinflammation. Clinical laboratory findings of elevated IL-2, IL-7, IL-6, [[granulocyte-macrophage colony-stimulating factor]] (GM-CSF), [[CXCL10|interferon-γ inducible protein 10]] (IP-10), [[Monocyte chemoattractant protein-1|monocyte chemoattractant protein{{nbsp}}1]] (MCP-1), [[Macrophage inflammatory protein|macrophage inflammatory protein 1-α]] (MIP-1α), and [[Tumor necrosis factor alpha|tumour necrosis factor-α]] (TNF-α) indicative of [[cytokine release syndrome]] (CRS) suggest an underlying immunopathology.<ref name="Huang24Jan2020"/>

Additionally, people with COVID‑19 and [[acute respiratory distress syndrome]] (ARDS) have classical serum biomarkers of CRS, including elevated [[C-reactive protein]] (CRP), [[lactate dehydrogenase]] (LDH), [[D-dimer]], and [[ferritin]].<ref>{{cite journal | vauthors = Zhang C, Wu Z, Li JW, Zhao H, Wang GQ | title = The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality | journal = International Journal of Antimicrobial Agents | date = March 2020 | page = 105954 | doi = 10.1016/j.ijantimicag.2020.105954 | pmid = 32234467 | pmc = 7118634 | url = https://www.sciencedirect.com/science/article/pii/S0924857920301047}}</ref>

Systemic inflammation results in vasodilation, allowing inflammatory lymphocytic and monocytic infiltration of the lung and the heart. In particular, pathogenic GM-CSF-secreting T-cells were shown to correlate with the recruitment of inflammatory IL-6-secreting monocytes and severe lung pathology in COVID‑19 patients.<ref>{{cite journal | vauthors = Zhou Y, Fu B, Zheng X, Wang D, Zhao C, Qi Y, Sun R, Tian Z, Xu X, Wei H | display-authors = 6 | title = Aberrant pathogenic GM-CSF+ T cells and inflammatory CD14+CD16+ monocytes in severe pulmonary syndrome patients of a new coronavirus | journal = bioRxiv Pre-print | year = 2020 | pages = 2020.02.12.945576 | doi = 10.1101/2020.02.12.945576 | url = https://www.biorxiv.org/content/10.1101/2020.02.12.945576v1}}</ref> Lymphocytic infiltrates have also been reported at autopsy.<ref name="AJCPCOVID"/>

==Diagnosis==

{{main|COVID-19 testing}}
[[File:Infektionsschutzzentrum im Rautenstrauch-Joest-Museum, Köln-6313 (cropped).jpg|thumb|Demonstration of a [[nasopharyngeal swab]] for [[COVID-19 testing]]]]
[[File:CDC 2019-nCoV Laboratory Test Kit.jpg|thumb|[[Centers for Disease Control and Prevention|CDC]] [[rRT-PCR]] test kit for COVID-19<ref>{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/about/testing.html|title=CDC Tests for 2019-nCoV|author=|date=5 February 2020|website=Centers for Disease Control and Prevention|url-status=live|archive-url=https://web.archive.org/web/20200214023335/https://www.cdc.gov/coronavirus/2019-ncov/about/testing.html|archive-date=14 February 2020|access-date=12 February 2020| name-list-format = vanc}}</ref>]]

The WHO has published several testing protocols for the disease.<ref>{{cite web|url=https://www.who.int/publications-detail/laboratory-testing-for-2019-novel-coronavirus-in-suspected-human-cases-20200117|title=Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases|website=[[World Health Organization]] (WHO)|access-date=13 March 2020|archive-url=https://web.archive.org/web/20200317023052/https://www.who.int/publications-detail/laboratory-testing-for-2019-novel-coronavirus-in-suspected-human-cases-20200117|archive-date=17 March 2020|url-status=live}}</ref> The standard method of testing is [[real-time reverse transcription polymerase chain reaction]] (rRT-PCR).<ref name="20200130cdc">{{cite web |url=https://www.cdc.gov/coronavirus/2019-ncov/summary.html |title=2019 Novel Coronavirus (2019-nCoV) Situation Summary |date=30 January 2020 |website=[[Centers for Disease Control and Prevention]] |url-status=live |archive-url=https://web.archive.org/web/20200126210549/https://www.cdc.gov/coronavirus/2019-nCoV/summary.html |archive-date=26 January 2020 |access-date=30 January 2020| name-list-format = vanc}}</ref> The test is typically done on respiratory samples obtained by a [[nasopharyngeal swab]]; however, a nasal swab or [[sputum]] sample may also be used.<ref name="CDC2020Testing"/><ref name="20200129cdc">{{cite web |url=https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-detection-instructions.html |title=Real-Time RT-PCR Panel for Detection 2019-nCoV |date=29 January 2020 |website=[[Centers for Disease Control and Prevention]] |access-date=1 February 2020 |archive-url=https://web.archive.org/web/20200130202031/https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-detection-instructions.html |archive-date=30 January 2020 |url-status=live | name-list-format = vanc}}</ref> Results are generally available within a few hours to two days.<ref name="globenewswire1977226">{{cite web |url=https://www.globenewswire.com/news-release/2020/01/30/1977226/0/en/Curetis-Group-Company-Ares-Genetics-and-BGI-Group-Collaborate-to-Offer-Next-Generation-Sequencing-and-PCR-based-Coronavirus-2019-nCoV-Testing-in-Europe.html |title=Curetis Group Company Ares Genetics and BGI Group Collaborate to Offer Next-Generation Sequencing and PCR-based Coronavirus (2019-nCoV) Testing in Europe |date=30 January 2020 |website=GlobeNewswire News Room |access-date=1 February 2020 |archive-url=https://web.archive.org/web/20200131201626/https://www.globenewswire.com/news-release/2020/01/30/1977226/0/en/Curetis-Group-Company-Ares-Genetics-and-BGI-Group-Collaborate-to-Offer-Next-Generation-Sequencing-and-PCR-based-Coronavirus-2019-nCoV-Testing-in-Europe.html |archive-date=31 January 2020 |url-status=live | name-list-format = vanc}}</ref><ref name="20200130businessinsider">{{cite web |url=https://www.businessinsider.com/how-to-know-if-you-have-the-coronavirus-pcr-test-2020-1 |title=There's only one way to know if you have the coronavirus, and it involves machines full of spit and mucus |last=Brueck |first=Hilary | name-list-format = vanc |date=30 January 2020 |website=Business Insider |access-date=1 February 2020 |archive-url= https://web.archive.org/web/20200201034232/https://www.businessinsider.com/how-to-know-if-you-have-the-coronavirus-pcr-test-2020-1 |archive-date=1 February 2020 |url-status=live }}</ref> Blood tests can be used, but these require two blood samples taken two weeks apart, and the results have little immediate value.<ref>{{cite web |url=https://www.who.int/publications-detail/laboratory-testing-for-2019-novel-coronavirus-in-suspected-human-cases-20200117 |title=Laboratory testing for 2019 novel coronavirus (2019-nCoV) in suspected human cases |access-date=26 February 2020 |archive-url=https://web.archive.org/web/20200221192745/https://www.who.int/publications-detail/laboratory-testing-for-2019-novel-coronavirus-in-suspected-human-cases-20200117 |archive-date=21 February 2020 |url-status=live }}</ref> Chinese scientists were able to isolate a strain of the coronavirus and publish the [[Nucleic acid sequence|genetic sequence]] so laboratories across the world could independently develop [[polymerase chain reaction]] (PCR) tests to detect infection by the virus.<ref name="Hui14Jan2020" /><ref name="Cohen17Jan20202">{{cite journal | vauthors = Cohen J, Normile D | title = New SARS-like virus in China triggers alarm | journal = Science | volume = 367 | issue = 6475 | pages = 234–35 | date = January 2020 | pmid = 31949058 |doi=10.1126/science.367.6475.234 | bibcode = 2020Sci...367..234C | url = https://mcb.uconn.edu/wp-content/uploads/sites/2341/2020/01/WuhanScience24Jan2020.pdf | access-date = 11 February 2020 | url-status = live | archive-url = https://web.archive.org/web/20200211230310/https://mcb.uconn.edu/wp-content/uploads/sites/2341/2020/01/WuhanScience24Jan2020.pdf | archive-date = 11 February 2020 }}</ref><ref name="ncbiWuhanGenomes">{{cite web |url=https://www.ncbi.nlm.nih.gov/labs/virus/vssi/#/virus?SeqType_s=Nucleotide&VirusLineage_ss=Wuhan%20seafood%20market%20pneumonia%20virus,%20taxid:2697049 |title=Severe acute respiratory syndrome coronavirus 2 data hub |website=NCBI |url-status=live |access-date=4 March 2020 |name-list-format=vanc |archive-url=https://web.archive.org/web/20200321235550/https://www.ncbi.nlm.nih.gov/labs/virus/vssi/#/virus?SeqType_s=Nucleotide&VirusLineage_ss=Wuhan%20seafood%20market%20pneumonia%20virus,%20taxid:2697049 |archive-date=21 March 2020 }}</ref> {{As of|2020|April|4}}, [[antibody titer|antibody test]]s (which may detect active infections and whether a person had been infected in the past) were in development, but not yet widely used.<ref>{{cite journal|last=Petherick|first=Anna|date=4 April 2020|title=Developing antibody tests for SARS-CoV-2|journal=The Lancet|volume=395|issue=10230|pages=1101–1102|doi=10.1016/s0140-6736(20)30788-1|pmid=32247384|issn=0140-6736|doi-access=free}}</ref><ref name="Vogel2020">{{cite journal |title=New blood tests for antibodies could show true scale of coronavirus pandemic |last=Vogel| first=Gretchen |journal=Science |doi=10.1126/science.abb8028|date=March 2020 |doi-access=free }}</ref><ref>{{cite journal | vauthors = Pang J, Wang MX, Ang IY, Tan SH, Lewis RF, Chen JI, Gutierrez RA, Gwee SX, Chua PE, Yang Q, Ng XY, Yap RK, Tan HY, Teo YY, Tan CC, Cook AR, Yap JC, Hsu LY | display-authors = 6 | title = Potential Rapid Diagnostics, Vaccine and Therapeutics for 2019 Novel Coronavirus (2019-nCoV): A Systematic Review | journal = Journal of Clinical Medicine | volume = 9 | issue = 3 | page = 623 | date = February 2020 | pmid = 32110875 | doi = 10.3390/jcm9030623 | pmc = 7141113 | doi-access = free }}</ref> The Chinese experience with testing has shown the [[Sensitivity and specificity|accuracy]] is only 60 to 70%.<ref>AFP News Agency (11 April 2020). "How false negatives are complicating COVID-19 testing". [https://www.aljazeera.com/news/2020/04/false-negatives-complicating-covid-19-testing-200411100741669.html Al Jazeera website] Retrieved 12 April 2020.</ref> The FDA in the United States approved the first [[Point-of-care testing|point-of-care test]] on 21 March 2020 for use at the end of that month.<ref>{{cite press release |title= Coronavirus (COVID-19) Update: FDA Issues first Emergency Use Authorization for Point of Care Diagnostic |date= 21 March 2020 |publisher= FDA |url= https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-first-emergency-use-authorization-point-care-diagnostic |access-date= 22 March 2020 |archive-url= https://web.archive.org/web/20200321224700/https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-first-emergency-use-authorization-point-care-diagnostic |archive-date= 21 March 2020 |url-status= live }}</ref>

Diagnostic guidelines released by Zhongnan Hospital of [[Wuhan University]] suggested methods for detecting infections based upon clinical features and epidemiological risk. These involved identifying people who had at least two of the following symptoms in addition to a history of travel to [[Wuhan]] or contact with other infected people: fever, imaging features of pneumonia, normal or reduced white blood cell count, or reduced [[lymphocyte]] count.<ref name="Jin2020">{{cite journal | vauthors=Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, Fang C, Huang D, Huang LQ, Huang Q, Han Y, Hu B, Hu F, Li BH, Li YR, Liang K, Lin LK, Luo LS, Ma J, Ma LL, Peng ZY, Pan YB, Pan ZY, Ren XQ, Sun HM, Wang Y, Wang YY, Weng H, Wei CJ, Wu DF, Xia J, Xiong Y, Xu HB, Yao XM, Yuan YF, Ye TS, Zhang XC, Zhang YW, Zhang YG, Zhang HM, Zhao Y, Zhao MJ, Zi H, Zeng XT, Wang YY, Wang XH | display-authors=6 | title=A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version) | journal=Military Medical Research | date=February 2020 | volume=7 | issue=1 | page=4 | doi=10.1186/s40779-020-0233-6 | doi-access=free | pmid=32029004 | pmc=7003341 }}</ref>

A study asked hospitalised COVID‑19 patients to cough into a sterile container, thus producing a saliva sample, and detected the virus in eleven of twelve patients using RT-PCR. This technique has the potential of being quicker than a swab and involving less risk to health care workers (collection at home or in the car).<ref name="Saliva2020">{{cite journal |first1=Kelvin Kai-Wang |last1=To |first2=Owen Tak-Yin |last2=Tsang |first3=Cyril Chik-Yan |last3=Yip |first4=Kwok-Hung |last4=Chan |first5=Tak-Chiu |last5=W |first6=Jacky Man-Chun |last6=Chan |first7=Wai-Shing |last7=Leung |first8=Thomas Shiu-Hong |last8=Chik |first9=Chris Yau-Chung |last9=Choi |first10=Darshana H |last10=Kandamby |first11=David Christopher |last11=Lung |first12=Anthony Raymond |last12=Tam |first13=Rosana Wing-Shan |last13=Poon |first14=Agnes Yim-Fong |last14=Fung |first15=Ivan Fan-Ngai |last15=Hung |first16=Vincent Chi-Chung |last16=Cheng |first17=Jasper Fuk-Woo |last17=Chan |first18=Kwok-Yung |last18=Yuen |authorlink18=Yuen Kwok-yung |display-authors=4 |title=Consistent Detection of 2019 Novel Coronavirus in Saliva |journal=[[Clinical Infectious Diseases]] |publisher=Oxford University Press |date=12 February 2020 |doi=10.1093/cid/ciaa149|pmid=32047895 |pmc=7108139 }}</ref><!-- from "Consistent Detection of 2019 Novel Coronavirus in Saliva", Feb 12, 2020: "Each saliva specimen was inoculated in duplicate; one tube contained tosylsulfonyl phenylalanyl chloromethyl [[ketone]]-treated [[trypsin]] (0.5 μg/mL) in serum-free MEM and the other tube contained MEM with 1% fetal calf serum{{nbsp}}... Virus-induced cytopathic effect was examined daily for up to seven days{{nbsp}}... The median viral load of the first available saliva specimens was 3.3 × 10^6 copies/mL (range, 9.9 × 10^2 to 1.2 × 10^8 copies/mL)." -->

Along with laboratory testing, chest CT scans may be helpful to diagnose COVID-19 in individuals with a high clinical suspicion of infection but are not recommended for routine screening.<ref name=":0" /><ref name="acr.org"/> Bilateral multilobar [[Ground-glass opacity|ground-glass opacities]] with a peripheral, asymmetric, and posterior distribution are common in early infection.<ref name=":0" /> Subpleural dominance, [[Crazy paving (medicine)|crazy paving]] (lobular septal thickening with variable alveolar filling), and [[Pulmonary consolidation|consolidation]] may appear as the disease progresses.<ref name=":0" /><ref>{{cite journal|last1=Lee|first1=Elaine Y. P.|last2=Ng|first2=Ming-Yen|last3=Khong|first3=Pek-Lan|date=24 February 2020|title=COVID-19 pneumonia: what has CT taught us?|url=https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30134-1/fulltext|journal=The Lancet Infectious Diseases|volume=0|issue=4|pages=384–385|doi=10.1016/S1473-3099(20)30134-1|issn=1473-3099|pmid=32105641|access-date=13 March 2020|archive-url=https://web.archive.org/web/20200308143943/https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30134-1/fulltext|archive-date=8 March 2020|url-status=live|pmc=7128449}}</ref>

In late 2019, WHO assigned the emergency [[ICD-10]] disease codes [[ICD-10 Chapter XXII: Codes for special purposes|U07.1]] for deaths from lab-confirmed SARS-CoV-2 infection and U07.2 for deaths from clinically or epidemiologically diagnosed COVID‑19 without lab-confirmed SARS-CoV-2 infection.<ref name="ICD10_2019_U07p2">{{cite web | title = ICD-10 Version:2019 | website = [[World Health Organization]] | quote = U07.2—COVID-19, virus not identified—COVID-19 NOS—Use this code when COVID-19 is diagnosed clinically or epidemiologically but laboratory testing is inconclusive or not available. Use additional code, if desired, to identify pneumonia or other manifestations | year = 2019 | url = https://icd.who.int/browse10/2019/en#/U07.1 | access-date = 2020-03-31 | archive-url = https://archive.today/20200331004754/https://icd.who.int/browse10/2019/en%23/U07.1#/U07.1 | archive-date = 31 March 2020 | url-status = live | url-access = <!-- (subscription/registration/limited) default=free --> }}</ref>

{{Multiple image
| image_style = border:none
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|align=center
|caption_align=center
|direction =vertical
|image1=COVID19CT2.webp| caption1= Typical [[CT imaging]] findings
|image2=COVID19CT1.webp|caption2=[[CT imaging]] of rapid progression stage
}}

===រោគវិទ្យា===

Few data are available about microscopic lesions and the pathophysiology of COVID‑19.<ref>{{cite journal |vauthors=Hanley B, Lucas SB, Youd E, Swift B, Osborn M |title=Autopsy in suspected COVID-19 cases |journal=J. Clin. Pathol. |volume= 73|issue= 5|pages= jclinpath-2020-206522|date=March 2020 |pmid=32198191 |doi=10.1136/jclinpath-2020-206522 |doi-access=free }}</ref><ref>{{cite journal |vauthors=Yao XH, Li TY, He ZC, Ping YF, Liu HW, Yu SC, Mou HM, Wang LH, Zhang HR, Fu WJ, Luo T, Liu F, Chen C, Xiao HL, Guo HT, Lin S, Xiang DF, Shi Y, Li QR, Huang X, Cui Y, Li XZ, Tang W, Pan PF, Huang XQ, Ding YQ, Bian XW | display-authors=6 |title=[A pathological report of three COVID-19 cases by minimally invasive autopsies] |language=Chinese |journal=Zhonghua Bing Li Xue Za Zhi |volume=49 |issue= |pages=E009 |date=March 2020 |pmid=32172546 |doi=10.3760/cma.j.cn112151-20200312-00193 }}</ref> The main pathological findings at autopsy are: 
* [[macroscopic scale|Macroscopy]]: [[pleurisy]], [[pericarditis]], [[lung consolidation]] and [[pulmonary oedema]]
* Four types of severity of [[viral pneumonia]] can be observed: 
** minor [[pneumonia]]: minor serous [[Exudate|exudation]], minor [[fibrin]] exudation
** mild pneumonia: pulmonary oedema, [[pneumocyte]] [[hyperplasia]], large atypical [[pneumocyte]]s, interstitial [[inflammation]] with [[lymphocytic]] [[Infiltration (medical)|infiltration]] and [[giant cell|multinucleated giant cell]] formation 
** severe pneumonia: [[diffuse alveolar damage]] (DAD) with diffuse [[Pulmonary alveolus|alveolar]] [[exudates]]. DAD is the cause of [[acute respiratory distress syndrome]] (ARDS) and severe [[hypoxemia]].
** healing pneumonia: [[healing|organisation]] of [[exudate]]s in [[Pulmonary alveolus|alveolar cavities]] and [[Pulmonary fibrosis|pulmonary interstitial fibrosis]]
** [[plasma cell|plasmocytosis]] in [[Bronchoalveolar lavage|BAL]]<ref>{{cite journal|title=Exuberant plasmocytosis in bronchoalveolar lavage of the first patient requiring Extracorporeal Membrane Oxygenation for SARS-CoV-2 in Europe|first1=Marco|last1=Giani|first2=Davide|last2=Seminati|first3=Alberto|last3=Lucchini|first4=Giuseppe|last4=Foti|first5=Fabio|last5=Pagni|date=16 March 2020|journal=Journal of Thoracic Oncology|volume=15|issue=5|pages=e65–e66|doi=10.1016/j.jtho.2020.03.008|pmid=32194247|pmc=7118681}}</ref>
* [[Blood]]: [[disseminated intravascular coagulation]] (DIC);<ref>{{cite journal|title=Disseminated intravascular coagulation in patients with 2019-nCoV pneumonia|first=David|last=Lillicrap|date=1 April 2020|journal=Journal of Thrombosis and Haemostasis: JTH|volume=18|issue=4|pages=786–787|doi=10.1111/jth.14781|pmid=32212240|pmc=7166410}}</ref> leukoerythroblastic reaction<ref>{{cite journal|title=Leukoerythroblastic reaction in a patient with COVID-19 infection|first1=Anupam|last1=Mitra|first2=Denis M.|last2=Dwyre|first3=Michael|last3=Schivo|first4=George R.|last4=Thompson|first5=Stuart H.|last5=Cohen|first6=Nam|last6=Ku|first7=John P.|last7=Graff|date=25 March 2020|journal=American Journal of Hematology|doi=10.1002/ajh.25793|pmid=32212392|doi-access=free}}</ref>
* [[Liver]]: microvesicular [[steatosis]]

==ការបង្ការ==

{{See also|COVID-19 pandemic#Prevention|flatten the curve|workplace hazard controls for COVID-19}}
[[File:20200410 Flatten the curve, raise the line - pandemic (English).gif|thumb|upright=1.5|Progressively stronger mitigation efforts to reduce the number of active cases at any given time—known as "[[flattening the curve]]"—allows healthcare services to better manage the same volume of patients.<ref>{{cite web |last=Wiles |first=Siouxsie |author-link=Siouxsie Wiles |title=The three phases of Covid-19—and how we can make it manageable |url=https://thespinoff.co.nz/society/09-03-2020/the-three-phases-of-covid-19-and-how-we-can-make-it-manageable/ |website=The Spinoff |access-date=9 March 2020 |date=9 March 2020 |name-list-format=vanc |archive-url=https://web.archive.org/web/20200327120015/https://thespinoff.co.nz/society/09-03-2020/the-three-phases-of-covid-19-and-how-we-can-make-it-manageable/ |archive-date=27 March 2020 |url-status=live }}</ref><ref name="Lancet2020Flatten">{{cite journal | vauthors = Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD | title = How will country-based mitigation measures influence the course of the COVID-19 epidemic? | journal = Lancet | date = March 2020 | volume = 395 | issue = 10228 | pages = 931–934 | pmid = 32164834 | doi = 10.1016/S0140-6736(20)30567-5 | pmc = 7158572 | quote = A key issue for epidemiologists is helping policy makers decide the main objectives of mitigation—e.g. minimising morbidity and associated mortality, avoiding an epidemic peak that overwhelms health-care services, keeping the effects on the economy within manageable levels, and flattening the epidemic curve to wait for vaccine development and manufacture on scale and antiviral drug therapies. | doi-access = free }}</ref><ref>{{cite web|url=https://www.vox.com/2020/3/10/21171481/coronavirus-us-cases-quarantine-cancellation|title=How canceled events and self-quarantines save lives, in one chart|first=Eliza|last=Barclay|date=10 March 2020|website=Vox|name-list-format=vanc|access-date=12 March 2020|archive-url=https://web.archive.org/web/20200312161852/https://www.vox.com/2020/3/10/21171481/coronavirus-us-cases-quarantine-cancellation|archive-date=12 March 2020|url-status=live}}</ref> Likewise, progressively greater increases in healthcare capacity—called ''raising the line''—such as by increasing bed count, personnel, and equipment, helps to meet increased demand.<ref name="Vox_20200407">{{cite news |last1=Barclay |first1=Eliza |last2=Scott |first2=Dylan |last3=Animashaun |first3=Animashaun |title=The US doesn't just need to flatten the curve. It needs to "raise the line." |url=https://www.vox.com/2020/4/7/21201260/coronavirus-usa-chart-mask-shortage-ventilators-flatten-the-curve |work=Vox |date=April 7, 2020 |archiveurl=https://web.archive.org/web/20200407155950/https://www.vox.com/2020/4/7/21201260/coronavirus-usa-chart-mask-shortage-ventilators-flatten-the-curve |archivedate=April 7, 2020 |url-status=live }}</ref>]]
[[File:20200409 Pandemic resurgence - effect of inadequate mitigation.gif|thumb|upright=1.5|Mitigation attempts that are inadequate in strictness or duration—such as premature relaxation of distancing rules or stay-at-home orders—can allow a resurgence after the initial surge and mitigation.<ref name="Lancet2020Flatten"/><ref name="Wiles">{{cite web |last=Wiles |first=Siouxsie |title=After 'Flatten the Curve', we must now 'Stop the Spread'. Here's what that means |url=https://thespinoff.co.nz/society/14-03-2020/after-flatten-the-curve-we-must-now-stop-the-spread-heres-what-that-means/ |website=The Spinoff |access-date=13 March 2020 |date=14 March 2020 |archive-url=https://web.archive.org/web/20200326232315/https://thespinoff.co.nz/society/14-03-2020/after-flatten-the-curve-we-must-now-stop-the-spread-heres-what-that-means/ |archive-date=26 March 2020 |url-status=live }}</ref>]]

Preventive measures to reduce the chances of infection include staying at home, avoiding crowded places, keeping distance from others, washing hands with soap and water often and for at least 20 seconds, practising good respiratory hygiene, and avoiding touching the eyes, nose, or mouth with unwashed hands.<ref name="CDC-Prevention & Treatment">{{cite web | url = https://www.cdc.gov/coronavirus/about/prevention.html | author = Centers for Disease Control | title = Coronavirus Disease 2019 (COVID-19): Prevention & Treatment | date = 3 February 2020 | access-date = 10 February 2020 | archive-url = https://web.archive.org/web/20191215193934/https://www.cdc.gov/coronavirus/about/prevention.html | archive-date = 15 December 2019 | url-status = live| author-link = Centers for Disease Control }}</ref><ref name="WHO Advice for Public">{{cite web | url = https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public | title = Advice for Public | vauthors = ((World Health Organization)) | access-date = 10 February 2020 | archive-url = https://web.archive.org/web/20200126025750/https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public | archive-date = 26 January 2020 | url-status = live| author-link = World Health Organization | name-list-format = vanc}}</ref><ref>{{cite web|url=https://www.npr.org/sections/goatsandsoda/2020/03/17/814221111/my-hand-washing-song-readers-offer-lyrics-for-a-20-second-scrub|title=My Hand-Washing Song: Readers Offer Lyrics For A 20-Second Scrub|website=NPR.org|access-date=20 March 2020|archive-url=https://web.archive.org/web/20200320145553/https://www.npr.org/sections/goatsandsoda/2020/03/17/814221111/my-hand-washing-song-readers-offer-lyrics-for-a-20-second-scrub|archive-date=20 March 2020|url-status=live}}</ref> The CDC recommends covering the mouth and nose with a tissue when coughing or sneezing and recommends using the inside of the elbow if no tissue is available.<ref name = "CDC-Prevention & Treatment"/> Proper hand hygiene after any cough or sneeze is encouraged.<ref name = "CDC-Prevention & Treatment"/> The CDC has recommended the use of [[Cloth face mask|cloth face coverings]] in public settings where other social distancing measures are difficult to maintain, in part to limit transmission by asymptomatic individuals.<ref name="cdc-cover">{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html|title=Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission|last=CDC|date=2020-02-11|website=Centers for Disease Control and Prevention|url-status=live|archive-url=|archive-date=|access-date=2020-04-17}}</ref> The U.S. [[National Institutes of Health]] guidelines do not recommend any medication for prevention of COVID‑19, before or after exposure to the SARS-CoV-2 virus, outside of the setting of a clinical trial.<ref name="NIHGuidelines2020"/>

[[Social distancing]] strategies aim to reduce contact of infected persons with large groups by closing schools and workplaces, restricting travel, and cancelling large public gatherings.<ref name="JHUSocialDistancing">{{cite web | first = Lisa Lockerd | last = Maragakis | name-list-format = vanc | title = Coronavirus, Social Distancing and Self Quarantine | url = https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-social-distancing-and-self-quarantine | website = www.hopkinsmedicine.org | publisher = Johns Hopkins University | access-date = 18 March 2020 | archive-url = https://web.archive.org/web/20200318012357/https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-social-distancing-and-self-quarantine | archive-date = 18 March 2020 | url-status = live }}</ref> Distancing guidelines also include that people stay at least {{Convert|6|ft||abbr=}} apart.<ref>{{cite news|last=Parker-Pope|first=Tara|url=https://www.nytimes.com/2020/03/19/well/live/coronavirus-quarantine-social-distancing.html|title=Deciding How Much Distance You Should Keep|date=19 March 2020|work=[[The New York Times]]|access-date=20 March 2020|issn=0362-4331|archive-url=https://web.archive.org/web/20200320003705/https://www.nytimes.com/2020/03/19/well/live/coronavirus-quarantine-social-distancing.html|archive-date=20 March 2020|url-status=live | name-list-format = vanc}}</ref> There is no medication known to be effective at preventing COVID‑19.<ref name="Sanders2020">{{cite journal |last1=Sanders |first1=JM |last2=Monogue |first2=ML |last3=Jodlowski |first3=TZ |last4=Cutrell |first4=JB |title=Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review |journal=JAMA |date=April 13, 2020 |doi=10.1001/jama.2020.6019|pmid=32282022 |doi-access=free }}</ref> After the implementation of [[social distancing]] and [[Shelter in place|stay-at-home]] orders, many regions have been able to sustain an effective transmission rate ("R<sub>t</sub>") of less than one, meaning the disease is in remission in those areas.<ref>{{cite web |last1=Systrom |first1=Kevin |last2=Krieger |first2=Mike |last3=O'Rourke |first3=Ryan |last4=Stein |first4=Robby |first5=Frank |last5=Dellaert |first6=Adam |last6=Lerer | name-list-format = vanc |title=R<sub>t</sub> Covid-19 |url=https://rt.live/ |website=rt.live |access-date=19 April 2020 |date=11 April 2020}} Based on {{cite journal |last1=Bettencourt |first1=Luís M. A. |last2=Ribeiro |first2=Ruy M. |title=Real Time Bayesian Estimation of the Epidemic Potential of Emerging Infectious Diseases |journal=PLOS ONE |date=14 May 2008 |volume=3 |issue=5 |pages=e2185 |doi=10.1371/journal.pone.0002185 |pmid=18478118 |issn=1932-6203|pmc=2366072 |bibcode=2008PLoSO...3.2185B }}</ref> In a [[Basic reproduction number#Simple model|simple model]] <math display="inline">log(R_t)\approx R_t-1</math> needs on average over time be kept at or below zero to avoid [[exponential growth]].{{citation needed|date=May 2020}}

As a [[COVID-19 vaccine|vaccine]] is not expected until 2021 at the earliest,<ref>{{cite web | url = https://www.sciencealert.com/who-says-a-coronavirus-vaccine-is-18-months-away | title = Here's Why It's Taking So Long to Develop a Vaccine for the New Coronavirus | website = Science Alert | first1 = Rob | last1 = Grenfell | first2 = Trevor | last2 = Drew | name-list-format = vanc | date = 17 February 2020 | access-date = 26 February 2020 | archive-url = https://web.archive.org/web/20200228010631/https://www.sciencealert.com/who-says-a-coronavirus-vaccine-is-18-months-away | archive-date = 28 February 2020 | url-status = live }}</ref> a key part of managing COVID‑19 is trying to decrease and delay the epidemic peak, known as "flattening the [[epidemic curve|curve]]".<ref name="Lancet2020Flatten" /> This is done by slowing the infection rate to decrease the risk of health services being overwhelmed, allowing for better treatment of current cases, and delaying additional cases until effective treatments or a vaccine become available.<ref name="Lancet2020Flatten" /><ref name="Wiles"/>

According to the WHO, the use of masks is recommended only if a person is coughing or sneezing or when one is taking care of someone with a suspected infection.<ref>{{cite web|url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks|title=When and how to use masks|website=[[World Health Organization]] (WHO)|access-date=8 March 2020|name-list-format=vanc|archive-url=https://web.archive.org/web/20200307013848/https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks|archive-date=7 March 2020|url-status=live}}</ref> For the [[European Centre for Disease Prevention and Control]] (ECDC) face masks "...{{nbsp}}could be considered especially when visiting busy closed spaces{{nbsp}}..." but "...{{nbsp}}only as a complementary measure{{nbsp}}..."<ref>{{cite web|url=https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-use-face-masks-community.pdf|title=Using face masks in the community—Technical Report|last=Staff|date=2020-04-08|website=ECDC|url-status=live|archive-url=|archive-date=|access-date=}}</ref> Several countries have [[Face masks during the 2019–20 coronavirus pandemic|recommended that healthy individuals wear face masks or cloth face coverings]] (like scarves or bandanas) at least in certain public settings, including China,<ref name="nhc_masks">{{cite web |url=http://en.nhc.gov.cn/2020-02/07/c_76337.htm |title=For different groups of people: how to choose masks |work=NHC.gov.cn |publisher=National Health Commission of the People's Republic of China |date=7 February 2020 |access-date=22 March 2020 |archive-url= |archive-date= |quote="Disposable medical masks: Recommended for: · People in crowded places · Indoor working environment with a relatively dense population · People going to medical institutions · Children in kindergarten and students at school gathering to study and do other activities" }}{{Dead link|date=April 2020 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> [[Hong Kong]],<ref>{{cite web |url=https://www.chp.gov.hk/files/pdf/prevention_of_covid_19_en.pdf |title=Prevention of Coronavirus Disease 2019 (COVID-19) |website=[[Centre for Health Protection]] |access-date=22 March 2020 |quote="Wear a surgical mask when taking public transport or staying in crowded places." |archive-url=https://web.archive.org/web/20200321175110/https://www.chp.gov.hk/files/pdf/prevention_of_covid_19_en.pdf |archive-date=21 March 2020 |url-status=dead |archivedate=21 មីនា 2020 |archiveurl=https://web.archive.org/web/20200321175110/https://www.chp.gov.hk/files/pdf/prevention_of_covid_19_en.pdf }}</ref> Spain,<ref>{{cite web|url=https://gazettelife.com/news/spain-officially-recommends-face-mask-use/|title=Spain officially recommends face mask use|last=Staff|date=2020-04-11|website=Gazette Life|url-status=live|archive-url=|archive-date=|access-date=2020-04-20}}</ref> Italy (Lombardy region),<ref>{{cite news|last=Giuffrida|first=Angela|url=https://www.theguardian.com/world/2020/apr/05/lombardy-insists-on-face-masks-outside-homes-to-stop-covid-19|title=Lombardy insists on face masks outside homes to stop Covid-19|date=2020-04-05|work=The Guardian|access-date=2020-04-20|url-status=live|last2=Beaumont|first2=Peter|issn=0261-3077}}</ref> Russia,<ref>{{cite news|url=https://tass.com/society/1152425|date=2020-05-01|title=Russian sanitary watchdog chief supports regions binding people to wear face masks|work=[[Tass]]|access-date=2020-05-03|url-status=live}}</ref> and the United States.<ref name="cdc-cover"/>
 
Those diagnosed with COVID‑19 or who believe they may be infected are advised by the CDC to stay home except to get medical care, call ahead before visiting a healthcare provider, wear a face mask before entering the healthcare provider's office and when in any room or vehicle with another person, cover coughs and sneezes with a tissue, regularly wash hands with soap and water and avoid sharing personal household items.<ref name="CDC2020IfSick" /><ref>{{cite web | url = https://www.cdc.gov/coronavirus/2019-ncov/about/prevention.html | title = Coronavirus Disease 2019 (COVID-19)—Prevention & Treatment | date = 10 March 2020 | work = Centers for Disease Control and Prevention | publisher = U.S. Department of Health & Human Services | access-date = 11 March 2020 | archive-url = https://web.archive.org/web/20200311163637/https://www.cdc.gov/coronavirus/2019-ncov/about/prevention.html | archive-date = 11 March 2020 | url-status = live }}</ref> The CDC also recommends that individuals wash hands often with soap and water for at least 20 seconds, especially after going to the toilet or when hands are visibly dirty, before eating and after blowing one's nose, coughing or sneezing. It further recommends using an alcohol-based [[hand sanitiser]] with at least 60% alcohol, but only when soap and water are not readily available.<ref name="CDC-Prevention & Treatment" />

For areas where commercial hand sanitisers are not readily available, the WHO provides two formulations for local production. In these formulations, the antimicrobial activity arises from [[ethanol]] or [[isopropanol]]. [[Hydrogen peroxide]] is used to help eliminate [[bacterial spores]] in the alcohol; it is "not an active substance for hand [[antisepsis]]". [[Glycerol]] is added as a [[humectant]].<ref>{{cite book | chapter-url = https://www.ncbi.nlm.nih.gov/books/NBK144054/ | chapter = WHO-recommended handrub formulations | title = WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. |date=19 March 2009 |publisher=World Health Organization|access-date=19 March 2020 }}</ref>

<gallery mode="nolines" widths="360px" heights="200px">
File:COVID19 W ENG.ogv|[[Handwashing]] instructions
File:Covid-19-Transmission-graphic-01.gif|Prevention efforts are multiplicative, with effects far beyond that of a single spread. Each avoided case leads to more avoided cases down the line, which in turn can stop the outbreak in its tracks.
</gallery>

==ការគ្រប់គ្រង==

People are managed with [[supportive care]], which may include [[Fluid replacement|fluid therapy]], [[oxygen support]], and supporting other affected vital organs.<ref name="NatureDale Fisher & David Heymann">{{cite journal | vauthors=Fisher D, Heymann D |title = Q&A: The novel coronavirus outbreak causing COVID-19 |journal=BMC Medicine |volume=18 |issue=1 |page=57 |doi=10.1186/s12916-020-01533-w |doi-access=free |pmid=32106852 |pmc=7047369 | date=February 2020 }}</ref><ref name="KuiFang2020">{{cite journal | vauthors = Kui L, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, Xiao W, Wang YN, Zhong MH, Li CH, Li GC, Liu HG | display-authors = 6 | title = Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province | journal = Chinese Medical Journal | date = February 2020 | volume = 133 | issue = 9 | pages = 1025–1031 | pmid = 32044814 |doi=10.1097/CM9.0000000000000744 | pmc = 7147277 |doi-access=free }}</ref><ref name="Wang Du Zhu Cao 2020 p.">{{cite journal | vauthors = Wang T, Du Z, Zhu F, Cao Z, An Y, Gao Y, Jiang B | title = Comorbidities and multi-organ injuries in the treatment of COVID-19 | journal = Lancet | date = March 2020 | volume = 395 | issue = 10228 | pages = e52 | pmid = 32171074 | doi = 10.1016/s0140-6736(20)30558-4 | publisher = Elsevier BV | doi-access = free }}</ref> The CDC recommends that those who suspect they carry the virus wear a simple face mask.<ref name=CDC2020IfSick/> [[Extracorporeal membrane oxygenation]] (ECMO) has been used to address the issue of respiratory failure, but its benefits are still under consideration.<ref name="Guan Ni Hu Liang p." /><ref name="Henry 2020 p.">{{cite journal | last=Henry | first=Brandon Michael | name-list-format = vanc | title=COVID-19, ECMO, and lymphopenia: a word of caution | journal=The Lancet Respiratory Medicine | publisher=Elsevier BV | date=2020 | volume=8 | issue=4 | pages=e24 | issn=2213-2600 | doi=10.1016/s2213-2600(20)30119-3 | pmid=32178774 | pmc=7118650 }}</ref> Personal hygiene and a healthy lifestyle and [[Healthy diet|diet]] have been recommended to improve immunity.<ref>{{cite journal |last1=Wang |first1=Li-sheng |last2=Wang |first2=Yi-ru |last3=Ye |first3=Da-wei |last4=Liu |first4=Qing-quan |title=A review of the 2019 novel coronavirus (COVID-19) based on current evidence |journal=International Journal of Antimicrobial Agents |date=19 March 2020 |page=105948 |doi=10.1016/j.ijantimicag.2020.105948 |pmid=32201353 |url=https://www.sciencedirect.com/science/article/pii/S0924857920300984 |access-date=27 March 2020 |issn=0924-8579 |archive-url=https://web.archive.org/web/20200327232545/https://www.sciencedirect.com/science/article/pii/S0924857920300984 |archive-date=27 March 2020 |url-status=live |pmc=7156162 }}</ref> Supportive treatments may be useful in those with mild symptoms at the early stage of infection.<ref>{{cite journal |last1=Wang |first1=Yixuan |last2=Wang |first2=Yuyi |last3=Chen |first3=Yan |last4=Qin |first4=Qingsong |title=Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures |journal=Journal of Medical Virology |year=2020 |volume=n/a |issue=n/a |pages=568–576 |doi=10.1002/jmv.25748 |pmid=32134116 |issn=1096-9071|doi-access=free }}</ref>

The WHO, the [[National Health Commission|Chinese National Health Commission]], and the United States' [[National Institutes of Health]] have published recommendations for taking care of people who are hospitalised with COVID‑19.<ref name="NIHGuidelines2020">{{cite web |title=COVID-19 Treatment Guidelines |url=https://covid19treatmentguidelines.nih.gov/introduction/ |website=www.nih.gov |publisher=National Institutes of Health |accessdate=21 April 2020 |archivedate=11 តុលា 2020 |archiveurl=https://web.archive.org/web/20201011115737/https://www.covid19treatmentguidelines.nih.gov/introduction// |url-status=dead }}</ref><ref name="Cheng2020">{{cite journal | vauthors = Cheng ZJ, Shan J | title = 2019 Novel coronavirus: where we are and what we know | journal = Infection | date = February 2020 | volume = 48 | issue = 2 | pages = 155–163 | pmid = 32072569 |doi=10.1007/s15010-020-01401-y | pmc = 7095345 |doi-access=free }}</ref><ref>{{cite web|url=https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected|title=Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected|website=[[World Health Organization]] (WHO)|access-date=13 February 2020|archive-url=https://web.archive.org/web/20200131032122/https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected|archive-date=31 January 2020|url-status=live }}</ref> [[Critical care medicine|Intensivists]] and [[Pulmonology|pulmonologists]] in the U.S. have compiled treatment recommendations from various agencies into a free resource, the [[EMCrit|IBCC]].<ref name="IBCC">{{cite book |last=Farkas |first=Josh | name-list-format = vanc |date=March 2020 |title=COVID-19—The Internet Book of Critical Care |url=https://emcrit.org/ibcc/covid19/ |url-status=live |format=digital |type=Reference manual |location=USA |publisher=EMCrit |archive-url=https://web.archive.org/web/20200311195758/https://emcrit.org/ibcc/covid19/ |archive-date=11 March 2020 |access-date=13 March 2020}}</ref><ref name="UPenn-IBCC">{{cite web |url=https://guides.library.upenn.edu/covid-19 |title=COVID19—Resources for Health Care Professionals |publisher=[[Penn Libraries]] |date=11 March 2020 |access-date=13 March 2020 |archive-url=https://web.archive.org/web/20200314035631/https://guides.library.upenn.edu/covid-19 |archive-date=14 March 2020 |url-status=dead |archivedate=14 មីនា 2020 |archiveurl=https://web.archive.org/web/20200314035631/https://guides.library.upenn.edu/covid-19 }}</ref>

===Medications===

{{See also|Coronavirus disease 2019#Research}}

Per the World Health Organization, as of April 2020, there is no specific treatment for COVID‑19.<ref name=WHO2020QA/> On May 1, 2020, the United States gave [[Emergency Use Authorization]] (not full approval) for [[remdesivir]] in people hospitalized with severe COVID-19 after a study suggested it reduced the duration of recovery.<ref name=fda20200501>{{cite press release | title=Coronavirus (COVID-19) Update: FDA Issues Emergency Use Authorization for Potential COVID-19 Treatment | website=U.S. [[Food and Drug Administration]] (FDA) | date=1 May 2020 | url=https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-emergency-use-authorization-potential-covid-19-treatment | access-date=1 May 2020}}</ref><ref name="EUA FAQ">{{cite web | title = Frequently Asked Questions on the Emergency Use Authorization for Remdesivir for Certain Hospitalized COVID‐19 Patients | url=https://www.fda.gov/media/137574/download | format=PDF | publisher = U.S. [[Food and Drug Administration]] (FDA) | date = 1 May 2020 | access-date = 1 May 2020 }} {{PD-notice}}</ref> Researchers continue working on more effective treatments and many vaccine candidates are in development or testing phases.

For symptoms, some medical professionals recommend [[paracetamol]] (acetaminophen) over [[ibuprofen]] for first-line use.<ref name="Day 2020 p.">{{cite journal | title = Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists | journal = BMJ | volume = 368 | date = 17 March 2020 | pmid = 32184201 | doi = 10.1136/bmj.m1086 | issn=1756-1833 | url = https://www.bmj.com/content/368/bmj.m1086 | access-date = 18 March 2020 | last = Day | first = Michael | pages = m1086 | archive-url = https://web.archive.org/web/20200319181945/https://www.bmj.com/content/368/bmj.m1086 | archive-date = 19 March 2020 | url-status = live | doi-access = free }}</ref><ref>{{cite web|url=https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/|title=Self-isolation advice—Coronavirus (COVID-19)|date=2020-02-28|website=National Health Service (United Kingdom)|access-date=2020-03-27|archive-url=https://web.archive.org/web/20200328000128/https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/|archive-date=28 March 2020|url-status=live}}</ref><ref>{{cite web |last = Godoy |first = Maria |date = 18 March 2020 |url = https://www.npr.org/sections/health-shots/2020/03/18/818026613/advice-from-france-to-avoid-ibuprofen-for-covid-19-leaves-experts-baffled |title = Concerned About Taking Ibuprofen For Coronavirus Symptoms? Here's What Experts Say |website = [[NPR]] |access-date = 8 April 2020}}</ref> The WHO and NIH do not oppose the use of [[non-steroidal anti-inflammatory drugs]] (NSAIDs) such as ibuprofen for symptoms,<ref name="NIHGuidelines2020"/><ref name="AFP 2020b">{{cite web|url=https://www.sciencealert.com/who-recommends-to-avoid-taking-ibuprofen-for-covid-19-symptoms|title=Updated: WHO Now Doesn't Recommend Avoiding Ibuprofen For COVID-19 Symptoms|author=AFP|date=19 March 2020|website=ScienceAlert|access-date=19 March 2020|archive-url=https://web.archive.org/web/20200318222020/https://www.sciencealert.com/who-recommends-to-avoid-taking-ibuprofen-for-covid-19-symptoms|archive-date=18 March 2020|url-status=live}}</ref> and the [[Food and Drug Administration|FDA]] says currently there is no evidence that NSAIDs worsen COVID‑19 symptoms.<ref>{{cite journal|last=Research|first=Center for Drug Evaluation and|date=2020-03-19|title=FDA advises patients on use of non-steroidal anti-inflammatory drugs (NSAIDs) for COVID-19|url=https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-patients-use-non-steroidal-anti-inflammatory-drugs-nsaids-covid-19|journal=Drug Safety and Availability|access-date=27 March 2020|archive-url=https://web.archive.org/web/20200327194633/https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-patients-use-non-steroidal-anti-inflammatory-drugs-nsaids-covid-19|archive-date=27 March 2020|url-status=live}}</ref>

While theoretical concerns have been raised about [[ACE inhibitors]] and [[angiotensin receptor blocker]]s, as of 19 March 2020, these are not sufficient to justify stopping these medications.<ref name="NIHGuidelines2020"/><ref>{{cite web |title=Patients taking ACE-i and ARBs who contract COVID-19 should continue treatment, unless otherwise advised by their physician |url=https://www.hfsa.org/patients-taking-ace-i-and-arbs-who-contract-covid-19-should-continue-treatment-unless-otherwise-advised-by-their-physician/ |access-date=21 March 2020 |archive-url=https://web.archive.org/web/20200321172112/https://www.hfsa.org/patients-taking-ace-i-and-arbs-who-contract-covid-19-should-continue-treatment-unless-otherwise-advised-by-their-physician/ |archive-date=21 March 2020 |url-status=dead |archivedate=21 មីនា 2020 |archiveurl=https://web.archive.org/web/20200321172112/https://www.hfsa.org/patients-taking-ace-i-and-arbs-who-contract-covid-19-should-continue-treatment-unless-otherwise-advised-by-their-physician/ }}</ref><ref>{{cite press release | title=Patients taking ACE-i and ARBs who contract COVID-19 should continue treatment, unless otherwise advised by their physician | website=American Heart Association | date=17 March 2020 | url=https://newsroom.heart.org/news/patients-taking-ace-i-and-arbs-who-contract-covid-19-should-continue-treatment-unless-otherwise-advised-by-their-physician | access-date=25 March 2020 | archive-url=https://web.archive.org/web/20200324050912/https://newsroom.heart.org/news/patients-taking-ace-i-and-arbs-who-contract-covid-19-should-continue-treatment-unless-otherwise-advised-by-their-physician | archive-date=24 March 2020 | url-status=live }}</ref><ref name="ESCPositionStatement">{{cite web |last=de Simone |first=Giovanni |title=Position Statement of the ESC Council on Hypertension on ACE-Inhibitors and Angiotensin Receptor Blockers |url=https://www.escardio.org/Councils/Council-on-Hypertension-(CHT)/News/position-statement-of-the-esc-council-on-hypertension-on-ace-inhibitors-and-ang |website=Council on Hypertension of the European Society of Cardiology |access-date=24 March 2020 |archive-url=https://web.archive.org/web/20200324073257/https://www.escardio.org/Councils/Council-on-Hypertension-(CHT)/News/position-statement-of-the-esc-council-on-hypertension-on-ace-inhibitors-and-ang |archive-date=24 March 2020 |url-status=live }}</ref> One study from April 22 found that people with COVID-19 and hypertension had ''lower'' all-cause mortality when on these medications.<ref>{{cite web |title=New Evidence Concerning Safety of ACE Inhibitors, ARBs in COVID-19 |url=https://www.pharmacytimes.com/news/new-evidence-concerning-safety-of-ace-inhibitors-arbs-in-covid-19 |website=Pharmacy Times |accessdate=2 May 2020 |archivedate=11 តុលា 2020 |archiveurl=https://web.archive.org/web/20201011115808/https://www.pharmacytimes.com/news/new-evidence-concerning-safety-of-ace-inhibitors-arbs-in-covid-19/ |url-status=dead }}</ref>

[[Steroids]], such as [[methylprednisolone]], are not recommended unless the disease is complicated by [[acute respiratory distress syndrome]].<ref name="Vetter Eckerle Kaiser 2020 p.">{{cite journal | vauthors=Vetter P, Eckerle I, Kaiser L | title=Covid-19: a puzzle with many missing pieces | journal=BMJ | volume=368 | pages=m627 | date=February 2020 | pmid=32075791 | doi=10.1136/bmj.m627 |doi-access=free }}</ref><ref>{{cite web |title=Novel Coronavirus—COVID-19: What Emergency Clinicians Need to Know |url=https://www.ebmedicine.net/topics/infectious-disease/COVID-19 |website=www.ebmedicine.net |access-date=9 March 2020 |name-list-format=vanc |archive-url=https://web.archive.org/web/20200314163512/https://www.ebmedicine.net/topics/infectious-disease/COVID-19 |archive-date=14 March 2020 |url-status=live }}</ref>

The [[Australasian Society of Clinical Immunology and Allergy]] recommend that [[tocilizumab]] should be considered as an off-label treatment option for those with COVID-19 related [[acute respiratory distress syndrome]]. It recommends this because of its known benefit in cytokine storm caused by a [[CAR T-cell therapy|specific cancer treatment]], and that cytokine storm may be a significant contributor to mortality in severe COVID-19.<ref>{{cite web|title=ASCIA Position Statement: Specific Treatments for COVID-19|url=https://allergy.org.au/hp/papers/specific-treatments-for-covid-19|last=Grainger|first=Suzanne|website=Australasian Society of Clinical Immunology and Allergy (ASCIA)|language=en-gb|access-date=2020-05-02|archivedate=16 មិថុនា 2020|archiveurl=https://web.archive.org/web/20200616150611/https://allergy.org.au/hp/papers/specific-treatments-for-covid-19|url-status=dead}}</ref>

Medications to [[thrombosis prevention|prevent blood clotting]] have been suggested for treatment,<ref name=":4" /> and anticoagulant therapy with [[low molecular weight heparin]] appears to be associated with better outcomes in severe COVID‐19 showing signs of [[coagulopathy]] (elevated [[D-dimer]]).<ref>{{cite journal|last=Tang|first=Ning|last2=Bai|first2=Huan|last3=Chen|first3=Xing|last4=Gong|first4=Jiale|last5=Li|first5=Dengju|last6=Sun|first6=Ziyong|title=Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy|journal=Journal of Thrombosis and Haemostasis|year=2020|volume=n/a|issue=n/a|pages=1094–1099|doi=10.1111/jth.14817|pmid=32220112|issn=1538-7836|doi-access=free}}</ref>

===Protective equipment===

{{see also|COVID-19 related shortages}}
[[File:DonningCDC2020.jpg|thumb|The [[Centers for Disease Control and Prevention|CDC]] recommends four steps to putting on [[personal protective equipment]] (PPE).<ref>{{cite web |title=Sequence for Putting On Personal Protective Equipment (PPE) |url=https://www.cdc.gov/hai/pdfs/ppe/PPE-Sequence.pdf |website=CDC |access-date=8 March 2020 |archive-url=https://web.archive.org/web/20200305173617/https://www.cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf |archive-date=5 March 2020 |url-status=live }}</ref>]]

Precautions must be taken to minimise the risk of virus transmission, especially in healthcare settings when performing procedures that can generate [[aerosol]]s, such as [[intubation]] or [[bag valve mask|hand ventilation]].<ref name="Cheung Ho Cheng Cham 2020 p.">{{cite journal | vauthors=Cheung JC, Ho LT, Cheng JV, Cham EY, Lam KN | title=Staff safety during emergency airway management for COVID-19 in Hong Kong | journal=Lancet Respiratory Medicine | date=February 2020 | volume=8 | issue=4 | pages=e19 | doi=10.1016/s2213-2600(20)30084-9 | doi-access=free | pmid=32105633 | pmc=7128208 }}</ref> For healthcare professionals caring for people with COVID‑19, the CDC recommends placing the person in an Airborne Infection Isolation Room (AIIR) in addition to using [[standard precautions]], contact precautions, and airborne precautions.<ref>{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/caring-for-patients-H.pdf|title=What healthcare personnel should know about caring for patients with confirmed or possible coronavirus disease 2|last=|date=12 March 2020|website=CDC|url-status=live|archive-url=|archive-date=|access-date=31 March 2020}}</ref>

The CDC outlines the guidelines for the use of [[personal protective equipment]] (PPE) during the pandemic. The recommended gear is a [[PPE gown]], [[respirator]] or [[surgical mask|facemask]], [[eye protection]], and [[medical glove]]s.<ref>{{cite web |title=Coronavirus Disease 2019 (COVID-19) |url=https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html |website=Centers for Disease Control and Prevention |access-date=11 March 2020 |date=11 February 2020 |name-list-format=vanc |archive-url=https://web.archive.org/web/20200304165907/https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html |archive-date=4 March 2020 |url-status=live }}</ref><ref>{{cite web |title=Coronavirus Disease 2019 (COVID-19) |url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/caring-for-patients.html |website=Centers for Disease Control and Prevention |access-date=8 March 2020 |date=11 February 2020 |name-list-format=vanc |archive-url=https://web.archive.org/web/20200304165907/https://www.cdc.gov/coronavirus/2019-ncov/hcp/caring-for-patients.html |archive-date=4 March 2020 |url-status=live }}</ref>

When available, respirators (instead of facemasks) are preferred.<ref>{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html|title=Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings|author=CDC|date=11 February 2020|website=Centers for Disease Control and Prevention|url-status=live|archive-url=https://web.archive.org/web/20200304165907/https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html|archive-date=4 March 2020|access-date=25 March 2020}}</ref> N95 respirators are approved for industrial settings but the FDA has authorised the masks for use under an [[Emergency Use Authorisation]] (EUA). They are designed to protect from airborne particles like dust but effectiveness against a specific biological agent is not guaranteed for off-label uses.<ref>{{cite web|title=Coronavirus Disease 2019 (COVID-19) Frequently Asked Questions|url=https://www.fda.gov/emergency-preparedness-and-response/mcm-issues/coronavirus-disease-2019-covid-19-frehttps://oc.wikipedia.org/wiki/Malauti%C3%A1_de_coronavirus_de_2019quently-asked-questions#5e78ba94b86da|website=Food and Drug Administration}}</ref> When masks are not available, the CDC recommends using face shields or, as a last resort, [[Cloth facemask|homemade masks]].<ref>{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html|title=Strategies for Optimizing the Supply of Facemasks|date=11 February 2020|publisher=CDC|access-date=23 March 2020|archive-url=https://web.archive.org/web/20200323173927/https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html|archive-date=23 March 2020|url-status=live}}</ref>

===Mechanical ventilation===

Most cases of COVID‑19 are not severe enough to require [[mechanical ventilation]] or alternatives, but a percentage of cases are.<ref name="murthy">{{cite journal | vauthors = Murthy S, Gomersall CD, Fowler RA | title = Care for Critically Ill Patients With COVID-19 | journal = JAMA | date = 11 March 2020 | volume = 323 | issue = 15 | page = 1499 | pmid = 32159735 | doi = 10.1001/jama.2020.3633 | url = https://jamanetwork.com/journals/jama/fullarticle/2762996 | access-date = 18 March 2020 | archive-url = https://web.archive.org/web/20200318203852/https://jamanetwork.com/journals/jama/fullarticle/2762996 |archive-date=18 March 2020 |url-status=live| doi-access = free }}</ref><ref>{{cite web|author=World Health Organization|date=28 January 2020|title=Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected|url=https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf|journal=|volume=|pages=|access-date=18 March 2020|archive-url=https://web.archive.org/web/20200226041620/https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf|archive-date=26 February 2020|url-status=live}}</ref> The type of respiratory support for individuals with COVID‑19 related [[respiratory failure]] is being actively studied for people in the hospital, with some evidence that [[Tracheal intubation|intubation]] can be avoided with a [[Heated humidified high-flow therapy|high flow nasal cannula]] or [[Positive airway pressure|bi-level positive airway pressure]].<ref>{{cite journal |last1=Wang |first1=Ke |last2=Zhao |first2=Wei |last3=Li |first3=Ji |last4=Shu |first4=Weiwei |last5=Duan |first5=Jun |title=The experience of high-flow nasal cannula in hospitalized patients with 2019 novel coronavirus-infected pneumonia in two hospitals of Chongqing, China |journal=Annals of Intensive Care |date=30 March 2020 |volume=10 |issue=1 |page=37 |doi=10.1186/s13613-020-00653-z|pmid=32232685 |pmc=7104710 }}</ref> Whether either of these two leads to the same benefit for people who are critically ill is not known.<ref>{{cite journal |last1=McEnery |first1=Tom |last2=Gough |first2=Ciara |last3=Costello |first3=Richard W |title=COVID-19: Respiratory support outside the intensive care unit |journal=The Lancet Respiratory Medicine |date=April 2020 |doi=10.1016/S2213-2600(20)30176-4|pmid=32278367 |pmc=7146718 }}</ref> Some doctors prefer staying with invasive mechanical ventilation when available because this technique limits the spread of [[Airborne disease|aerosol]] particles compared to a high flow nasal cannula.<ref name="murthy"/>

Severe cases are most common in older adults (those older than 60 years,<ref name="murthy"/> and especially those older than 80 years).<ref>{{cite document |last1=Ferguson |first1=N. |last2=Laydon |first2=D.|last3=Nedjati Gilani |first3=G. |last4=Imai |first4=N. |last5=Ainslie |first5=K. |last6=Baguelin |first6=M. |last7=Bhatia |first7=S. |last8=Boonyasiri|first8=A.|last9=Cucunuba Perez|first9=Zulma|last10=Cuomo-Dannenburg |first10=G. |last11=Dighe |first11=A. |date=16 March 2020 |title=Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand|publisher=[[Imperial College London]] |url=https://spiral.imperial.ac.uk/handle/10044/1/77482|doi=10.25561/77482|hdl=20.1000/100|doi-access=free|at=Table 1|journal=|access-date=25 March 2020|archive-url=https://web.archive.org/web/20200321133445/https://spiral.imperial.ac.uk/handle/10044/1/77482|archive-date=21 March 2020|url-status=live}}</ref> Many developed countries do not have enough [[List of countries by hospital beds|hospital beds per capita]], which limits a [[health system]]'s capacity to handle a sudden spike in the number of COVID‑19 cases severe enough to require hospitalisation.<ref name="VoxCOVID">{{cite news |last=Scott |first=Dylan |title=Coronavirus is exposing all of the weaknesses in the US health system High health care costs and low medical capacity made the US uniquely vulnerable to the coronavirus. |url=https://www.vox.com/policy-and-politics/2020/3/16/21173766/coronavirus-covid-19-us-cases-health-care-system |access-date=18 March 2020 |publisher=Vox |date=16 March 2020 |archive-url=https://web.archive.org/web/20200318022237/https://www.vox.com/policy-and-politics/2020/3/16/21173766/coronavirus-covid-19-us-cases-health-care-system |archive-date=18 March 2020 |url-status=live}}</ref> This limited capacity is a significant driver behind calls to flatten the curve.<ref name="VoxCOVID"/> One study in China found 5% were admitted to [[intensive care unit]]s, 2.3% needed mechanical support of ventilation, and 1.4% died.<ref name="Guan Ni Hu Liang p.">{{cite journal | vauthors = Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DS, Du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS | display-authors = 6 | title = Clinical Characteristics of Coronavirus Disease 2019 in China | journal = The New England Journal of Medicine | date = February 2020 | volume = 382 | issue = 18 | pages = 1708–1720 | pmid = 32109013 | doi = 10.1056/nejmoa2002032 | publisher = Massachusetts Medical Society | pmc = 7092819 | doi-access = free }}</ref> In China, approximately 30% of people in hospital with COVID‑19 are eventually admitted to ICU.<ref name="CDC Interim Guidance">{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html|title=Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19) |last=|date=2020-04-06|website=Centers for Disease Control and Prevention|access-date=2020-04-19|archive-url=https://web.archive.org/web/20200302201644/https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html|archive-date=2 March 2020|url-status=live}}</ref>

===Acute respiratory distress syndrome===

{{main|Acute respiratory distress syndrome}}

[[Mechanical ventilation]] becomes more complex as [[acute respiratory distress syndrome]] (ARDS) develops in COVID‑19 and oxygenation becomes increasingly difficult.<ref name="LancetRespMar2020" /> Ventilators capable of [[Modes of mechanical ventilation|pressure control modes]] and high [[PEEP]]<ref>{{cite journal |last1=Briel |first1=Matthias |last2=Meade |first2=Maureen |last3=Mercat |first3=Alain |last4=Brower |first4=Roy G. |last5=Talmor |first5=Daniel |last6=Walter |first6=Stephen D. |last7=Slutsky |first7=Arthur S. |last8=Pullenayegum |first8=Eleanor |last9=Zhou |first9=Qi |last10=Cook |first10=Deborah |last11=Brochard |first11=Laurent |last12=Richard |first12=Jean-Christophe M. |last13=Lamontagne |first13=François |last14=Bhatnagar |first14=Neera |last15=Stewart |first15=Thomas E. |last16=Guyatt |first16=Gordon |title=Higher vs Lower Positive End-Expiratory Pressure in Patients With Acute Lung Injury and Acute Respiratory Distress Syndrome |journal=JAMA |date=3 March 2010 |volume=303 |issue=9 |pages=865–73 |doi=10.1001/jama.2010.218|pmid=20197533 |doi-access=free }}</ref> are needed to maximise oxygen delivery while minimising the risk of [[ventilator-associated lung injury]] and [[pneumothorax]].<ref name="barotrauma">{{cite book |last1=Diaz |first1=Raiko |last2=Heller |first2=Daniel |title=Barotrauma And Mechanical Ventilation |url=https://www.ncbi.nlm.nih.gov/books/NBK545226/ |website=StatPearls |publisher=StatPearls Publishing |date=2020|pmid=31424810 }}</ref> High PEEP may not be available on older ventilators.{{citation needed|date=May 2020}}

{| class="wikitable" style="text-align:center; margin-right:1em;"
|+ style="background:#E5AFAA;" |Options for ARDS<ref name="LancetRespMar2020">{{cite journal |last1=Matthay |first1=Michael A. |last2=Aldrich |first2=J. Matthew |last3=Gotts |first3=Jeffrey E. |title=Treatment for severe acute respiratory distress syndrome from COVID-19 |journal=The Lancet Respiratory Medicine |date=March 2020 |volume=8 |issue=5 |pages=433–434 |doi=10.1016/S2213-2600(20)30127-2|pmid=32203709 |pmc=7118607 }}</ref>
|- style="background: #E5AFAA;text-align:center;"
! Therapy
! Recommendations
|-
| [[Nasal cannula|High-flow nasal oxygen]]
| For [[oxygen saturation|SpO<sub>2</sub>]] <93%. May prevent the need for intubation and ventilation
|-
| [[Tidal volume]]
| 6mL per kg and can be reduced to 4mL/kg
|-
| [[Plateau pressure|Plateau airway pressure]]
| Keep below 30 [[Centimetre of water|cmH<sub>2</sub>O]] if possible (high [[respiratory rate]] (35 per minute) may be required)
|-
| [[Positive end-expiratory pressure]]
| Moderate to high levels
|-
| [[Prone positioning]]
| For worsening oxygenation
|-
| [[Fluid replacement|Fluid management]]
| Goal is a negative balance of 0.5–1.0[[liter|L]] per day
|-
| [[Antibiotics]]
| For secondary bacterial infections
|-
| [[Glucocorticoids]]
| Not recommended
|}

===Experimental treatment===

{{see also|Coronavirus disease 2019#Research|label 1=§ Research}}

Research into potential treatments started in January 2020,<ref>{{cite news|url=https://www.reuters.com/article/us-china-health-hospital-idUSKBN20B1M6|title=Chinese doctors using plasma therapy on coronavirus, WHO says 'very valid' approach|newspaper=Reuters|date=17 February 2020|access-date=19 March 2020|archive-url=https://web.archive.org/web/20200304173709/https://www.reuters.com/article/us-china-health-hospital-idUSKBN20B1M6|archive-date=4 March 2020|url-status=live}}</ref> and several [[antiviral drug]]s are in clinical trials.<ref name="Reut_NIH_Moderna_3months">{{cite news | last1= Steenhuysen | first1= Julie | last2= Kelland | first2= Kate | name-list-format = vanc | title= With Wuhan virus genetic code in hand, scientists begin work on a vaccine | date= 24 January 2020 | agency= [[Reuters]] | url= https://www.reuters.com/article/us-china-health-vaccines-idUSKBN1ZN2J8 |access-date=25 January 2020 |archive-url= https://web.archive.org/web/20200125203723/https://www.reuters.com/article/us-china-health-vaccines-idUSKBN1ZN2J8 |archive-date= 25 January 2020 |url-status=live }}</ref><ref name="clinicaltrialsarena">{{cite web|url=https://www.clinicaltrialsarena.com/analysis/coronavirus-mers-cov-drugs/|title=Coronavirus outbreak: Vaccines/drugs in the pipeline for Covid-19|last=Duddu|first=Praveen|date=19 February 2020|work=clinicaltrialsarena.com|archive-url=https://web.archive.org/web/20200219184512/https://www.clinicaltrialsarena.com/analysis/coronavirus-mers-cov-drugs/|archive-date=19 February 2020|name-list-format=vanc|access-date=7 ឧសភា 2020|archivedate=19 កុម្ភៈ 2020|archiveurl=https://web.archive.org/web/20200219184512/https://www.clinicaltrialsarena.com/analysis/coronavirus-mers-cov-drugs/|url-status=dead}}</ref> [[Remdesivir]] appears to be the most promising.<ref name="Sanders2020"/> Although new medications may take until 2021 to develop,<ref>{{cite journal|vauthors=Lu H|date=28 January 2020|title=Drug treatment options for the 2019-new coronavirus (2019-nCoV).|journal=Biosci Trends|volume=14|issue=1|pages=69–71|doi=10.5582/bst.2020.01020|pmid=31996494|doi-access=free}}</ref> several of the medications being tested are already approved for other uses or are already in advanced testing.<ref name="LiDeClerq" /> Antiviral medication may be tried in people with severe disease.<ref name="NatureDale Fisher & David Heymann" /> The WHO recommended volunteers take part in trials of the effectiveness and safety of potential treatments.<ref name="ThomReut_notreatment_20200205">{{cite news|last1=Nebehay|first1=Stephanie|url=https://www.reuters.com/article/us-china-health-treatments-who-idUSKBN1ZZ1M6|title=WHO: 'no known effective' treatments for new coronavirus|date=5 February 2020|access-date=5 February 2020|url-status=live |archive-url=https://web.archive.org/web/20200205155653/https://www.reuters.com/article/us-china-health-treatments-who-idUSKBN1ZZ1M6|archive-date=5 February 2020|agency=[[Thomson Reuters]]|last2=Kelland|first2=Kate|last3=Liu|first3=Roxanne|name-list-format=vanc}}</ref>

The FDA has granted temporary authorisation to [[convalescent plasma]] as an experimental treatment in cases where the person's life is seriously or immediately threatened. It has not undergone the clinical studies needed to show it is safe and effective for the disease.<ref>{{cite web|url=https://www.technologyreview.com/2020/04/08/998700/blood-plasma-taken-from-covid-19-survivors-might-help-patients-fight-it-off/|title=Blood plasma taken from covid-19 survivors might help patients fight off the disease|website=MIT Technology Review}}</ref><ref>{{cite journal|url=https://www.wired.com/story/trials-of-plasma-from-recovered-covid-19-patients-have-begun/|title=Trials of Plasma From Recovered Covid-19 Patients Have Begun|journal=[[Wired (magazine)|Wired]]}}</ref><ref>{{cite web|url=https://social.techcrunch.com/2020/03/24/fda-now-allows-treatment-of-life-threatening-covid-19-cases-using-blood-from-patients-who-have-recovered/|title=FDA now allows treatment of life-threatening COVID-19 cases using blood from patients who have recovered|website=TechCrunch|access-date=2020-04-09|archivedate=11 តុលា 2020|archiveurl=https://web.archive.org/web/20201011115831/https://techcrunch.com/2020/03/24/fda-now-allows-treatment-of-life-threatening-covid-19-cases-using-blood-from-patients-who-have-recovered//|url-status=dead}}</ref>

===បច្ចេកវិទ្យាព័ត៌មាន===

{{see also|Contact tracing|Government by algorithm}}

In February 2020, China launched a [[mobile app]] to deal with the disease outbreak.<ref>{{cite news |title=China launches coronavirus 'close contact' app |url=https://www.bbc.com/news/technology-51439401 |access-date=7 March 2020 |work=BBC News |date=11 February 2020 |name-list-format=vanc |archive-url=https://web.archive.org/web/20200228003957/https://www.bbc.com/news/technology-51439401 |archive-date=28 February 2020 |url-status=live }}</ref> Users are asked to enter their name and ID number. The app can detect 'close contact' using surveillance data and therefore a potential risk of infection. Every user can also check the status of three other users. If a potential risk is detected, the app not only recommends self-quarantine, it also alerts local health officials.<ref>{{cite web |last1=Chen |first1=Angela | name-list-format = vanc |title=China's coronavirus app could have unintended consequences |url=https://www.technologyreview.com/s/615199/coronavirus-china-app-close-contact-surveillance-covid-19-technology/ |website=MIT Technology Review |access-date=7 March 2020 }}</ref>

[[Big data]] analytics on cellphone data, [[Facial recognition system|facial recognition]] technology, [[mobile phone tracking]], and [[artificial intelligence]] are used to track infected people and people whom they contacted in South Korea, Taiwan, and Singapore.<ref>{{cite news |title=Gov in the Time of Corona |url=https://govinsider.asia/innovation/gov-in-the-time-of-corona/ |access-date=20 March 2020 |work=GovInsider |date=19 March 2020 |archive-url=https://web.archive.org/web/20200320125215/https://govinsider.asia/innovation/gov-in-the-time-of-corona/ |archive-date=20 March 2020 |url-status=live }}</ref><ref>{{cite news |last=Manancourt |first=Vincent |title=Coronavirus tests Europe's resolve on privacy |url=https://www.politico.eu/article/coronavirus-tests-europe-resolve-on-privacy-tracking-apps-germany-italy/ |access-date=20 March 2020 |work=POLITICO |date=10 March 2020 |archive-url=https://web.archive.org/web/20200320105744/https://www.politico.eu/article/coronavirus-tests-europe-resolve-on-privacy-tracking-apps-germany-italy/ |archive-date=20 March 2020 |url-status=live }}</ref> In March 2020, the Israeli government enabled security agencies to track mobile phone data of people supposed to have coronavirus. The measure was taken to enforce quarantine and protect those who may come into contact with infected citizens.<ref>{{cite news|last=Tidy|first=Joe|url=https://www.bbc.com/news/technology-51930681|title=Coronavirus: Israel enables emergency spy powers|date=17 March 2020|work=BBC News|access-date=18 March 2020|archive-url=https://web.archive.org/web/20200318113608/https://www.bbc.com/news/technology-51930681|archive-date=18 March 2020|url-status=live}}</ref> Also in March 2020, [[Deutsche Telekom]] shared aggregated phone location data with the German federal government agency, [[Robert Koch Institute]], to research and prevent the spread of the virus.<ref name="heise-handydaten">{{cite news |last=Bünte |first=Oliver |title=Corona-Krise: Deutsche Telekom liefert anonymisierte Handydaten an RKI |url=https://www.heise.de/newsticker/meldung/Corona-Krise-Deutsche-Telekom-liefert-anonymisierte-Handydaten-an-RKI-4685191.html |access-date=25 March 2020 |work=Heise Online |date=18 March 2020 |language=German |trans-title=Corona crisis: Deutsche Telekom delivers anonymized cell phone data to RKI |archive-url=https://web.archive.org/web/20200324115410/https://www.heise.de/newsticker/meldung/Corona-Krise-Deutsche-Telekom-liefert-anonymisierte-Handydaten-an-RKI-4685191.html |archive-date=24 March 2020 |url-status=live }}</ref> Russia deployed facial recognition technology to detect quarantine breakers.<ref>{{cite news |title=Moscow deploys facial recognition technology for coronavirus quarantine |url=https://www.reuters.com/article/us-china-health-moscow-technology-idUSKBN20F1RZ |access-date=20 March 2020 |work=Reuters |date=21 February 2020 |archive-url=https://web.archive.org/web/20200222215731/https://www.reuters.com/article/us-china-health-moscow-technology-idUSKBN20F1RZ |archive-date=22 February 2020 |url-status=live }}</ref> Italian regional health commissioner [[Giulio Gallera]] said he has been informed by mobile phone operators that "40% of people are continuing to move around anyway".<ref>{{cite news |title=Italians scolded for flouting lockdown as death toll nears 3,000 |url=https://www.post-gazette.com/news/world/2020/03/18/Italy-coronavirus-475-deaths-one-day-death-toll-2978-COVID-19-doctors/stories/202003180182 |access-date=20 March 2020 |work=Pittsburgh Post-Gazette |archive-url=https://web.archive.org/web/20200320110555/https://www.post-gazette.com/news/world/2020/03/18/Italy-coronavirus-475-deaths-one-day-death-toll-2978-COVID-19-doctors/stories/202003180182 |archive-date=20 March 2020 |url-status=live }}</ref> German government conducted a 48 hours weekend [[hackathon]] with more than 42.000 participants.<ref>{{cite web |title=Kreative Lösungen gesucht |url=https://www.bundesregierung.de/breg-de/themen/coronavirus/wir-vs-virus-1731968 |website=Startseite |language=de |access-date=23 March 2020 |archive-url=https://web.archive.org/web/20200324085627/https://www.bundesregierung.de/breg-de/themen/coronavirus/wir-vs-virus-1731968 |archive-date=24 March 2020 |url-status=dead |archivedate=24 មីនា 2020 |archiveurl=https://web.archive.org/web/20200324085627/https://www.bundesregierung.de/breg-de/themen/coronavirus/wir-vs-virus-1731968 }}</ref><ref>{{cite news |last1=Dannewitz |first1=Juliane |title=Hackathon Germany: #WirvsVirus |url=https://www.datenschutzbeauftragter-info.de/hackathon-germany-wirvsvirus/ |work=Datenschutzbeauftragter |date=23 March 2020 |language=de-DE}}</ref> Two million people in the UK used an app developed in March 2020 by [[King's College London]] and Zoe to track people with COVID‑19 symptoms.<ref>{{cite web|url=https://www.kcl.ac.uk/news/lockdown-is-working-suggests-latest-data-from-symptom-tracker-app|title=Lockdown is working, suggests latest data from symptom tracker app|last=Staff|date=2020-04-08|website=Kings College London News Centre|url-status=live|archive-url=|archive-date=|access-date=2020-04-20}}</ref> Also, the president of Estonia, [[Kersti Kaljulaid]], made a global call for creative solutions against the spread of coronavirus.<ref>{{cite news |first=Andrew |last=Whyte |title=President makes global call to combat coronavirus via hackathon |url=https://news.err.ee/1067171/president-makes-global-call-to-combat-coronavirus-via-hackathon |work=ERR |date=21 March 2020 |access-date=23 March 2020 |archive-url=https://web.archive.org/web/20200324050421/https://news.err.ee/1067171/president-makes-global-call-to-combat-coronavirus-via-hackathon |archive-date=24 March 2020 |url-status=live }}</ref>

===Psychological support===

{{see also|Mental health during the 2019–20 coronavirus pandemic}}

Individuals may experience distress from quarantine, travel restrictions, side effects of treatment, or fear of the infection itself. To address these concerns, the [[National Health Commission|National Health Commission of China]] published a national guideline for psychological crisis intervention on 27 January 2020.<ref name="Xiang4Feb2020">{{cite journal | vauthors = Xiang YT, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, Ng CH | display-authors = 6 | title = Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed | journal = The Lancet. Psychiatry | volume = 7 | issue = 3 | pages = 228–29 | date = March 2020 | pmid = 32032543 |doi=10.1016/S2215-0366(20)30046-8 | pmc = 7128153 |doi-access=free }}</ref><ref name="Kang5Feb2020">{{cite journal | vauthors = Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, Wang Y, Hu J, Lai J, Ma X, Chen J, Guan L, Wang G, Ma H, Liu Z | display-authors = 6 | title = The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus | journal = The Lancet. Psychiatry | volume = 7 | issue = 3 | pages = e14 | date = March 2020 | pmid = 32035030 |doi=10.1016/S2215-0366(20)30047-X | pmc = 7129673 |doi-access=free }}</ref>

''The Lancet'' published a 14-page call for action focusing on the UK and stated conditions were such that a range of mental health issues was likely to become more common. BBC quoted Rory O'Connor in saying, "Increased social isolation, loneliness, health anxiety, stress, and an economic downturn are a perfect storm to harm people's mental health and wellbeing."<ref name="BBC, mental health impact, 16 April 2020">[https://www.bbc.com/news/health-52295894 Coronavirus: 'Profound' mental health impact prompts calls for urgent research], BBC, Philippa Roxby, April 16, 2020.</ref><ref><!-- Since this is a "call to action" and not a traditional medical article, it's perhaps best to go with a simpler WYSIWYG reference style, rather than the format style we use with traditional medical articles. -->[https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(20)30168-1.pdf Multidisciplinary research priorities for the COVID‑19 pandemic: a call for action for mental health science], ''The Lancet'', Emily Holmes, Rory O'Connor, Hugh Perry, et al., April 15, 2020, page 1: "A fragmented research response, characterised by small-scale and localised initiatives, will not yield the clear insights necessary to guide policymakers or the public."</ref>

==Prognosis==

{{Primary sources|date=March 2020}}
{{multiple image
 | align = right
 | direction = vertical
 | total_width = 400
 | caption_align = center
 | image1 = Severity-of-coronavirus-cases-in-China-1.png
 | alt1 = The severity of diagnosed cases in China
 | caption1 = The severity of diagnosed COVID-19 cases in China<ref>{{cite journal |last1=Roser |first1=Max |last2=Ritchie |first2=Hannah |last3=Ortiz-Ospina |first3=Esteban |name-list-format=vanc |title=Coronavirus Disease (COVID-19) |url=https://ourworldindata.org/coronavirus |journal=Our World in Data |access-date=12 March 2020 |date=4 March 2020 |archive-url=https://web.archive.org/web/20200319171947/https://ourworldindata.org/coronavirus |archive-date=19 March 2020 |url-status=live }}</ref>
 | image2 = COVID-CFR-by-age-CN-KR-ES-IT-latest-nolegend.svg
 | alt2 = Case fatality rates for COVID-19 by age by country.
 | caption2 = <div style="text-align: left;">Case fatality rates by age group: {{legend|#d62728|China, as of 11 February 2020<ref name="Epidemiology2020Feb17" />}} {{legend|#2ca02c|South Korea, as of 17 July 2020<ref name="KCDCReport-20200717">{{cite report|url=https://www.cdc.go.kr/board/board.es?mid=a20501000000&bid=0015&list_no=367829&act=view|title=코로나바이러스감염증-19 국내 발생 현황(7월 17일, 정례브리핑) |language=ko|date=2020-07-17|publisher=[[Korea Centers for Disease Control and Prevention]]|access-date=2020-07-17|url-status=live}}</ref>}} {{legend|#ff7f0e|Spain, as of 18 May 2020<ref name="MSCBSReport">{{cite report|url=https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/Actualizacion_109_COVID-19.pdf|title=Actualización nº 109. Enfermedad por el coronavirus (COVID-19)|date=18 May 2020|publisher=[[Ministry of Health (Spain)|Ministerio de Sanidad, Consumo y Bienestar Social]]|language=Spanish|access-date=20 May 2020|url-status=live}}</ref>}} {{legend|#1f77b4|Italy, as of 3 June 2020<ref>{{cite web|url=https://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_3-giugno-2020.pdf|title=Epidemia COVID-19 – Bollettino sorveglianza integrata COVID-19|publisher=[[Istituto Superiore di Sanità]]|access-date=2020-06-10|language=it|date=2020-06-05}}</ref>}}</div>
 | image3 = Comorbidity and severity in covid-19 data from China CDC Weekly 2020, 2(8), pp. 113-122 (cropped).png
 | alt3 = Case fatality rate depending on other health problems
 | caption3 = Case fatality rate in China depending on other health problems. Data through 11 February 2020.<ref name="Epidemiology2020Feb17" />
 | image4 = Covid-19-total-confirmed-cases-vs-total-confirmed-deaths.svg
 | alt4 = Case fatality rate by country and number of cases
 | caption4 = The number of deaths vs total cases by country and approximate case fatality rate<ref>{{cite journal |last1=Roser |first1=Max |last2=Ritchie |first2=Hannah |last3=Ortiz-Ospina |first3=Esteban |name-list-format=vanc |title=Coronavirus Disease (COVID-19) |url=https://ourworldindata.org/coronavirus |journal=Our World in Data |access-date=6 April 2020 |date=6 April 2020}}</ref>
}}
The severity of COVID‑19 varies. The disease may take a mild course with few or no symptoms, resembling other common upper respiratory diseases such as the [[common cold]]. Mild cases typically recover within two weeks, while those with severe or critical diseases may take three to six weeks to recover. Among those who have died, the time from symptom onset to death has ranged from two to eight weeks.<ref name="WHOReport24Feb2020">{{cite report | title = Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) | date = 16–24 February 2020 | url = https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf | publisher = [[World Health Organization]] (WHO) | access-date = 21 March 2020 | archive-url = https://web.archive.org/web/20200229221222/https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf | archive-date = 29 February 2020 | url-status = live }}</ref>

Children make up a small proportion of reported cases, with about 1% of cases being under 10 years and 4% aged 10–19 years.<ref name="ECDCQA"/> They are likely to have milder symptoms and a lower chance of severe disease than adults; in those younger than 50 years the risk of death is less than 0.5%, while in those older than 70 it is more than 8%.<ref name="JAMAPedsCOVID19">{{cite journal |last1=Castagnoli |first1=R |last2=Votto |first2=M |last3=Licari |first3=A |title=Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Children and Adolescents A Systematic Review |journal=JAMA Pediatrics |date=April 2020 |doi=10.1001/jamapediatrics.2020.1467 |pmid=32320004 |url=https://jamanetwork.com/journals/jamapediatrics/fullarticle/2765169 |accessdate=22 April 2020|doi-access=free }}</ref><ref name="Lu Zhang Du Zhang p.">{{cite journal|display-authors=6|vauthors=Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, Zhang W, Wang Y, Bao S, Li Y, Wu C, Liu H, Liu D, Shao J, Peng X, Yang Y, Liu Z, Xiang Y, Zhang F, Silva RM, Pinkerton KE, Shen K, Xiao H, Xu S, Wong GW|date=18 March 2020|title=SARS-CoV-2 Infection in Children|journal=New England Journal of Medicine|volume=382|issue=17|pages=1663–1665|publisher=Massachusetts Medical Society|doi=10.1056/nejmc2005073|issn=0028-4793|pmid=32187458|pmc=7121177}}</ref><ref name="pediatrics_tong">{{cite journal | vauthors = Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, Tong S | journal = Pediatrics | title = Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China | date = 2020 | pages = e20200702 | url = https://pediatrics.aappublications.org/content/pediatrics/early/2020/03/16/peds.2020-0702.full.pdf | doi = 10.1542/peds.2020-0702 | pmid = 32179660 | access-date = 16 March 2020 | archive-url = https://web.archive.org/web/20200317223427/https://pediatrics.aappublications.org/content/pediatrics/early/2020/03/16/peds.2020-0702.full.pdf | archive-date = 17 March 2020 | url-status = live }}</ref> [[COVID-19 in pregnancy|Pregnant women]] may be at higher risk for severe infection with COVID-19 based on data from other similar viruses, like [[Severe acute respiratory syndrome|SARS]] and [[Middle East respiratory syndrome|MERS]], but data for COVID-19 is lacking.<ref>{{cite journal | vauthors = Fang L, Karakiulakis G, Roth M | title = Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? | journal = [[The Lancet Respiratory Medicine]] | volume = 395 | issue = 10224 | pages = e40 | date = March 2020 | pmid = 32171062 | doi = 10.1016/S0140-6736(20)30311-1 | pmc = 7118626 }}</ref><ref name="CDC 2020children">{{cite web|url=https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/children-faq.html|title=Coronavirus Disease 2019 (COVID-19)|author=|date=11 February 2020|website=Centers for Disease Control and Prevention|access-date=2 March 2020|name-list-format=vanc|archive-url=https://web.archive.org/web/20200302064104/https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/children-faq.html|archive-date=2 March 2020|url-status=live}}</ref> In China, children acquired infections mainly through close contact with their parents or other family members who lived in Wuhan or had traveled there.<ref name="JAMAPedsCOVID19"/>

Some studies have found that the [[neutrophil to lymphocyte ratio]] (NLR) may be helpful in early screening for severe illness.<ref>{{cite journal|title=Dysregulation of immune response in patients with COVID-19 in Wuhan, China|journal=Clinical Infectious Diseases|doi=10.1093/cid/ciaa248|date=12 March 2020|last1=Tian|first1=Dai-Shi|last2=Wang|first2=Wei|last3=Shang|first3=Ke|last4=Ma|first4=Ke|last5=Xie|first5=Cuihong|last6=Tao|first6=Yu|last7=Yang|first7=Sheng|last8=Zhang|first8=Shuoqi|last9=Hu|first9=Ziwei|last10=Zhou|first10=Luoqi|last11=Qin|first11=Chuan|pmid=32161940|pmc=7108125}}</ref>

Most of those who die of COVID‑19 have [[pre-existing condition|pre-existing (underlying) conditions]], including [[hypertension]], [[diabetes mellitus]], and [[cardiovascular disease]].<ref name=":8">{{cite web |url=https://www.who.int/dg/speeches/detail/who-director-general-s-statement-on-the-advice-of-the-ihr-emergency-committee-on-novel-coronavirus |title=WHO Director-General's statement on the advice of the IHR Emergency Committee on Novel Coronavirus |website=[[World Health Organization]] (WHO) }}</ref> The [[Istituto Superiore di Sanità]] reported that out of 8.8% of deaths where [[medical record|medical charts]] were available for review, 97.2% of sampled patients had at least one [[comorbidity]] with the average patient having 2.7 diseases.<ref name="ISSCharacteristics">{{cite report|vauthors=Palmieri L, Andrianou X, Barbariol P, Bella A, Bellino S, Benelli E, Bertinato L, Boros S, Brambilla G, Calcagnini G, Canevelli M, Castrucci MR, Censi F, Ciervo A, Colaizzo E, D'Ancona F, Del Manso M, Donfrancesco C, Fabiani M, Filia A, Floridia M, Giuliano M, Grisetti T, Langer M, Lega I, Lo Noce C, Maiozzi P, Malchiodi Albedi F, Manno V, Martini M, Mateo Urdiales A, Mattei E, Meduri C, Meli P, Minelli G, Nebuloni M, Nisticò L, Nonis M, Onder G, Palmisano L, Petrosillo N, Pezzotti P, Pricci F, Punzo O, Puro V, Raparelli V, Rezza G, Riccardo F, Rota MC, Salerno P, Serra D, Siddu A, Stefanelli P, Tamburo De Bella M, Tiple D, Unim B, Vaianella L, Vanacore N, Vichi M, Villani ER, Brusaferro S|display-authors= 6|title=Characteristics of COVID-19 patients dying in Italy Report based on available data on April 2th, 2020|url=https://www.epicentro.iss.it/en/coronavirus/bollettino/Report-COVID-2019_2_april_2020.pdf|date=3 April 2020|publisher=[[Istituto Superiore di Sanità]]|access-date=3 April 2020|url-status=live}}</ref> According to the same report, the median time between the onset of symptoms and death was ten days, with five being spent hospitalised. However, patients transferred to an ICU had a median time of seven days between hospitalisation and death.<ref name="ISSCharacteristics" /> In a study of early cases, the median time from exhibiting initial symptoms to death was 14 days, with a full range of six to 41 days.<ref>{{cite journal | vauthors = Wang W, Tang J, Wei F | title = Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China | journal = Journal of Medical Virology | volume = 92 | issue = 4 | pages = 441–47 | date = April 2020 | pmid = 31994742 |doi=10.1002/jmv.25689 | pmc = 7167192 |doi-access=free }}</ref> In a study by the [[National Health Commission]] (NHC) of China, men had a death rate of 2.8% while women had a death rate of 1.7%.<ref name="WM2020Feb26">{{cite web |title=Coronavirus Age, Sex, Demographics (COVID-19) |url=https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/ |website=www.worldometers.info |access-date=26 February 2020 |archive-url=https://web.archive.org/web/20200227112932/https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/ |archive-date=27 February 2020 |url-status=live | name-list-format = vanc}}</ref> [[Histopathology|Histopathological]] examinations of post-mortem lung samples show [[diffuse alveolar damage]] with cellular fibromyxoid [[exudate]]s in both lungs. Viral [[cytopathic effect|cytopathic]] changes were observed in the [[pneumocytes]]. The lung picture resembled [[acute respiratory distress syndrome]] (ARDS).<ref name="WHOReport24Feb2020" /> In 11.8% of the deaths reported by the National Health Commission of China, heart damage was noted by elevated levels of [[Troponin I|troponin]] or cardiac arrest.<ref name="Zheng Ma Zhang Xie p." /> According to March data from the United States, 89% of those hospitalised had preexisting conditions.<ref>{{cite journal |last1=Garg |first1=Shikha |title=Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019—COVID-NET, 14 States, March 1–30, 2020 |journal=MMWR. Morbidity and Mortality Weekly Report |date=2020-04-08 |display-authors=etal |volume=69 |issue=15 |pages=458–464 |doi=10.15585/mmwr.mm6915e3 |pmid=32298251 |url=https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm |issn=0149-2195|doi-access=free }}</ref>

The availability of medical resources and the [[socioeconomics]] of a region may also affect mortality.<ref name="Ji Ma Peppelenbosch Pan 2020 p.">{{cite journal | vauthors=Ji Y, Ma Z, Peppelenbosch MP, Pan Q | title=Potential association between COVID-19 mortality and health-care resource availability | journal=Lancet Global Health | volume= 8| date=February 2020 | issue=4 | pages=e480 | pmid=32109372 | doi=10.1016/S2214-109X(20)30068-1 | pmc=7128131 | doi-access=free }}</ref> Estimates of the mortality from the condition vary because of those regional differences,<ref name="pmid32159317">{{cite journal | vauthors = Li XQ, Cai WF, Huang LF, Chen C, Liu YF, Zhang ZB, Yuan J, Li TG, Wang M | display-authors = 6 | title = [Comparison of epidemic characteristics between SARS in2003 and COVID-19 in 2020 in Guangzhou] | language = Chinese | journal = Zhonghua Liu Xing Bing Xue Za Zhi = Zhonghua Liuxingbingxue Zazhi | volume = 41 | issue = 5 | pages = 634–637 | date = March 2020 | pmid = 32159317 | doi = 10.3760/cma.j.cn112338-20200228-00209 }}</ref> but also because of [[Methodology|methodological]] difficulties. The under-counting of mild cases can cause the mortality rate to be overestimated.<ref>{{cite journal | vauthors = Jung SM, Akhmetzhanov AR, Hayashi K, Linton NM, Yang Y, Yuan B, Kobayashi T, Kinoshita R, Nishiura H | display-authors = 6 | title = Real-Time Estimation of the Risk of Death from Novel Coronavirus (COVID-19) Infection: Inference Using Exported Cases | journal = Journal of Clinical Medicine | volume = 9 | issue = 2 | page = 523 | date = February 2020 | pmid = 32075152 | doi = 10.3390/jcm9020523 | pmc = 7074479 }}</ref> However, the fact that deaths are the result of cases contracted in the past can mean the current mortality rate is underestimated.<ref>{{cite journal | vauthors = Chughtai A, Malik A | title = Is Coronavirus disease (COVID-19) case fatality ratio underestimated? | journal = Global Biosecurity | date = March 2020 | volume = 1 | issue = 3 | doi = 10.31646/gbio.56 | doi-broken-date = 2020-04-26 }}</ref><ref>{{cite journal | vauthors = Baud D, Qi X, Nielsen-Saines K, Musso D, Pomar L, Favre G | title = Real estimates of mortality following COVID-19 infection. | journal = The Lancet Infectious Diseases | date = March 2020 | doi = 10.1016/S1473-3099(20)30195-X | pmid = 32171390 | pmc = 7118515 }}</ref> Smokers were 1.4 times more likely to have severe symptoms of COVID‑19 and approximately 2.4 times more likely to require intensive care or die compared to non-smokers.<ref>{{cite journal |last1=Vardavas |first1=Constantine I. |last2=Nikitara |first2=Katerina |title=COVID-19 and smoking: A systematic review of the evidence |journal=Tobacco Induced Diseases |date=20 March 2020 |volume=18 |issue=March |page=20 |doi=10.18332/tid/119324 |pmid=32206052 |issn=1617-9625|pmc=7083240 }}</ref>

Concerns have been raised about long-term [[sequela]]e of the disease. The [[Hong Kong Hospital Authority]] found a drop of 20% to 30% in lung capacity in some people who recovered from the disease, and lung scans suggested organ damage.<ref>{{cite web |last1=Cheung |first1=Elizabeth |name-list-format=vanc |title=Some recovered Covid-19 patients may have lung damage, doctors say |url=https://www.scmp.com/news/hong-kong/health-environment/article/3074988/coronavirus-some-recovered-patients-may-have |website=[[South China Morning Post]] |date=13 March 2020 |access-date=15 March 2020 |archive-url=https://web.archive.org/web/20200315172445/https://www.scmp.com/news/hong-kong/health-environment/article/3074988/coronavirus-some-recovered-patients-may-have |archive-date=15 March 2020 |url-status=live }}</ref> This may also lead to [[post-intensive care syndrome]] following recovery.<ref>{{cite journal|last=Servick|first=Kelly|date=2020-04-08|title=For survivors of severe COVID-19, beating the virus is just the beginning|url=https://www.sciencemag.org/news/2020/04/survivors-severe-covid-19-beating-virus-just-beginning|journal=Science|doi=10.1126/science.abc1486|doi-access=free|issn=0036-8075}}</ref>

{| class="wikitable"
|+Case fatality rates (%) by age and country or US state
|-
!Age
!0–9
!10–19
!20–29
!30–39
!40–49
!50–59
!60–69
!70–79
!80-89
!90+ 
|-
|[[COVID-19 pandemic in Canada|Canada]] as of 5 May<ref>{{cite web|url=https://www.canada.ca/content/dam/phac-aspc/documents/services/diseases/2019-novel-coronavirus-infection/surv-covid19-epi-update-eng.pdf|title=Coronavirus Disease 2019 (COVID-19) DAILY EPIDEMIOLOGY UPDATE Updated: 5 May, 2020, 11:00 AM ET|date=2020-05-05|website=Public Health Agency of Canada|url-status=live|access-date=2020-05-06}}</ref>
|colspan="2" {{shade|align=center|0.0}}
|colspan="2" {{shade|align=center|0.1}}
|colspan="2" {{shade|align=center|0.6}}
|colspan="2" {{shade|align=center|6.4}}
|colspan="2" {{shade|align=center|21.5}}
|-
|[[COVID-19 pandemic in mainland China|China]] as of 11 February<ref name="Epidemiology2020Feb17" />
|{{shade|align=center|0.0}}
|{{shade|align=center|0.2}}
|{{shade|align=center|0.2}}
|{{shade|align=center|0.2}}
|{{shade|align=center|0.4}}
|{{shade|align=center|1.3}}
|{{shade|align=center|3.6}}
|{{shade|align=center|8.0}}
|colspan="2" {{shade|align=center|14.8}}
|-
|[[COVID-19 pandemic in Denmark|Denmark]] as of 5 May<ref name="SSIReport">{{cite report|url=https://files.ssi.dk/COVID19-overvaagningsrapport-30042020-2h7d|title=COVID-19 i Danmark: Epidemiologisk overvågningsrapport den 5. maj 2020|date=2020-05-05|publisher=[[Statens Serum Institut]]|language=Danish|access-date=2020-05-05|url-status=live|archivedate=10 ឧសភា 2020|archiveurl=https://web.archive.org/web/20200510173051/https://files.ssi.dk/COVID19-overvaagningsrapport-30042020-2h7d|deadurl=yes}}</ref>
|colspan="6" {{shade|align=center|0.2}}
|{{shade|align=center|4.4}}
|{{shade|align=center|16.7}}
|{{shade|align=center|26.4}}
|{{shade|align=center|44.3}}
|-
|[[COVID-19 pandemic in Germany|Germany]] as of 5 May<ref>https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/2020-05-05-de.pdf</ref><ref>{{cite web|url=https://experience.arcgis.com/experience/478220a4c454480e823b17327b2bf1d4 |title=Robert Koch-Institut: COVID-19-Dashboard |publisher=Experience.arcgis.com |date= |accessdate=2020-05-07}}</ref>
|colspan="6" {{shade|align=center|0.3}}
|colspan="2" {{shade|align=center|6.9}}
|colspan="2" {{shade|align=center|23.7}}
|-
|[[COVID-19 pandemic in Israel|Israel]] as of 3 May<ref>{{cite web|url=https://t.me/MOHreport/4421?single|title=קורונה - משרד הבריאות|publisher=[[Ministry of Health (Israel)]]|date=2020-05-03|accessdate=2020-05-05}}</ref>
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}<!--used to be 0.5% until May 2nd (too bad it wasn't Easter)-->
|{{shade|align=center|0.9}}
|{{shade|align=center|0.9}}
|{{shade|align=center|3.1}}
|{{shade|align=center|9.7}}
|{{shade|align=center|22.9}}
|{{shade|align=center|30.8}}
|{{shade|align=center|31.3}}
|-
|[[COVID-19 pandemic in Italy|Italy]] as of 28 April<ref name="ISSReport">{{cite report|url=https://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_28-aprile-2020.pdf|title=Epidemia COVID-19. Aggiornamento nazionale 28 aprile 2020|date=29 April 2020|publisher=[[Istituto Superiore di Sanità]]|location=Rome|language=Italian|access-date=30 April 2020|url-status=live}}</ref>
|{{shade|align=center|0.1}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.1}}
|{{shade|align=center|0.3}}
|{{shade|align=center|0.9}}
|{{shade|align=center|2.6}}
|{{shade|align=center|9.8}}
|{{shade|align=center|24.2}}
|{{shade|align=center|29.0}}
|{{shade|align=center|24.7}}
|-
|[[COVID-19 pandemic in Kentucky|KY state]] as of 5 May<ref>{{cite web|url=https://kygeonet.maps.arcgis.com/apps/opsdashboard/index.html#/543ac64bc40445918cf8bc34dc40e334 |title=KDPH COVID-19 Dashboard |publisher=Kygeonet.maps.arcgis.com |date= |accessdate=2020-05-07}}</ref>
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.2}}
|{{shade|align=center|0.6}}
|{{shade|align=center|2.3}}
|{{shade|align=center|6.8}}
|{{shade|align=center|13.3}}
|colspan="2" {{shade|align=center|27.9}}
|-
|[[COVID-19 pandemic in Massachusetts|MA state]] as of 5 May<ref>{{cite web|url=https://www.mass.gov/info-details/covid-19-response-reporting |title=COVID-19 Response Reporting |publisher=Mass.gov |date=2020-01-01 |accessdate=2020-05-07}}</ref>
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.1}}
|{{shade|align=center|0.4}}
|{{shade|align=center|1.3}}
|{{shade|align=center|4.5}}
|{{shade|align=center|14.2}}
|colspan="2" {{shade|align=center|24.7}}
|-
|[[COVID-19 pandemic in the Netherlands|Netherlands]] as of 25 April<ref name="RIVMReport">{{cite report|url=https://www.rivm.nl/documenten/epidemiologische-situatie-covid-19-in-nederland-25-april-2020|title=Epidemiologische situatie COVID-19 in Nederland 25 april 2020|date=25 April 2020|publisher=[[Netherlands National Institute for Public Health and the Environment|Rijksinstituut voor Volksgezondheid en Milie]]|location=Bilthoven|language=Dutch|access-date=25 April 2020|url-status=live}}</ref>
|{{shade|align=center|0.0}}
|{{shade|align=center|0.3}}
|{{shade|align=center|0.1}}
|{{shade|align=center|0.2}}
|{{shade|align=center|0.5}}
|{{shade|align=center|1.5}}
|{{shade|align=center|7.6}}
|{{shade|align=center|23.2}}
|{{shade|align=center|30.0}}
|{{shade|align=center|29.3}}
|-
|[[COVID-19 pandemic in Norway|Norway]] as of 5 May<ref>https://www.fhi.no/contentassets/ca5914bd0aa14e15a17f8a7d48fa306a/2020_05_05_dagsrapport-norge-covid-19.pdf{{Dead link|date=តុលា 2022 |bot=InternetArchiveBot |fix-attempted=yes }}</ref>
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.2}}
|{{shade|align=center|0.4}}
|{{shade|align=center|1.7}}
|{{shade|align=center|8.5}}
|{{shade|align=center|21.3}}
|{{shade|align=center|50.4}}
|-
|[[COVID-19 pandemic in Portugal|Portugal]] as of 5 May<ref>{{cite web|url=https://covid19.min-saude.pt/wp-content/uploads/2020/05/64_DGS_boletim_20200505.pdf|title=NOVO CORONAVÍRUS COVID-19 RELATÓRIO DE SITUAÇÃO|date=2020-05-05|accessdate=2020-05-05|language=pt|archivedate=5 ឧសភា 2020|archiveurl=https://web.archive.org/web/20200505134519/https://covid19.min-saude.pt/wp-content/uploads/2020/05/64_DGS_boletim_20200505.pdf|url-status=dead}}</ref>
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.2}}
|{{shade|align=center|0.8}}
|{{shade|align=center|3.1}}
|{{shade|align=center|9.5}}
|colspan="2" {{shade|align=center|17.8}}
|-
|[[COVID-19 pandemic in South Korea|South Korea]] as of 30 April<ref name="KCDCReport">{{cite report|url=https://www.cdc.go.kr/board/board.es?mid=a20501000000&bid=0015&list_no=367051&act=view|title=코로나바이러스감염증-19 국내 발생 현황(4월 30일, 정례브리핑)|language=ko|date=30 April 2020|publisher=[[Korea Centers for Disease Control and Prevention]]|access-date=30 April 2020|url-status=live}}</ref>
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.2}}
|{{shade|align=center|0.2}}
|{{shade|align=center|0.8}}
|{{shade|align=center|2.6}}
|{{shade|align=center|10.4}}
|colspan="2" {{shade|align=center|24.3}}
|-
|[[COVID-19 pandemic in Spain|Spain]] as of 5 May<ref name="MSCBSReport">{{cite report|url=https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/Actualizacion_97_COVID-19.pdf|title=Actualización nº 97. Enfermedad por el coronavirus (COVID-19)|date=6 May 2020|publisher=[[Ministry of Health (Spain)|Ministerio de Sanidad, Consumo y Bienestar Social]]|language=Spanish|access-date=2020-05-06|url-status=live}}</ref>
|{{shade|align=center|0.3}}
|{{shade|align=center|0.4}}
|{{shade|align=center|0.2}}
|{{shade|align=center|0.3}}
|{{shade|align=center|0.6}}
|{{shade|align=center|1.5}}
|{{shade|align=center|4.8}}
|{{shade|align=center|13.9}}
|{{shade|align=center|20.9}}
|{{shade|align=center|21.9}}
|-
|[[COVID-19 pandemic in Sweden|Sweden]] as of 5 May<ref>{{cite web|url=https://experience.arcgis.com/experience/09f821667ce64bf7be6f9f87457ed9aa |title=FOHM Covid-19 |publisher=[[Public Health Agency of Sweden]] |date= |accessdate=2020-05-05}}</ref>
|{{shade|align=center|0.9}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.4}}
|{{shade|align=center|0.4}}
|{{shade|align=center|0.9}}
|{{shade|align=center|2.3}}
|{{shade|align=center|7.4}}
|{{shade|align=center|22.8}}
|{{shade|align=center|32.0}}
|{{shade|align=center|36.1}}
|-
|[[COVID-19 pandemic in Switzerland|Switzerland]] as of 5 May<ref>{{cite web|url=https://datawrapper.dwcdn.net/IJC8v/45/|title=Todesfälle in der Schweiz nach Altersgruppen|website=datawrapper.dwcdn.net|date=2020-04-30|accessdate=2020-04-30}}</ref>
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.0}}
|{{shade|align=center|0.1}}
|{{shade|align=center|0.1}}
|{{shade|align=center|0.5}}
|{{shade|align=center|2.9}}
|{{shade|align=center|10.9}}
|colspan="2" {{shade|align=center|25.9}}
|-
|[[2020 coronavirus pandemic in Washington (state)|WA state]] as of 3 May<ref>{{cite web|url=https://www.doh.wa.gov/emergencies/coronavirus |title=2019 Novel Coronavirus Outbreak (COVID-19) |publisher=Washington State Department of Health |date=2020-05-05|accessdate=2020-05-06}}</ref>
|colspan="2" {{shade|align=center|0.0}}
|colspan="2" {{shade|align=center|0.2}}
|colspan="2" {{shade|align=center|1.3}}
|colspan="2" {{shade|align=center|9.1}}
|colspan="2" {{shade|align=center|29.8}}
|}
{| class="wikitable"
|+Case fatality rates (%) by age in the United States
|-
!Age
!0–19
!20–44
!45–54
!55–64
!65–74
!75–84
!85+
|-
|[[COVID-19 pandemic in the United States|United States]] as of 16 March<ref name="CDCMMWR18Mar2020">{{cite journal|author=CDC COVID-19 Response Team|title=Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19)—United States, February 12 – March 16, 2020|url=https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm|journal=[[Morbidity and Mortality Weekly Report]]|volume=69|issue=12|pages=343–346|date=18 March 2020|publisher=[[Centers for Disease Control]]|doi=10.15585/mmwr.mm6912e2|pmid=32214079|access-date=22 March 2020|archive-url=https://web.archive.org/web/20200322021219/https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm|archive-date=22 March 2020|url-status=live|doi-access=free}}</ref>
|style="text-align:center;"|0.0
|style="text-align:center;"|0.1–0.2
|style="text-align:center;"|0.5–0.8
|style="text-align:center;"|1.4–2.6
|style="text-align:center;"|2.7–4.9
|style="text-align:center;"|4.3–10.5
|style="text-align:center;"|10.4–27.3
|-
| colspan="8" |Note: The lower bound includes all cases. The upper bound excludes cases that were missing data.
|}

{| class="wikitable"
|+Estimate of infection fatality rates and probability of severe disease course (%) by age based on cases from China<ref>{{cite journal|last=Verity|first=Robert|last2=Okell|first2=Lucy C|last3=Dorigatti|first3=Ilaria|last4=Winskill|first4=Peter|last5=Whittaker|first5=Charles|last6=Imai|first6=Natsuko|last7=Cuomo-Dannenburg|first7=Gina|last8=Thompson|first8=Hayley|last9=Walker|first9=Patrick G T|last10=Fu|first10=Han|last11=Dighe|first11=Amy|date=30 March 2020|title=Estimates of the severity of coronavirus disease 2019: a model-based analysis|journal=The Lancet Infectious Diseases|doi=10.1016/s1473-3099(20)30243-7|pmid=32240634|pmc=7158570|doi-access=free|issn=1473-3099}}</ref>
|-
!
!0–9
!10–19
!20–29
!30–39
!40–49
!50–59
!60–69
!70–79
!80+
|-
!Severe disease
|{{shade|align=center|0.0}}<br /><small>(0.0–0.0)</small>
|{{shade|align=center|0.04}}<br /><small>(0.02–0.08)</small>
|{{shade|align=center|1.0}}<br /><small>(0.62–2.1)</small>
|{{shade|align=center|3.4}}<br /><small>(2.0–7.0)</small>
|{{shade|align=center|4.3}}<br /><small>(2.5–8.7)</small>
|{{shade|align=center|8.2}}<br /><small>(4.9–17)</small>
|{{shade|align=center|11}}<br /><small>(7.0–24)</small>
|{{shade|align=center|17}}<br /><small>(9.9–34)</small>
|{{shade|align=center|18}}<br /><small>(11–38)</small>
|-
!Death
|{{shade|align=center|0.0016}}<br /><small>(0.00016–0.025)</small>
|{{shade|align=center|0.0070}}<br /><small>(0.0015–0.050)</small>
|{{shade|align=center|0.031}}<br /><small>(0.014–0.092)</small>
|{{shade|align=center|0.084}}<br /><small>(0.041–0.19)</small>
|{{shade|align=center|0.16}}<br /><small>(0.076–0.32)</small>
|{{shade|align=center|0.60}}<br /><small>(0.34–1.3)</small>
|{{shade|align=center|1.9}}<br /><small>(1.1–3.9)</small>
|{{shade|align=center|4.3}}<br /><small>(2.5–8.4)</small>
|{{shade|align=center|7.8}}<br /><small>(3.8–13)</small>
|-
|colspan=10| Total infection fatality rate is estimated to be 0.66% (0.39–1.3). Infection fatality rate is fatality per all infected individuals, regardless of whether they were diagnosed or had any symptoms. Numbers in parentheses are 95% [[credible interval]]s for the estimates.
|}

===ភាពស៊ាំ===

It is unknown (as of April 2020) if past infection provides effective and long-term [[Immunity (medical)|immunity]] in people who recover from the disease.<ref>{{cite web|url=https://www.immunology.org/news/bsi-open-letter-government-sars-cov-2-outbreak-response|title=BSI open letter to Government on SARS-CoV-2 outbreak response|publisher=British Society for Immunology|website=immunology.org|access-date=15 March 2020|archive-url=https://web.archive.org/web/20200314221816/https://www.immunology.org/news/bsi-open-letter-government-sars-cov-2-outbreak-response|archive-date=14 March 2020|url-status=dead|archivedate=14 មីនា 2020|archiveurl=https://web.archive.org/web/20200314221816/https://www.immunology.org/news/bsi-open-letter-government-sars-cov-2-outbreak-response}}</ref><ref name="Immunity Passports">{{cite news |last1=Schraer |first1=Rachel |title=Coronavirus: Immunity passports 'could increase virus spread' |url=https://www.bbc.com/news/world-52425825 |accessdate=26 April 2020 |date=25 April 2020}}</ref> Some of the infected have been reported to develop [[Antibody|protective antibodies]], so [[Adaptive immune system|acquired immunity]] is presumed likely, based on the behaviour of other coronaviruses.<ref>{{cite news| url= https://www.independent.co.uk/life-style/health-and-families/coronavirus-immunity-reinfection-get-covid-19-twice-sick-spread-relapse-a9400691.html |title= Can you get coronavirus twice or does it cause immunity?|date=13 March 2020|website=The Independent|access-date=15 March 2020|archive-url= https://web.archive.org/web/20200314211439/https://www.independent.co.uk/life-style/health-and-families/coronavirus-immunity-reinfection-get-covid-19-twice-sick-spread-relapse-a9400691.html|archive-date=14 March 2020|url-status=live}}</ref> However, cases in which recovery from COVID‑19 was followed by positive tests for coronavirus at a later date have been reported.<ref name="SLT-202004112">{{cite news |last=Politi |first=Daniel |title=WHO Investigating Reports of Coronavirus Patients Testing Positive Again After Recovery |url=https://slate.com/news-and-politics/2020/04/who-reports-coronavirus-testing-positive-recovery.html |date=11 April 2020 |work=[[Slate (magazine)|Slate]] |accessdate=11 April 2020 }}</ref><ref>{{cite web|url=https://www.latimes.com/world-nation/story/2020-03-13/china-japan-korea-coronavirus-reinfection-test-positive|title=They survived the coronavirus. Then they tested positive again. Why?|date=13 March 2020|website=Los Angeles Times|access-date=15 March 2020|archive-url=https://web.archive.org/web/20200314220822/https://www.latimes.com/world-nation/story/2020-03-13/china-japan-korea-coronavirus-reinfection-test-positive|archive-date=14 March 2020|url-status=live}}</ref><ref>{{cite web |url= https://www.caixinglobal.com/2020-02-26/14-of-recovered-covid-19-patients-in-guangdong-tested-positive-again-101520415.html|title=14% of Recovered Covid-19 Patients in Guangdong Tested Positive Again| publisher= Caixin Global|website= caixinglobal.com|access-date=15 March 2020|archive-url= https://web.archive.org/web/20200303181249/https://www.caixinglobal.com/2020-02-26/14-of-recovered-covid-19-patients-in-guangdong-tested-positive-again-101520415.html|archive-date=3 March 2020|url-status=live}}</ref><ref name="Omer2020">{{cite journal |last1=Omer |first1=SB |last2=Malani |first2=P |last3=del Rio |first3=C |title=The COVID-19 Pandemic in the US A Clinical Update |journal=JAMA |date= 6 April 2020 |doi=10.1001/jama.2020.5788|pmid=32250388 |doi-access=free }}</ref> These cases are believed to be lingering infection rather than reinfection,<ref name="Omer2020"/> or [[false positive]]s due to remaining RNA fragments.<ref>{{citation |url=https://www.thetimes.co.uk/article/coronavirus-patients-cant-relapse-south-korean-scientists-believe-rkm8zm7d9 |title=Coronavirus patients can't relapse, South Korean scientists believe |newspaper=The Times |author=Richard Lloyd Parry |date=30 April 2020}}</ref> Some other coronaviruses circulating in people are capable of reinfection after roughly a year.<ref>{{cite web|title=What if immunity to covid-19 doesn't last?|url=https://www.technologyreview.com/2020/04/27/1000569/how-long-are-people-immune-to-covid-19/|website=MIT Technology Review|language=en|access-date=2020-05-01}}</ref><ref>{{cite web|title=Direct observation of repeated infections with endemic coronaviruses|url=http://www.columbia.edu/~jls106/galanti_shaman_ms_supp.pdf|publisher=Department of Environmental Health Sciences, Mailman School of Public Health, [[Columbia University]]|website=Columbia University in the City of New York|language=en|access-date=2020-05-02|date=April 15, 2020}}</ref>

==ប្រវត្តិ==

{{main|Timeline of the 2019–20 coronavirus pandemic}}

The virus is thought to be natural and has an [[zoonosis|animal origin]],<ref name="NM-20200317">{{cite journal |vauthors=Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF |title=The proximal origin of SARS-CoV-2 |date=17 March 2020 |journal=[[Nature Medicine]] |volume=26 |issue=4 |pages=450–452 |doi=10.1038/s41591-020-0820-9 |pmid=32284615 |issn=1546-170X |pmc=7095063 }}</ref> through [[spillover infection]].<ref>{{cite web|url=https://nautil.us/issue/83/intelligence/the-man-who-saw-the-pandemic-coming|title=The Man Who Saw the Pandemic Coming|last=Berger|first=Kevin|name-list-format=vanc|date=12 March 2020|website=Nautilus|access-date=16 March 2020|archive-url=https://web.archive.org/web/20200315180124/http://nautil.us/issue/83/intelligence/the-man-who-saw-the-pandemic-coming|archive-date=15 March 2020|url-status=dead|archivedate=15 មីនា 2020|archiveurl=https://web.archive.org/web/20200315180124/http://nautil.us/issue/83/intelligence/the-man-who-saw-the-pandemic-coming}}</ref> The actual origin is unknown, but the first known cases of infection happened in China. By December 2019, the spread of infection was almost entirely driven by human-to-human transmission.<ref name="Epidemiology2020Feb17">{{cite journal|vauthors=Yanping Z, et al.|collaboration=The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team|title=The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19)—China, 2020|url=http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51|journal=China CDC Weekly|volume=2|issue=8|pages=113–122|date=17 February 2020|publisher=[[Chinese Center for Disease Control and Prevention]]|access-date=18 March 2020|archive-url=https://web.archive.org/web/20200219142101/http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51|archive-date=19 February 2020|url-status=live}}</ref><ref name="Heymann Shindo 2020 pp. 542–45">{{cite journal | vauthors=Heymann DL, Shindo N | title=COVID-19: what is next for public health? | journal=Lancet | volume=395 | issue=10224 | date=February 2020 | pmid=32061313 | doi=10.1016/S0140-6736(20)30374-3 | doi-access=free | pages=542–45 }}</ref> A study of the first 41 cases of confirmed COVID‑19, published in January 2020 in ''The Lancet'', revealed the earliest date of onset of symptoms as 1{{nbsp}}December 2019.<ref name="WuMarch2020">{{cite journal|last=Wu|first=Yi-Chi|last2=Chen|first2=Ching-Sung|last3=Chan|first3=Yu-Jiun|date=March 2020|title=The outbreak of COVID-19: An overview|journal=Journal of the Chinese Medical Association|volume=83|issue=3|pages=217–220|doi=10.1097/JCMA.0000000000000270|pmid=32134861|issn=1726-4901|pmc=7153464}}</ref><ref name="Wang24Jan2020">{{cite journal |last1=Wang |first1=C. |last2=Horby |first2=P. W. |last3=Hayden |first3=F. G. |last4=Gao |first4=G. F. |title=A novel coronavirus outbreak of global health concern |journal=[[Lancet (journal)|Lancet]] |volume=395 |issue=10223 |pages=470–473 |date=February 2020 |pmid=31986257 |doi=10.1016/S0140-6736(20)30185-9 |doi-access=free |url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30185-9/abstract|pmc=7135038 }}</ref><ref name="AutoDW-67">{{cite journal |last=Cohen |first=Jon |date=January 2020 |title=Wuhan seafood market may not be source of novel virus spreading globally |url=https://www.sciencemag.org/news/2020/01/wuhan-seafood-market-may-not-be-source-novel-virus-spreading-globally |journal=[[Science (journal)|Science]] |doi=10.1126/science.abb0611}}</ref> Official publications from the WHO reported the earliest onset of symptoms as 8{{nbsp}}December 2019.<ref>{{cite web | title=Novel Coronavirus—China | date=12 January 2020 | website=[[World Health Organization]] (WHO) | url=https://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/}}</ref> Human-to-human transmission was confirmed by the WHO and Chinese authorities by 20 January 2020.<ref>{{cite news |last1=Kessler |first1=Glenn |title=Trump's false claim that the WHO said the coronavirus was 'not communicable' |url=https://www.washingtonpost.com/politics/2020/04/17/trumps-false-claim-that-who-said-coronavirus-was-not-communicable/ |accessdate=17 April 2020 |work=[[The Washington Post]] |date=17 April 2020 |archiveurl=https://archive.today/20200417193804/https://www.washingtonpost.com/politics/2020/04/17/trumps-false-claim-that-who-said-coronavirus-was-not-communicable/ |archivedate=17 April 2020 |name-list-format=vanc |url-status=live }}</ref><ref>{{cite news |last1=Kuo |first1=Lily |title=China confirms human-to-human transmission of coronavirus |url=https://www.theguardian.com/world/2020/jan/20/coronavirus-spreads-to-beijing-as-china-confirms-new-cases |accessdate=18 April 2020 |work=[[The Guardian]] |date=21 January 2020}}</ref>

==រោគរាតត្បាតវិទ្យា==

{{main|រោគរាតត្បាតកូវីដ-១៩}}

Several measures are commonly used to quantify mortality.<ref>{{cite web|url=https://www.cdc.gov/csels/dsepd/ss1978/lesson3/section3.html|title=Principles of Epidemiology {{!}} Lesson 3—Section 3|date=18 February 2019|website=www.cdc.gov|access-date=28 March 2020|archive-url=https://web.archive.org/web/20200228150607/https://www.cdc.gov/csels/dsepd/ss1978/lesson3/section3.html|archive-date=28 February 2020|url-status=live}}</ref> These numbers vary by region and over time and are influenced by the volume of testing, healthcare system quality, treatment options, time since the initial outbreak, and population characteristics such as age, sex, and overall health.<ref>{{cite web |url=https://ourworldindata.org/covid-mortality-risk |title=What do we know about the risk of dying from COVID-19? |last=Ritchie |first=Hannah |last2=Roser |first2=Max |date=25 March 2020 |editor-last=Chivers |editor-first=Tom |website=[[Our World in Data]] |url-status=live |access-date=28 March 2020 |archive-url=https://web.archive.org/web/20200328192730/https://ourworldindata.org/covid-mortality-risk |archive-date=28 March 2020 }}</ref>

The death-to-case ratio reflects the number of deaths divided by the number of diagnosed cases within a given time interval. Based on Johns Hopkins University statistics, the global death-to-case ratio is {{Cases in 2019–20 coronavirus pandemic|ratio|editlink=|ref=no}} ({{Cases in 2019–20 coronavirus pandemic|deaths|editlink=|ref=no}}/{{Cases in 2019–20 coronavirus pandemic|confirmed|editlink=|ref=no}}) as of {{Cases in 2019–20 coronavirus pandemic|date|editlink=|ref=no}}.{{Cases in 2019–20 coronavirus pandemic|ref=yes}} The number varies by region.<ref>{{cite journal |last=Lazzerini |first=Marzia |last2=Putoto |first2=Giovanni |date=18 March 2020 |title=COVID-19 in Italy: momentous decisions and many uncertainties |url=https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30110-8/abstract |journal=The Lancet Global Health |volume=0 |issue=5 |pages=e641–e642 |doi=10.1016/S2214-109X(20)30110-8 |issn=2214-109X |pmid=32199072|pmc=7104294 }}</ref>

Other measures include the [[case fatality rate]] (CFR), which reflects the percent of diagnosed individuals who die from a disease, and the infection fatality rate (IFR), which reflects the percent of infected individuals (diagnosed and undiagnosed) who die from a disease. These statistics are not time-bound and follow a specific population from infection through case resolution. Many academics have attempted to calculate these numbers for specific populations.<ref>{{cite web |url=https://ourworldindata.org/covid-mortality-risk |title=What do we know about the risk of dying from COVID-19? |website=Our World in Data |access-date=28 March 2020 |archive-url=https://web.archive.org/web/20200328192730/https://ourworldindata.org/covid-mortality-risk |archive-date=28 March 2020 |url-status=live }}</ref>

Outbreaks have occurred in prisons due to crowding and an inability to enforce adequate social distancing.<ref name="Hawks2020"/> In the United States, the prisoner population is aging and many of them are at high risk for poor outcomes from COVID-19 due to high rates of coexisting heart and lung disease, and poor access to high-quality healthcare.<ref name="Hawks2020">{{cite journal |last1=Hawks |first1=L |last2=Woolhandler |first2=S |last3=McCormick |first3=D |title=COVID-19 in Prisons and Jails in the United States. |journal=JAMA Internal Medicine |date=April 2020 |doi=10.1001/jamainternmed.2020.1856 |pmid=32343355 | doi-access=free}}</ref>

{{Multiple image
 | image_style = border:none;
||total_width=800
|align=center
|caption_align=center
| image1 =Total-cases-covid-19-who.png| caption1 =Total confirmed cases over time
| image2 =Total-deaths-covid-19-who (1).png| caption2 =Total deaths over time
}}
{{Multiple image
 | image_style = border:none;
||total_width=800
|align=center
|caption_align=center
| image1 =Total-confirmed-cases-of-covid-19-per-million-people.png| caption1 =Total confirmed cases of COVID‑19 per million people<ref>{{cite web |title=Total confirmed cases of COVID-19 per million people |url=https://ourworldindata.org/grapher/total-confirmed-cases-of-covid-19-per-million-people |website=Our World in Data |access-date=10 April 2020 |archive-url=https://web.archive.org/web/20200319163452/https://ourworldindata.org/grapher/total-confirmed-cases-of-covid-19-per-million-people |archive-date=19 March 2020 |url-status=live }}</ref>
| image2 =World map of total confirmed COVID-19 deaths per million people by country.svg| caption2 =Total confirmed deaths due to COVID‑19 per million people<ref>{{cite web |title=Total confirmed deaths due to COVID-19 per million people |url=https://ourworldindata.org/grapher/total-covid-deaths-per-million |website=Our World in Data |access-date=10 April 2020 |archive-url=https://web.archive.org/web/20200319163452/https://ourworldindata.org/grapher/total-covid-deaths-per-million |archive-date=19 March 2020 |url-status=live }}</ref>
}}

===Infection fatality rate===

[[Our World in Data]] states that as of March 25, 2020, the [[infection fatality rate]] (IFR) cannot be accurately calculated.<ref>{{cite web |title=What do we know about the risk of dying from COVID-19? |url=https://ourworldindata.org/covid-mortality-risk |website=Our World in Data |accessdate=23 April 2020}}</ref> In February, the World Health Organization estimated the IFR at 0.94%, with a confidence interval between 0.37 percent to 2.9 percent.<ref>{{cite web |title=Coronavirus disease 2019 (COVID-19) Situation Report—31 |url=https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200220-sitrep-31-covid-19.pdf |accessdate=23 April 2020 |date=20 February 2020}}</ref> The [[University of Oxford]] [[Centre for Evidence-Based Medicine]] (CEBM) estimated a global [[Case fatality rate|CFR]] of 0.72 percent and IFR of 0.1 percent to 0.36 percent.<ref name="cebm-global-cf">{{cite web|url=https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/|title=Global Covid-19 Case Fatality Rates|date=17 March 2020|website=[[Centre for Evidence-Based Medicine]]|url-status=dead|archive-url=|archive-date=|accessdate=10 April 2020|archivedate=18 ឧសភា 2020|archiveurl=https://web.archive.org/web/20200518190820/http://www.cebm.net/covid-19/global-covid-19-case-fatality-rates}}</ref> According to CEBM, random antibody testing in Germany suggested an IFR of 0.37% (0.12% to 0.87%) there, but there have been concerns about false positives.<ref name="cebm-global-cf"/><ref>{{cite web|url=https://towardsdatascience.com/gangelt-a-representative-study-on-the-lethality-of-covid-19-5d877dbd6e55|title=Gangelt — A representative study on the lethality of COVID-19|last=Haake|first=Daniel|date=2020-04-24|website=Medium|access-date=2020-04-27}}{{Dead link|date=តុលា 2022 |bot=InternetArchiveBot |fix-attempted=yes }}</ref><ref>{{cite web|url=https://www.sciencemag.org/news/2020/04/antibody-surveys-suggesting-vast-undercount-coronavirus-infections-may-be-unreliable|title=Antibody surveys suggesting vast undercount of coronavirus infections may be unreliable|last=VogelApr. 21|first=Gretchen|last2=2020|date=2020-04-21|website=Science {{!}} AAAS|access-date=2020-04-29|last3=Pm|first3=6:30}}</ref> Firm lower limits of infection fatality rates have been established in a number of locations. In [[New York City]], with a population of 8.4&nbsp;million, as of April 25, 16,673 (0.20% of the population) have died from COVID-19, and 20,800 (0.25% of the population) excess deaths have occurred, and in [[Bergamo]] province, where 0.57% of the population has died.<ref>{{cite web|url=https://medium.com/bccp-uc-berkeley/how-deadly-is-covid-19-data-science-offers-answers-from-italy-mortality-data-58abedf824cf|title=How deadly is COVID-19? Data Science offers answers from Italy mortality data.|last=Modi|first=Chirag|date=2020-04-21|website=Medium|access-date=2020-04-23}}</ref><ref>{{cite journal|last=Modi|first=Chirag|last2=Boehm|first2=Vanessa|last3=Ferraro|first3=Simone|last4=Stein|first4=George|last5=Seljak|first5=Uros|date=2020-04-20|title=Total COVID-19 Mortality in Italy: Excess Mortality and Age Dependence through Time-Series Analysis|url=https://www.medrxiv.org/content/10.1101/2020.04.15.20067074v2|journal=MedRxiv|pages=2020.04.15.20067074|doi=10.1101/2020.04.15.20067074|doi-access=free}}</ref><ref>{{cite news|last=Wu|first=Jin|url=https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html|title=36,000 Missing Deaths: Tracking the True Toll of the Coronavirus Crisis|date=2020-04-27|work=[[The New York Times]]|access-date=2020-04-27|url-status=live|last2=McCann|first2=Allison|issn=0362-4331|last3=Katz|first3=Josh|last4=Peltier|first4=Elian | name-list-format = vanc}}</ref> To get a better view on the number of people infected initial antibody testing have been carried out, but there are no valid scientific reports based on any of them as of yet.<ref>{{cite web|url=https://www.bloomberg.com/opinion/articles/2020-04-24/is-coronavirus-worse-than-the-flu-blood-studies-say-yes-by-far|title=The Coronavirus Isn't Just the Flu, Bro|last=|first=|date=|website=www.bloomberg.com|url-status=live|archive-url=|archive-date=|access-date=2020-04-26}}</ref><ref>{{cite web|url=https://arstechnica.com/science/2020/04/experts-demolish-studies-suggesting-covid-19-is-no-worse-than-flu/|title=Experts demolish studies suggesting COVID-19 is no worse than flu|last=Mole|first=Beth|date=2020-04-24|website=[[Ars Technica]]|access-date=2020-04-26}}</ref>

===ភាពខុសគ្នាប្រាំមួយយ៉ាង===

{{Main|Gendered impact of the COVID-19 pandemic}}

The impact of the pandemic and its mortality rate are different for men and women.<ref name="lancet">{{cite journal |last1=Wenham |first1=Clare |last2=Smith |first2=Julia |last3=Morgan |first3=Rosemary |title=COVID-19: the gendered impacts of the outbreak |journal=The Lancet |date=14 March 2020 |volume=395 |issue=10227 |pages=846–848 |doi=10.1016/S0140-6736(20)30526-2 |pmid=32151325 |pmc=7124625 |doi-access=free }}</ref> Mortality is higher in men in studies conducted in China and Italy.<ref name="chinamortality">{{cite journal |vauthors=Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L |title=Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study |journal=Lancet |volume=395 |issue=10223 |pages=507–513 |date=February 2020 |pmid=32007143 |pmc=7135076 |doi=10.1016/S0140-6736(20)30211-7 |doi-access=free }}</ref><ref>{{cite journal |last1=Team |first1=The Novel Coronavirus Pneumonia Emergency Response Epidemiology |title=The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China |journal=Chinese Journal of Epidemiology |date=17 February 2020 |volume=41 |issue=2 |pages=145–151 |doi=10.3760/cma.j.issn.0254-6450.2020.02.003 |pmid=32064853 |url=http://rs.yiigle.com/yufabiao/1181998.htm |accessdate=7 April 2020 |language=ch |issn=0254-6450 |archive-date=10 មេសា 2020 |archive-url=https://web.archive.org/web/20200410004232/http://rs.yiigle.com/yufabiao/1181998.htm |dead-url=yes }}</ref><ref name="italy">{{cite news |last1=Rabin |first1=Roni Caryn |title=In Italy, Coronavirus Takes a Higher Toll on Men |url=https://www.nytimes.com/2020/03/20/health/coronavirus-italy-men-risk.html |accessdate=7 April 2020 |work=[[The New York Times]] |date=20 March 2020 | name-list-format = vanc}}</ref> The higher risk for men appears in their 50s, and begins to taper off only at 90.<ref name = italy/> In China, the death rate was 2.8 percent for men and 1.7 percent for women.<ref name = italy/> The exact reasons for this sex-difference are not known, but genetic and behavioural factors could be a reason.<ref name="lancet"/> Sex-based immunological differences, a lower prevalence of smoking in women, and men developing co-morbid conditions such as hypertension at a younger age than women could have contributed to the higher mortality in men.<ref name = italy/> In Europe, of those infected with COVID‑19, 57% were men; of those infected with COVID‑19 who also died, 72% were men.<ref>{{cite web |title=COVID-19 weekly surveillance report |url=http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/weekly-surveillance-report |website=www.euro.who.int |accessdate=7 April 2020 |archivedate=15 មីនា 2020 |archiveurl=https://web.archive.org/web/20200315074508/http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/weekly-surveillance-report |url-status=dead }}</ref> As of April 2020, the U.S. government is not tracking sex-related data of COVID‑19 infections.<ref name="nytimesus">{{cite news |last1=Gupta |first1=Alisha Haridasani |title=Does Covid-19 Hit Women and Men Differently? U.S. Isn't Keeping Track |url=https://www.nytimes.com/2020/04/03/us/coronavirus-male-female-data-bias.html |accessdate=7 April 2020 |work=[[The New York Times]] |date=3 April 2020 | name-list-format = vanc}}</ref> Research has shown that viral illnesses like [[Ebola virus disease|Ebola]], [[HIV]], [[influenza]], and [[SARS]] affect men and women differently.<ref name="nytimesus"/> A higher percentage of health workers, particularly nurses, are women, and they have a higher chance of being exposed to the virus.<ref>{{cite web |title=Gender equity in the health workforce: Analysis of 104 countries |url=https://apps.who.int/iris/bitstream/handle/10665/311314/WHO-HIS-HWF-Gender-WP1-2019.1-eng.pdf |publisher=World Health Organization |accessdate=7 April 2020}}</ref> School closures, lockdowns, and reduced access to healthcare following the 2019–20 coronavirus pandemic may differentially affect the genders and possibly exaggerate existing gender disparity.<ref name="lancet"/><ref name="thinkglobalhealth">{{cite web |title=Gender and the Coronavirus Outbreak: Think Global Health |url=https://www.thinkglobalhealth.org/article/gender-and-coronavirus-outbreak |website=Council on Foreign Relations |accessdate=7 April 2020 }}</ref>

===Ethnic differences===

In the U.S., a greater proportion of deaths due to COVID-19 have occurred among [[African Americans]].<ref name="AVD">{{cite journal |last1=Dorn |first1=Aaron van |last2=Cooney |first2=Rebecca E |last3=Sabin |first3=Miriam L |title=COVID-19 exacerbating inequalities in the US |journal=The Lancet |date=April 2020 |volume=395 |issue=10232 |pages=1243–1244 |doi=10.1016/S0140-6736(20)30893-X|pmid=32305087 |pmc=7162639 }}</ref> Structural factors that prevent African Americans from practicing social distancing include their concentration in crowded substandard housing and "essential" occupations such as public transit employees and health-care workers. Greater prevalence of lacking [[health insurance]] and care and of underlying conditions such as [[diabetes]], [[hypertension]] and [[heart disease]] also increase their risk of death.<ref>{{cite journal |last1=Adams |first1=Mary L. |last2=Katz |first2=David L. |last3=Grandpre |first3=Joseph |title=Population-Based Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States |journal=Emerging Infectious Diseases |date=August 2020 |volume=26 |issue=8 |doi=10.3201/eid2608.200679|pmid=32324118 }}</ref> Similar issues affect [[Indigenous peoples of the Americas|Native American]] and [[Latino]] communities.<ref name="AVD" /> Leaders have called for efforts to research and address the disparities.<ref>{{cite journal |last1=Laurencin |first1=Cato T. |last2=McClinton |first2=Aneesah |title=The COVID-19 Pandemic: a Call to Action to Identify and Address Racial and Ethnic Disparities |journal=Journal of Racial and Ethnic Health Disparities |date=18 April 2020 |doi=10.1007/s40615-020-00756-0|pmid=32306369 }}</ref>

===Existing respiratory problems===

When someone with existing respiratory problems is infected with COVID-19, they are at greater risk for severe symptoms.<ref>{{cite web|title=Coronavirus Disease 2019 (COVID-19)|url=https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/groups-at-higher-risk.html|last=CDC|date=2020-02-11|website=Centers for Disease Control and Prevention|language=en-us|access-date=2020-05-04}}</ref> COVID-19 also poses a greater risk to people who misuse opioids and methamphetamines, insofar as their drug use may have caused lung damage.<ref>{{cite web|title=People who use drugs are more vulnerable to coronavirus. Here's what clinics are doing to help.|url=https://www.theadvocate.com/baton_rouge/news/coronavirus/article_f80cf77e-84fa-11ea-88d5-2b37dc9dd966.html|last=DeRobertis|first=Jacqueline|date=3 May 2020|website=The Advocate (Louisiana)|language=en|url-status=live|archive-url=|archive-date=|access-date=4 May 2020}}</ref>

==សង្គម និង វប្បធម៌==
===ឈ្មោះ===

During the initial outbreak in Wuhan, China, the virus and disease were commonly referred to as "coronavirus" and "Wuhan coronavirus",<ref>{{cite web|url=https://www.npr.org/sections/health-shots/2020/01/24/799208865/a-second-u-s-case-of-wuhan-coronavirus-is-confirmed|title=2nd U.S. Case Of Wuhan Coronavirus Confirmed|website=NPR.org|access-date=2020-04-04}}</ref><ref>{{cite news|last=Jr|first=Donald G. McNeil|url=https://www.nytimes.com/2020/02/02/health/coronavirus-pandemic-china.html|title=Wuhan Coronavirus Looks Increasingly Like a Pandemic, Experts Say|date=2020-02-02|work=[[The New York Times]]|access-date=2020-04-04|issn=0362-4331 | name-list-format = vanc}}</ref><ref>{{cite news|url=https://www.cnn.com/2020/02/05/asia/wuhan-coronavirus-update-death-toll-spike-intl-hnk/index.html|title=Wuhan coronavirus deaths spike again as outbreak shows no signs of slowing|last=Griffiths|first=James|website=CNN|access-date=2020-04-04}}</ref> with the disease sometimes called "Wuhan pneumonia".<ref>{{cite journal |last1=Jiang |first1=Shibo |last2=Xia |first2=Shuai |last3=Ying |first3=Tianlei |last4=Lu |first4=Lu |title=A novel coronavirus (2019-nCoV) causing pneumonia-associated respiratory syndrome |journal=Cellular & Molecular Immunology |date=February 2020 | volume=17 | issue=554 |page=554 |doi=10.1038/s41423-020-0372-4 |pmid=32024976 |doi-access=free }}</ref><ref>{{cite journal |vauthors=Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, Xing F, Liu J, Yip CC, Poon RW, Tsoi HW, Lo SK, Chan KH, Poon VK, Chan WM, Ip JD, Cai JP, Cheng VC, Chen H, Hui CK, Yuen KY |title=A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster |journal=Lancet |volume=395 |issue=10223 |pages=514–523 |date=February 2020 |pmid=31986261 |pmc=7159286 |doi=10.1016/S0140-6736(20)30154-9 | doi-access=free }}</ref> In the past, many diseases have been named after geographical locations, such as the [[Spanish flu]],<ref>{{cite journal |last1=Shablovsky |first1=Suzanne |title=The legacy of the Spanish flu |journal=Science |date=22 September 2017 |volume=357 |issue=6357 |page=1245 |doi=10.1126/science.aao4093 |bibcode=2017Sci...357.1245S |url=https://science.sciencemag.org/content/357/6357/1245 |issn=0036-8075}}</ref> [[Middle East Respiratory Syndrome]], and [[Zika virus]].<ref name="Nature Stop">{{cite news |title=Stop the coronavirus stigma now |url=https://www.nature.com/articles/d41586-020-01009-0 |accessdate=16 April 2020 |work=Nature |date=7 April 2020 |page=165 |doi=10.1038/d41586-020-01009-0}}</ref>

In January 2020, the [[World Health Organization|World Health Organisation]] recommended 2019-nCov<ref>{{cite web|url=https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200121-sitrep-1-2019-ncov.pdf|title=Novel Coronavirus (2019-nCoV) SITUATION REPORT—1|last=|first=|date=21 January 2020|website=WHO|url-status=live|archive-url=|archive-date=|access-date=}}</ref> and 2019-nCoV acute respiratory disease<ref>{{cite web|url=https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200130-sitrep-10-ncov.pdf|title=Novel Coronavirus(2019-nCoV) Situation Report—10|last=|first=|date=30 January 2020|website=WHO|url-status=live|archive-url=|archive-date=|access-date=}}</ref> as interim names for the virus and disease per 2015 guidance and international guidelines against using geographical locations (e.g. Wuhan, China), animal species or groups of people in disease and virus names to prevent [[social stigma]].<ref>{{cite news |title=Novel coronavirus named 'Covid-19': WHO |url=https://www.todayonline.com/world/wuhan-novel-coronavirus-named-covid-19-who |access-date=11 February 2020 |publisher=TODAYonline |name-list-format=vanc |archive-url=https://archive.today/20200321085608/https://www.todayonline.com/world/wuhan-novel-coronavirus-named-covid-19-who |archive-date=21 March 2020 |url-status=live }}</ref><ref name="veconomist">{{cite news|author= |title= The coronavirus spreads racism against—and among—ethnic Chinese|url= https://www.economist.com/china/2020/02/17/the-coronavirus-spreads-racism-against-and-among-ethnic-chinese|work= [[The Economist]]|date= 17 February 2020|access-date= 17 February 2020|archive-url= https://web.archive.org/web/20200217223902/https://www.economist.com/china/2020/02/17/the-coronavirus-spreads-racism-against-and-among-ethnic-chinese|archive-date= 17 February 2020|url-status= live| name-list-format = vanc}}</ref><ref>{{cite web|url=https://apps.who.int/iris/bitstream/handle/10665/163636/WHO_HSE_FOS_15.1_eng.pdf|title=World Health Organization Best Practices for the Naming of New Human Infectious Diseases|last=|first=|date=May 2015|website=WHO|url-status=live|archive-url=|archive-date=|access-date=}}</ref>

The official names COVID‑19 and SARS-CoV-2 were issued by the WHO on 11 February 2020.<ref name="WHO-naming">{{cite web|url=https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it|title=Naming the coronavirus disease (COVID-19) and the virus that causes it|website=[[World Health Organization]] (WHO)|access-date=13 March 2020|archive-url=https://web.archive.org/web/20200228035651/https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it|archive-date=28 February 2020|url-status=live}}</ref> WHO chief [[Tedros Adhanom]] Ghebreyesus explained: CO for ''corona'', VI for ''virus'', D{{nbsp}}for ''disease'' and 19 for when the outbreak was first identified (31 December 20''19'').<ref>{{cite news |title=Coronavirus disease 2019 (COVID-19) in the EU/EEA and the UK—eighth update |url=https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-rapid-risk-assessment-coronavirus-disease-2019-eighth-update-8-april-2020.pdf |access-date=19 April 2020 |publisher=ecdc |archive-url=https://web.archive.org/web/20200314223709/https://www.ecdc.europa.eu/sites/default/files/documents/RRA-sixth-update-Outbreak-of-novel-coronavirus-disease-2019-COVID-19.pdf |archive-date=14 March 2020 |url-status=live }}</ref> The WHO additionally uses "the COVID‑19 virus" and "the virus responsible for COVID‑19" in public communications.<ref name="WHO-naming" /> Both the disease and virus are commonly referred to as "coronavirus" in the media and public discourse.

===Misinformation===

{{main|Misinformation related to the 2019–20 coronavirus pandemic}}

After the initial [[COVID-19 pandemic|outbreak]] of COVID‑19, conspiracy theories, [[misinformation]] and [[disinformation]] emerged regarding the origin, scale, prevention, treatment and other aspects of the disease and rapidly spread online.<ref name="bbc_misinfo">{{cite news |url=https://www.bbc.com/news/blogs-trending-51271037 |title=China coronavirus: Misinformation spreads online about origin and scale |date=30 January 2020 |work=[[BBC News]] |access-date=10 February 2020 |archive-url= https://web.archive.org/web/20200204163412/https://www.bbc.com/news/blogs-trending-51271037 |archive-date=4 February 2020 |url-status=live}}</ref><ref name="GUAR">{{cite newspaper | url=https://www.theguardian.com/world/2020/jan/31/bat-soup-dodgy-cures-and-diseasology-the-spread-of-coronavirus-bunkum | title=Bat soup, dodgy cures and 'diseasology': the spread of coronavirus misinformation | date=January 31, 2020 | access-date=February 3, 2020 | first=Josh | last=Taylor | newspaper=[[The Guardian]] | archive-url=https://web.archive.org/web/20200202141231/https://www.theguardian.com/world/2020/jan/31/bat-soup-dodgy-cures-and-diseasology-the-spread-of-coronavirus-bunkum | archive-date=February 2, 2020 | url-status=live }}</ref><ref name="RunningList">{{cite web |url=https://www.buzzfeednews.com/article/janelytvynenko/coronavirus-disinformation-spread |title=Here's A Running List Of Disinformation Spreading About The Coronavirus |website=Buzzfeed News |access-date=February 8, 2020 |archive-url=https://web.archive.org/web/20200206212717/https://www.buzzfeednews.com/article/janelytvynenko/coronavirus-disinformation-spread |archive-date=February 6, 2020 |url-status=live }}</ref>

===Decreased emergency room use===

In Austria, 39% fewer persons sought help for cardiac symptoms in the month of March. A study estimated that there were 110 incidents of preventable cardiac death as compared to 86 confirmed deaths from Coronavirus as of March 29.<ref>{{cite journal |display-authors=etal|last1=Metzler | first1= Bernhard | last2=Siostrzonek |first2= Peter | last3= Binder |first3= Ronald | title=Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage |journal= European Heart Journal |date= 16 April 2020 |doi=10.1093/eurheartj/ehaa314|pmid=32297932 |pmc=7184486 }}</ref>

A preliminary study in the U.S. found 38% under-utilization of cardiac care units as compared to normal.<ref>{{cite journal |display-authors=etal|last1=Garcia | first1=Santiago | last2=Albaghdadi |first2=Mazen | last3=Meraj|first3=Perwaiz | title=PRE-PRINT: Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States during COVID-19 Pandemic |journal=Journal of the American College of Cardiology (JACC) |date= April 2020 |doi=10.1016/j.jacc.2020.04.011|pmid=32283124 |pmc=7151384 }}</ref> The head of cardiology at the University of Arizona has stated, "My worry is some of these people are dying at home because they're too scared to go to the hospital."<ref name="StatApril23">[https://www.statnews.com/2020/04/23/coronavirus-phobia-keeping-heart-patients-away-from-er/ 'Where are all our patients?': Covid phobia is keeping people with serious heart symptoms away from ERs], ''Stat News'', Usha Lee McFarling, April 23, 2020.</ref> There is also concern that persons with symptoms of stroke and appendicitis are delaying seeking help.<ref name=StatApril23/><ref>See also . . [https://www.nytimes.com/2020/04/25/health/coronavirus-heart-stroke.html Amid the Coronavirus Crisis, Heart and Stroke Patients Go Missing], ''New York Times'', Gina Kolata, April 25, 2020.</ref>

==សត្វផ្សេងៗ==

Humans appear to be capable of spreading the virus to some other animals. A domestic [[cat]] in [[Liège]], Belgium, tested positive after it started showing symptoms (diarrhoea, vomiting, shortness of breath) a week later than its owner, who was also positive.<ref>{{cite web|url=https://www.brusselstimes.com/all-news/belgium-all-news/103003/coronavirus-belgian-woman-infected-her-cat/ |title=Coronavirus: Belgian cat infected by owner |publisher=Brusselstimes.com |date=2020-03-27 |accessdate=2020-04-12}}</ref> [[Tiger]]s at the [[Bronx Zoo]] in New York, United States, tested positive for the virus and showed symptoms of COVID‑19, including a dry cough and loss of appetite.<ref>{{cite news |last=Goldstein |first=Joseph |title=Bronx Zoo Tiger Is Sick With the Coronavirus |url=https://www.nytimes.com/2020/04/06/nyregion/bronx-zoo-tiger-coronavirus.html |website=[[The New York Times]] |date=6 April 2020 |access-date=9 April 2020 | name-list-format = vanc}}</ref> [[Mink]]s at two farms in the Netherlands also tested positive for COVID-19.<ref>{{cite web|url=https://www.foxnews.com/world/mink-netherlands-coronavirus-farm |title=Coronavirus hits Netherlands farm animals as minks test positive for virus |publisher=Fox News |date= 26 April 2020|accessdate=2020-04-27}}</ref>

A study on domesticated animals inoculated with the virus found that [[cat]]s and [[ferret]]s appear to be "highly susceptible" to the disease, while [[dog]]s appear to be less susceptible, with lower levels of viral replication. The study failed to find evidence of viral replication in [[domestic pig|pigs]], [[domestic duck|ducks]], and [[chicken]]s.<ref>{{cite journal |last1=Shi |first1=Jianzhong |last2=Wen |first2=Zhiyuan |last3=Zhong |first3=Gongxun |title=Susceptibility of ferrets, cats, dogs, and other domesticated animals to SARS–coronavirus 2 |url=https://science.sciencemag.org/content/early/2020/04/07/science.abb7015 |journal=Science |date=8 April 2020 |pages=eabb7015 |doi=10.1126/science.abb7015 |doi-access=free |pmid=32269068 |pmc=7164390 |access-date=9 April 2020}}</ref>

==ការស្រាវជ្រាវ==

{{Main|COVID-19 drug development}}

No medication or vaccine is approved to treat the disease.<ref name="LiDeClerq">{{cite journal | vauthors = Li G, De Clercq E | title = Therapeutic options for the 2019 novel coronavirus (2019-nCoV) | journal = Nature Reviews. Drug Discovery | volume = 19 | issue = 3 | pages = 149–150 | date = March 2020 | pmid = 32127666 | doi = 10.1038/d41573-020-00016-0 | doi-access = free }}</ref> International research on vaccines and medicines in COVID‑19 is underway by government organisations, academic groups, and industry researchers.<ref name="dhama">{{cite journal | vauthors=Dhama K, Sharun K, Tiwari R, Dadar M, Malik YS, Singh KP, Chaicumpa W | display-authors=6 | title=COVID-19, an emerging coronavirus infection: advances and prospects in designing and developing vaccines, immunotherapeutics, and therapeutics | journal=Human Vaccines and Immunotherapeutics| date=March 2020 | issn=2164-5515 | pmid=32186952 | doi=10.1080/21645515.2020.1735227 | pages=1–7 | pmc=7103671 |doi-access=free}}</ref><ref name="zhang2020">{{cite journal | vauthors=Zhang L, Liu Y | title=Potential interventions for novel coronavirus in China: A systematic review | journal=Journal of Medical Virology | volume=92 | issue=5 | date=March 2020 | issn=0146-6615 | doi=10.1002/jmv.25707 | pages=479–90 | pmid=32052466 | pmc=7166986 }}</ref> In March, the [[World Health Organisation]] initiated the "[[Solidarity Trial|SOLIDARITY Trial]]" to assess the treatment effects of four existing antiviral compounds with the most promise of efficacy.<ref name="kai">{{cite journal|last1=Kupferschmidt|first1=Kai|last2=Cohen|first2=Jon| title=WHO launches global megatrial of the four most promising coronavirus treatments |journal=Science Magazine | date=22 March 2020 | url=https://www.sciencemag.org/news/2020/03/who-launches-global-megatrial-four-most-promising-coronavirus-treatments | access-date=27 March 2020|doi=10.1126/science.abb8497}}</ref>

There has been a great deal of COVID-19 research, involving accelerated research processes and publishing shortcuts to meet the global demand. To minimise the impact of [[Misinformation related to the 2019–20 coronavirus pandemic|misinformation]], medical professionals and the public are advised to expect rapid changes to available information, and to be attentive to [[Retractions in academic publishing|retractions]] and other updates.<ref>{{cite web|url=https://rise.articulate.com/share/soW5Pvyk3T4Ib-P4A7gS6AFqyOxsB2Eo#/|title=Navigating the COVID-19 Evidence Landscape|last=Bradley-Ridout|first=Glyneva|last2=Fuller|first2=Kaitlin|date=9 Apr 2020|website=|publisher=University of Toronto Libraries - Gerstein Science Information Centre|url-status=live|archive-url=|archive-date=|access-date=|last3=Gray|first3=Mikaela|last4=Nekolaichuk|first4=Erica}}</ref>

===វ៉ាក់សាំង===

{{main|វ៉ាក់សាំងកូវីដ-១៩}}

There is no available vaccine, but various agencies are actively developing vaccine candidates. Previous work on [[SARS-CoV]] is being used because both SARS-CoV and SARS-CoV-2 use the ACE2 receptor to enter human cells.<ref>{{cite book | vauthors=Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R | chapter=Features, Evaluation and Treatment Coronavirus (COVID-19) | title=StatPearls [Internet] | chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK554776/ |date=March 2020 | publisher=StatPearls |pmid= 32150360 | id=Bookshelf ID: NBK554776 }}</ref> Three vaccination strategies are being investigated. First, researchers aim to build a whole virus vaccine. The use of such a virus, be it [[inactivated vaccine|inactive]] or dead, aims to elicit a prompt [[immune response]] of the human body to a new infection with COVID‑19. A second strategy, subunit vaccines, aims to create a vaccine that sensitises the immune system to certain subunits of the virus. In the case of SARS-CoV-2, such research focuses on the S-spike protein that helps the virus intrude the [[ACE2 enzyme]] receptor. A third strategy is that of the nucleic acid vaccines ([[DNA vaccination|DNA]] or [[RNA vaccines]], a novel technique for creating a vaccination). Experimental vaccines from any of these strategies would have to be tested for safety and efficacy.<ref name="Chen Strych Hotez Bottazzi p.">{{cite journal | vauthors = Chen WH, Strych U, Hotez PJ, Bottazzi ME | title=The SARS-CoV-2 Vaccine Pipeline: an Overview | journal=Current Tropical Medicine Reports | date=3 March 2020 | pages=1–4 |doi=10.1007/s40475-020-00201-6 |doi-access=free | pmid=32219057 | pmc=7094941 | name-list-format = vanc}}</ref>

On 16 March 2020, the first clinical trial of a vaccine started with four volunteers in [[Seattle]], United States. The vaccine contains a harmless genetic code copied from the virus that causes the disease.<ref>{{cite news |last=Roberts |first=Michelle |name-list-format=vanc |url=https://www.bbc.com/news/health-51906604 |title=Coronavirus: US volunteers test first vaccine |date=17 March 2020 |work=BBC News |access-date=17 March 2020 |archive-url=https://web.archive.org/web/20200317034657/https://www.bbc.com/news/health-51906604 |archive-date=17 March 2020 |url-status=live }}</ref>

[[Antibody-dependent enhancement]] has been suggested as a potential challenge for vaccine development for SARS-COV-2, but this is controversial.<ref name="PNAS2020">{{cite journal |last1=Peeples |first1=Lynn |title=News Feature: Avoiding pitfalls in the pursuit of a COVID-19 vaccine |journal=Proceedings of the National Academy of Sciences of the United States of America |year=2020 |volume=117 |issue=15 |pages=8218–8221 |publisher=Proceedings of the National Academy of Sciences |doi=10.1073/pnas.2005456117 |pmid=32229574 |pmc=7165470 }}</ref>

===Medications===

{{Main|COVID-19 drug repurposing research}}

At least 29 phase II–IV efficacy trials in COVID‑19 were concluded in March 2020 or scheduled to provide results in April from hospitals in China.<ref name="milken">{{cite web |title=COVID-19 treatment and vaccine tracker |url=https://milkeninstitute.org/sites/default/files/2020-04/Covid19%20Tracker%20NEW4-21-20-2.pdf |publisher=Milken Institute |access-date=21 April 2020 |date=21 April 2020 |lay-url=https://milkeninstitute.org/covid-19-tracker }}</ref><ref name="koch">{{cite web |author1=Selina Koch |author2=Winnie Pong |title=First up for COVID-19: nearly 30 clinical readouts before end of April |url=https://www.biocentury.com/article/304658 |publisher=BioCentury Inc. |access-date=1 April 2020 |date=13 March 2020}}</ref> There are more than 300 active clinical trials underway as of April 2020.<ref name="Sanders2020"/> Seven trials were evaluating already approved treatments, including four studies on hydroxychloroquine or chloroquine.<ref name=koch/> Repurposed [[antiviral drug]]s make up most of the Chinese research, with nine phase III trials on remdesivir across several countries due to report by the end of April.<ref name=milken/><ref name=koch/> Other candidates in trials include [[vasodilator]]s, [[corticosteroid]]s, [[immunotherapy|immune therapies]], [[lipoic acid]], [[bevacizumab]], and [[recombinant DNA|recombinant]] [[angiotensin-converting enzyme 2]].<ref name=koch/>

The COVID‑19 Clinical Research Coalition has goals to 1) facilitate rapid reviews of clinical trial proposals by [[ethics committee]]s and national regulatory agencies, 2) fast-track approvals for the candidate therapeutic compounds, 3) ensure standardised and rapid analysis of emerging efficacy and safety data and 4) facilitate sharing of clinical trial outcomes before publication.<ref name="coalition">{{cite journal | title=Global coalition to accelerate COVID-19 clinical research in resource-limited settings | journal=The Lancet |author=COVID-19 Clinical Research Coalition| year=2020 | volume=395 | issue=10233 | pages=1322–1325 | issn=0140-6736 | doi=10.1016/s0140-6736(20)30798-4 | pmid=32247324 |url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30798-4/fulltext#articleInformation| doi-access=free }}</ref><ref name="maguire">{{cite journal | last=Maguire | first=Brittany J. | last2=Guérin | first2=Philippe J. | title=A living systematic review protocol for COVID-19 clinical trial registrations | journal=Wellcome Open Research | volume=5 | date=2 April 2020 | issn=2398-502X | doi=10.12688/wellcomeopenres.15821.1 | page=60| pmid=32292826 | pmc=7141164 }}</ref>

Several existing medications are being evaluated for the treatment of COVID‑19,<ref name="LiDeClerq" /> including [[remdesivir]], [[chloroquine]], [[hydroxychloroquine]], [[lopinavir/ritonavir]], and lopinavir/ritonavir combined with [[Interferon-beta|interferon beta]].<ref name=kai/><ref>{{cite web|url=https://news.un.org/en/story/2020/03/1059722|title=UN health chief announces global 'solidarity trial' to jumpstart search for COVID-19 treatment|date=18 March 2020|website=UN News|access-date=23 March 2020|archive-url=https://web.archive.org/web/20200323101633/https://news.un.org/en/story/2020/03/1059722|archive-date=23 March 2020|url-status=live}}</ref> There is tentative evidence for efficacy by remdesivir, as of March 2020.<ref>{{cite journal|vauthors=Ko WC, Rolain JM, Lee NY, Chen PL, Huang CT, Lee PI, Hsueh PR|date=March 2020|title=Arguments in favor of remdesivir for treating SARS-CoV-2 infections|journal=International Journal of Antimicrobial Agents|volume=55|issue=4|page=105933|doi=10.1016/j.ijantimicag.2020.105933|pmid=32147516|pmc=7135364|doi-access=free}}</ref><ref>{{cite web | last=Feuerstein | first=Adam | last2=Garde | first2=Damian | last3=Robbins | first3=Rebecca | title=Gilead data suggests coronavirus patients are responding to treatment | website=STAT | date=16 April 2020 | url=https://www.statnews.com/2020/04/16/early-peek-at-data-on-gilead-coronavirus-drug-suggests-patients-are-responding-to-treatment/ | access-date=16 April 2020 | name-list-format = vanc }}</ref> Clinical improvement was observed in patients treated with [[Expanded access|compassionate-use]] remdesivir.<ref>{{cite journal |vauthors=Grein J, Ohmagari N, Shin D, Diaz G, Asperges E, Castagna A, Feldt T, Green G, Green ML, Lescure FX, Nicastri E, Oda R, Yo K, Quiros-Roldan E, Studemeister A, Redinski J, Ahmed S, Bernett J, Chelliah D, Chen D, Chihara S, Cohen SH, Cunningham J, D'Arminio Monforte A, Ismail S, Kato H, Lapadula G, L'Her E, Maeno T, Majumder S, Massari M, Mora-Rillo M, Mutoh Y, Nguyen D, Verweij E, Zoufaly A, Osinusi AO, DeZure A, Zhao Y, Zhong L, Chokkalingam A, Elboudwarej E, Telep L, Timbs L, Henne I, Sellers S, Cao H, Tan SK, Winterbourne L, Desai P, Mera R, Gaggar A, Myers RP, Brainard DM, Childs R, Flanigan T | display-authors=6 |title=Compassionate Use of Remdesivir for Patients with Severe Covid-19 |journal=N. Engl. J. Med. |volume= |issue= |pages= |date=April 2020 |pmid=32275812 |doi=10.1056/NEJMoa2007016 |url=|pmc=7169476 }}</ref> Remdesivir inhibits SARS-CoV-2 ''[[in vitro]]''.<ref name="pmid32020029">{{cite journal|display-authors=6|vauthors=Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, Shi Z, Hu Z, Zhong W, Xiao G|date=February 2020 |title= Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro|journal=Cell Research |volume= 30| issue= 3|pages=269–71|doi=10.1038/s41422-020-0282-0|pmc=7054408|pmid=32020029|doi-access=free|name-list-format=vanc}}</ref> [[Phase III|Phase{{nbsp}}III clinical trial]]s are underway in the U.S., China, and Italy.<ref name="LiDeClerq" /><ref name=milken/><ref>{{cite journal |last1=Beeching |first1=Nicholas J. |last2=Fletcher |first2=Tom E. |last3=Fowler |first3=Robert |name-list-format=vanc |date=2020 |title=BMJ Best Practices: COVID-19 |url= https://bestpractice.bmj.com/topics/en-gb/3000168/pdf/3000168/COVID-19.pdf |url-status=live |journal=BMJ |access-date=11 March 2020 |archive-url=https://web.archive.org/web/20200222170544/https://bestpractice.bmj.com/topics/en-gb/3000168/pdf/3000168/COVID-19.pdf |archive-date=22 February 2020 }}</ref>

In 2020, a trial found that lopinavir/ritonavir was ineffective in the treatment of severe illness.<ref>{{cite journal | vauthors = Cao B, Wang Y, Wen D, Liu W, Wang J, Fan G, Ruan L, Song B, Cai Y, Wei M, Li X, Xia J, Chen N, Xiang J, Yu T, Bai T, Xie X, Zhang L, Li C, Yuan Y, Chen H, Li H, Huang H, Tu S, Gong F, Liu Y, Wei Y, Dong C, Zhou F, Gu X, Xu J, Liu Z, Zhang Y, Li H, Shang L, Wang K, Li K, Zhou X, Dong X, Qu Z, Lu S, Hu X, Ruan S, Luo S, Wu J, Peng L, Cheng F, Pan L, Zou J, Jia C, Wang J, Liu X, Wang S, Wu X, Ge Q, He J, Zhan H, Qiu F, Guo L, Huang C, Jaki T, Hayden FG, Horby PW, Zhang D, Wang C | display-authors = 6 | title = A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19 | journal = New England Journal of Medicine | date = March 2020 | pmid = 32187464 | doi = 10.1056/NEJMoa2001282 | pmc = 7121492 }}</ref> [[Nitazoxanide]] has been recommended for further ''[[in vivo]]'' study after demonstrating low concentration inhibition of SARS-CoV-2.<ref name="pmid32020029" />

There are mixed results as of 3 April 2020 as to the effectiveness of [[hydroxychloroquine]] as a treatment for COVID‑19, with some studies showing little or no improvement.<ref>{{cite news |last1=Seley-Radtke |first1=Katherine |title=Professor of Chemistry and Biochemistry and President-Elect of the International Society for Antiviral Research, University of Maryland, Baltimore County |url=https://theconversation.com/a-small-trial-finds-that-hydroxychloroquine-is-not-effective-for-treating-coronavirus-135484 |access-date=5 April 2020 |publisher=The Conversation |date=3 April 2020}}</ref><ref>{{cite journal|last=Molina|first=Jean Michel|last2=Delaugerre|first2=Constance|last3=Goff|first3=Jerome Le|last4=Mela-Lima|first4=Breno|last5=Ponscarme|first5=Diane|last6=Goldwirt|first6=Lauriane|last7=de Castro|first7=Nathalie|date=March 2020|title=No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the Combination of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection|url=https://linkinghub.elsevier.com/retrieve/pii/S0399077X20300858|journal=Médecine et Maladies Infectieuses|language=fr|pages=S0399077X20300858|doi=10.1016/j.medmal.2020.03.006|pmid=32240719|pmc=7195369}}</ref> The studies of chloroquine and hydroxychloroquine with or without [[azithromycin]] have major limitations that have prevented the medical community from embracing these therapies without further study.<ref name="Sanders2020"/>

[[Oseltamivir]] does not inhibit SARS-CoV-2 ''in vitro'' and has no known role in COVID‑19 treatment.<ref name="Sanders2020"/>

===Anti-cytokine storm===

[[Cytokine release syndrome]] (CRS) can be a complication in the later stages of severe COVID‑19. There is preliminary evidence that [[hydroxychloroquine]] may have anti-cytokine storm properties.<ref name="pmid32150618">{{cite journal |vauthors=Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P, Liu X, Zhao L, Dong E, Song C, Zhan S, Lu R, Li H, Tan W, Liu D |title=In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) |journal=Clin. Infect. Dis. |volume= |issue= |pages= |date=March 2020 |pmid=32150618 |doi=10.1093/cid/ciaa237 |pmc=7108130 }}</ref>

[[Tocilizumab]] has been included in treatment guidelines by China's [[National Health Commission]] after a small study was completed.<ref name="tocil-1">{{cite news|last1=Liu|first1=Roxanne|last2=Miller|first2=Josh|name-list-format=vanc|url=https://www.reuters.com/article/us-health-coronavirus-china-roche-hldg/china-approves-use-of-roche-arthritis-drug-for-coronavirus-patients-idUSKBN20R0LF|title=China approves use of Roche drug in battle against coronavirus complications|date=3 March 2020|work=[[Reuters]]|access-date=14 March 2020|archive-url=https://web.archive.org/web/20200312204625/https://www.reuters.com/article/us-health-coronavirus-china-roche-hldg/china-approves-use-of-roche-arthritis-drug-for-coronavirus-patients-idUSKBN20R0LF|archive-date=12 March 2020|url-status=live}}</ref><ref name="tocil-2">{{cite document |date=5 March 2020 |title=Effective Treatment of Severe COVID-19 Patients with Tocilizumab |url=http://chinaxiv.org/abs/202003.00026 |publisher=ChinaXiv.org |doi=10.12074/202003.00026|doi-broken-date=2020-04-26 |access-date=14 March 2020|journal=|archive-url=https://web.archive.org/web/20200319022047/http://chinaxiv.org/abs/202003.00026|archive-date=19 March 2020|url-status=live}}</ref> It is undergoing a [[Phase IIb|phase{{nbsp}}2]] non-randomised trial at the national level in Italy after showing positive results in people with severe disease.<ref>{{cite web |last1=Ovadia |first1=Daniela |last2=Agenzia |first2=Zoe |title=COVID-19—Italy launches an independent trial on tocilizumab |url=https://www.univadis.co.uk/viewarticle/covid-19-italy-launches-an-independent-trial-on-tocilizumab-715741 |website=Univadis from Medscape |publisher=Aptus Health |accessdate=22 April 2020}}</ref><ref>{{cite web |title=Tocilizumab in COVID-19 Pneumonia (TOCIVID-19) (TOCIVID-19) |url=https://clinicaltrials.gov/ct2/show/NCT04317092 |website=www.clinicaltrials.gov |publisher=National Library of Medicine |accessdate=22 April 2020}}</ref> Combined with a [[Ferritin|serum ferritin blood test]] to identify [[Cytokine release syndrome|cytokine storms]], it is meant to counter such developments, which are thought to be the cause of death in some affected people.<ref name="tocil-5">{{cite web|url=https://www.vox.com/2020/3/12/21176783/coronavirus-covid-19-deaths-china-treatment-cytokine-storm-syndrome|title=How doctors can potentially significantly reduce the number of deaths from Covid-19|publisher=[[Vox (website)|Vox]]|access-date=14 March 2020|date=12 March 2020|archive-url=https://web.archive.org/web/20200319155218/https://www.vox.com/2020/3/12/21176783/coronavirus-covid-19-deaths-china-treatment-cytokine-storm-syndrome|archive-date=19 March 2020|url-status=live}}</ref><ref name="tocil-6">{{cite journal | vauthors = Ruan Q, Yang K, Wang W, Jiang L, Song J | title = Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China | journal = Intensive Care Medicine | date = March 2020 | pmid = 32125452 | doi = 10.1007/s00134-020-05991-x | pmc = 7080116 }}</ref><ref name="tocil-8">{{cite journal |vauthors=Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ |title=COVID-19: consider cytokine storm syndromes and immunosuppression |journal=Lancet |volume=395 |issue=10229 |pages=1033–1034 |date=March 2020 |pmid=32192578 |doi=10.1016/S0140-6736(20)30628-0 |doi-access=free }}</ref> The [[Interleukin 6|interleukin-6]] [[receptor antagonist]] was approved by the [[Food and Drug Administration|FDA]] to undergo a phase III clinical trial assessing the medication's impact on COVID‑19 based on retrospective case studies for the treatment of steroid-refractory cytokine release syndrome induced by a different cause, [[Chimeric antigen receptor T cell|CAR T cell]] [[Gene therapy|therapy]], in 2017.<ref name="CancerNetworkTocilizumabTrial">{{cite web |last1=Slater |first1=Hannah |title=FDA Approves Phase III Clinical Trial of Tocilizumab for COVID-19 Pneumonia |url=https://www.cancernetwork.com/news/fda-approves-phase-iii-clinical-trial-tocilizumab-covid-19-pneumonia |website=www.cancernetwork.com |date=26 March 2020 |publisher=Cancer Network |accessdate=22 April 2020 |archivedate=17 មិថុនា 2020 |archiveurl=https://web.archive.org/web/20200617025935/https://www.cancernetwork.com/news/fda-approves-phase-iii-clinical-trial-tocilizumab-covid-19-pneumonia |url-status=dead }}</ref> To date, there is no randomised, controlled evidence that tocilizumab is an efficacious treatment for CRS. Prophylactic tocilizumab has been shown to increase serum IL-6 levels by saturating the IL-6R, driving IL-6 across the [[blood-brain barrier]], and exacerbating neurotoxicity while having no impact on the incidence of CRS.<ref>{{cite journal | vauthors = Locke FL, Neelapu SS, Bartlett NL, Lekakis LJ, Jacobson CA, Braunschweig I, Oluwole OO, Siddiqi T, Lin Y, Timmerman JM, Reagan PM, Bot A, Rossi JM, Sherman M, Navale L, Jiang Y, Aycock JS, Elias M, Wiezorek JS, Go WY, Miklos DB | display-authors = 6 | title = Preliminary Results of Prophylactic Tocilizumab after Axicabtageneciloleucel (axi-cel; KTE-C19) Treatment for Patients with Refractory,Aggressive Non-Hodgkin Lymphoma (NHL) | journal = Blood | date = 2017 | volume = 130 | issue = Supplement 1 | page = 1547 | doi = 10.1182/blood.V130.Suppl_1.1547.1547 | doi-broken-date = 2020-04-11 | url = https://ashpublications.org/blood/article/130/Supplement%201/1547/79746}}</ref>

[[Lenzilumab]], an anti-GM-CSF [[monoclonal antibody]], is protective in murine models for CAR T cell-induced CRS and neurotoxicity and is a viable therapeutic option due to the observed increase of pathogenic GM-CSF secreting T-cells in hospitalised patients with COVID‑19.<ref>{{cite journal | vauthors = Sterner RM, Sakemura R, Cox MJ, Yang N, Khadka RH, Forsman CL, Hansen MJ, Jin F, Ayasoufi K, Hefazi M, Schick KJ, Walters DK, Ahmed O, Chappell D, Sahmoud T, Durrant C, Nevala WK, Patnaik MM, Pease LR, Hedin KE, Kay NE, Johnson AJ, Kenderian SS | display-authors = 6 | title = GM-CSF inhibition reduces cytokine release syndrome and neuroinflammation but enhances CAR-T cell function in xenografts. | journal = Blood. | date = 2019 | pmid = 30463995 | doi = 10.1182/blood-2018-10-881722 | volume = 133 | issue = 7 | pmc = 6376281 | pages = 697–709}}</ref>

The [[Feinstein Institute for Medical Research|Feinstein Institute]] of [[Northwell Health]] announced in March a study on "a human antibody that may prevent the activity" of IL-6.<ref>{{cite news|url=https://www.longislandpress.com/2020/03/21/northwell-health-initiates-clinical-trials-of-2-covid-19-drugs/|title=Northwell Health Initiates Clinical Trials of 2 COVID-19 Drugs|date=21 March 2020|access-date=23 March 2020|archive-url=https://web.archive.org/web/20200323081238/https://www.longislandpress.com/2020/03/21/northwell-health-initiates-clinical-trials-of-2-covid-19-drugs/|archive-date=23 March 2020|url-status=live}}</ref>

===Passive antibodies===

Transferring purified and concentrated [[Immunoglobulin therapy|antibodies]] produced by the [[immune system]]s of those who have recovered from COVID‑19 to people who need them is being investigated as a non-vaccine method of [[Passive immunity|passive immunisation]].<ref name="pmid-32167489">{{cite journal | vauthors = Casadevall A, Pirofski LA | title = The convalescent sera option for containing COVID-19 | journal = The Journal of Clinical Investigation | date = March 2020 | volume = 130 | issue = 4 | pages = 1545–1548 | pmid = 32167489 | doi = 10.1172/JCI138003 | pmc = 7108922 }}</ref> This strategy was tried for SARS with inconclusive results.<ref name="pmid-32167489" /> [[Neutralisation (immunology)|Viral neutralisation]] is the anticipated [[mechanism of action]] by which passive antibody therapy can mediate defence against SARS-CoV-2. Other mechanisms, however, such as [[antibody-dependent cellular cytotoxicity]] and/or [[phagocytosis]], may be possible.<ref name="pmid-32167489" /> Other forms of passive antibody therapy, for example, using manufactured monoclonal antibodies, are in development.<ref name="pmid-32167489" /> Production of [[convalescent serum]], which consists of the liquid portion of the blood from recovered patients and contains antibodies specific to this virus, could be increased for quicker deployment.<ref name="Pearce-2020-03-13">{{cite web |last=Pearce |first=Katie |name-list-format=vanc |date=13 March 2020 |title=Antibodies from COVID-19 survivors could be used to treat patients, protect those at risk: Infusions of antibody-laden blood have been used with reported success in prior outbreaks, including the SARS epidemic and the 1918 flu pandemic |work=The Hub at Johns Hopkins University |url=https://hub.jhu.edu/2020/03/13/covid-19-antibody-sera-arturo-casadevall/ |access-date=14 March 2020 |archive-url=https://web.archive.org/web/20200314185825/https://hub.jhu.edu/2020/03/13/covid-19-antibody-sera-arturo-casadevall/ |archive-date=14 March 2020 |url-status=live }}</ref>

==សូមមើលផង==
* [[Coronavirus disease]]s, a group of closely related syndromes
* [[Coronavirus recession]]
* [[Disease X]], a WHO term
* [[Li Wenliang]], a doctor at Central Hospital of Wuhan who died of COVID-19 after raising awareness of its spread
* [[List of unproven methods against COVID-19]]
{{Portalbar | border=n | Coronavirus disease 2019 | Medicine | Viruses}}

==កំណត់==
{{notelist}}

==ឯកសារយោង==
{{reflist}}

==External links==
{{Sister project links|wikt=COVID-19|c=category:COVID-19|n=category:COVID-19|q=COVID-19|s=category:COVID-19|voy=2019–2020 coronavirus pandemic|v=COVID-19|b=no}}
{{Scholia|topic}}

===Health agencies===
* [https://www.who.int/emergencies/diseases/novel-coronavirus-2019 Coronavirus disease (COVID-19)] by the [[World Health Organization]]
* [https://www.cdc.gov/coronavirus/2019-ncov/index.html Coronavirus 2019 (COVID-19)] by the [[Centers for Disease Control and Prevention|U.S. Centers for Disease Control and Prevention]]

===Directories===
* {{Curlie|Health/Conditions_and_Diseases/Respiratory_Disorders/COVID-19|COVID-19}}
* [https://openmd.com/directory/covid-19 COVID-19 Resource Directory on OpenMD]

===Medical journals===
* [https://jamanetwork.com/journals/jama/pages/coronavirus-alert Coronavirus Disease 2019 (COVID-19)] by ''[[JAMA (journal)|JAMA]]''
* [https://www.bmj.com/coronavirus Coronavirus: News and Resources] by the [[BMJ (company)|BMJ Publishing Group]]
* [https://www.elsevier.com/connect/coronavirus-information-center Novel Coronavirus Information Center] by [[Elsevier]]
* [https://www.thelancet.com/coronavirus COVID-19 Resource Centre] by ''[[The Lancet]]''
* [https://www.springernature.com/gp/researchers/campaigns/coronavirus SARS-CoV-2 and COVID-19] by ''[[Nature (journal)|Nature]]''
* [https://www.nejm.org/coronavirus Coronavirus (Covid-19)] by ''[[The New England Journal of Medicine]]''
* [https://novel-coronavirus.onlinelibrary.wiley.com/ Covid-19: Novel Coronavirus] {{Webarchive|url=https://web.archive.org/web/20200924195411/https://novel-coronavirus.onlinelibrary.wiley.com/ |date=24 កញ្ញា 2020 }} by [[Wiley (publisher)|Wiley Publishing]]

{{medical resources| ICD10 = {{ICD10|U07.1}}, {{ICD10|U07.2}}}}
{{Respiratory pathology}}
{{Viral diseases}}
{{COVID-19 pandemic}}
{{Authority control}}

[[Category:COVID-19| ]]
[[Category:Occupational safety and health]]
[[Category:Viral respiratory tract infections]]
[[Category:Zoonoses]]
[[ចំណាត់ថ្នាក់ក្រុម:ជំងឺបង្ករោគ]]