If I get sick with coronavirus (COVID-19), what will it be like?
First off, remember that the majority of people sick with coronavirus do absolutely fine. Early data suggests that 80% of people will have mild to very mild symptoms of (maybe) fever, cough, sore throat. Less common are symptoms of runny nose, sneezing, or even diarrhea. We also know that we need to worry more about patients who are older, or who have other underlying medical conditions (obesity, diabetes, high blood pressure, chronic lung disease or those who are immunocompromised). See graph below for common symptoms.
The incubation period averages 4-5 days (maximum of 12 days), meaning it takes this long from exposure to the virus to developing symptoms. Unfortunately we also know that people are quite contagious for 2-3 days BEFORE they develop symptoms, and this fact is driving the current emphasis on “sheltering in place”, so we can try to limit spread of this virus to others.
The majority of people will have a short, typical, “viral syndrome”, with a few days of mild to moderate symptoms as described above. We think that after 72 hour of no fever, including significant improvement in breathing symptoms (eg: cough, shortness of breath) AND 7 days after symptom onset, the patient is no longer contagious.
However, a group of patients will go on to develop more severe symptoms characterized by fever, cough, and eventual shortness of breath. If it is going to develop, this shortness of breath starts at about day 6-7 of illness. Roughly 15% of patients will feel poorly enough to need to be hospitalized for supplemental oxygen, with a with a range of 7 to 14 days from symptom onset to the need for hospitalization.. Even fewer (~25% of admitted patients, or ~5% of all patients) will need to be admitted to the intensive care unit with ~50% put on a ventilator (breathing machine) to support their breathing. Unfortunately, if you are sick enough to be admitted to the hospital, there is a significant mortality rate. Even more so if you need to be have a breathing tube inserted and to be put on a ventilator in the ICU.
Again, these more severe outcomes are unlikely for the majority of us, but not trivial for our older loved ones or those with chronic medical conditions. There is good reason to take this seriously. #stayhomesavelives (March 21, 2020)
If you are more visual learner, this is an excellent review of COVID-19 illness.