SARS-CoV-2 and COVID-19: A Brief Review for Family Physicians

SARS-CoV-2, the newest coronavirus, causes COVID-19, a disease that runs the gamut of symptoms from none too mild to severe to death. The severe cases are most often due to acute respiratory distress. In addition to pulmonary symptoms, the virus causes a wide variety of pathological manifestations involving multiple other systems, including eliciting an exaggerated immune response that contributes to fatalities. The elderly are at the highest risk of severe disease. Higher mortality is seen among males, along with individuals with pre-existing comorbidities such as cardiovascular disease and diabetes, among others. Although pregnancy has not been identified as a risk factor yet, more research is needed to assess vertical transmission and strict perinatal precautions are recommended to minimize infecting newborns. Although COVID-19 in children is less likely to be severe, recent cases, albeit rare, have emerged of a multiorgan inflammatory syndrome, similar to Kawasaki disease. Early diagnosis can be done using molecular tests that detect viral genome, while cases manifesting late symptoms can be detected using serological tests looking for antibodies. Although there are no FDA-approved vaccines or therapeutics for prophylaxis, there are many viable vaccine candidates either in clinical trials or awaiting study in humans. Of the several drugs being considered for treatment, some target the virus, while others address the host factors that facilitate virus infection, from proteases that enable virus entry, to cytokines that elicit a harmful and out-of-control immune response. While we await a standardized prophylactic regimen, it is our collective responsibility to continue engaging in prevention measures.