Disease Severity and Progression

Disease Severity and Progression

Disease Severity

It is unclear what proportion of infected individuals remain asymptomatic


  • Dry cough
  • Fever (may be prolonged (7+ days) and intermittent)
  • Myalgia
  • Headache
  • Dyspnea
  • Sore throat
  • Diarrhea
  • Nausea/vomiting

Less Common

  • Loss of smell or taste
  • Abdominal pain
  • Rhinorrhea
  • Conjunctivitis

Pneumonia may or may not be present

  • Dyspnea
  • Hypoxia
  • >50% lung involvement on imaging

Acute respiratory distress syndrome (ARDS), septic shock, multiple organ dysfunction

Disease Progression and Predictive Features

Chest imaging often shows consolidation, ground-glass opacities, or bilateral infiltrates

Progression to ARDS occurs late in the disease course at a median of 8 days after symptom onset

Clinical and laboratory features associated with severe illness:

  • Older age
  • Comorbidities: cardiovascular disease, diabetes mellitus, hypertension, chronic lung disease, cancer (particularly hematologic malignancies, lung cancer, and metastatic disease), chronic kidney disease, obesity, and smoking
  • Lymphocytopenia, elevated D-dimer, elevated liver enzymes, elevated LDH, elevated CRP level, elevated ferritin, elevated PT, elevated troponin, elevated CK level, acute kidney injury

Children may have more mild presentations than adults. Severe illness seems uncommon amongst children