FAQs

Find answers to frequently asked questions about COVID-19, including how the virus is spread, risk factors for severe disease, and information on new monoclonal antibody treatments.

Coronavirus and COVID-19 are not the same thing, but sometimes these terms are used interchangeably. Coronaviruses are a family of viruses that have crown-like spikes on their surface. The scientific name for the new coronavirus that emerged from China in December 2019 is SARS-CoV-2, which stands for severe acute respiratory syndrome coronavirus 2.

COVID-19 is the disease caused by the new SARS-CoV-2 virus and stands for coronavirus disease 2019.

Fever, aches, and a cough are symptoms commonly found in patients with either COVID-19 or the flu. Both diseases can range in severity from mild to severe and may lead to the development of pneumonia. Although both viruses may be fatal, COVID-19 is associated with a significantly higher mortality rate than the flu. Estimates vary, but approximately 1% to 3% of people with COVID-19 will die from the disease.

There are several reasons why the coronavirus is more dangerous than the flu:

  • Coronavirus is twice as contagious as the flu. Research indicates that a person with the flu infects an average of 1.28 other people. However, a person with coronavirus can infect between 2 to 3 other people.
  • Coronavirus has a longer incubation period. The incubation period is the time between exposure to the virus and the onset of symptoms. People with coronavirus might not have symptoms for up to 14 days, and some may not develop symptoms at all. People with the flu usually develop symptoms within 2 days of infection. Since coronavirus has a significantly longer incubation period, infected individuals may unknowingly spread the virus for a longer period of time.
  • There is an effective vaccine available for the flu. There is no vaccine available for COVID-19, but development and testing are in progress.

Based on currently available information, people aged 65 years and older and people of any age with serious underlying medical conditions may be at higher risk of severe illness from COVID-19. Preexisting medical conditions that increase the risk of serious illness include:

  • Chronic lung disease or moderate-to-severe asthma
  • Cardiovascular disease, hypertension (high blood pressure), and serious heart conditions
  • Diabetes
  • Liver disease
  • Cancer
  • Chronic kidney disease and dialysis
  • Severe obesity (body mass index [BMI] of 40 or more)
  • Immunosuppression (bone marrow or organ transplantation, immune deficiencies, autoimmune diseases, poorly controlled HIV or AIDS, or long-term use of corticosteroids)

People who are at high risk of serious illness with COVID-19 should practice good hand hygiene and social distancing to minimize their chance of contracting the new coronavirus.

The new coronavirus is spread through respiratory droplets released into the air when an infected person coughs, sneezes, or talks. These droplets generally do not travel more than a few feet before falling to the ground. If you are in close proximity to someone who is infected, you may inhale the virus.

Coronavirus can also be transmitted from objects and surfaces that are contaminated with the virus. Studies suggest that the virus can live on surfaces for a few hours or up to several days, depending on the surface and environmental factors. A small amount of virus can be found on plastic for up to 3 days, on stainless steel for up to 2 days, and for up to one day on cardboard. It is important to practice good hand hygiene to minimize the risk of infection. It is recommended that you wash your hands for 20 seconds with soap and water or use an alcohol-based hand sanitizer that contains at least 60% alcohol to prevent the spread of the virus.

Symptoms could appear as soon as 2 days or as late as 14 days after exposure to the virus. The median time for symptoms to develop is about 5 days. If you believe you have been exposed to the new coronavirus, it is important to quarantine for 14 days to prevent the spread of the virus to others.

It is estimated that on average people with COVID-19 first develop symptoms approximately 5 days after exposure to the virus. However, symptoms may develop between 2 and 14 days after exposure. One study found that people with COVID-19 were contagious approximately 2 to 3 days before symptom onset and were most infectious the day before symptoms appeared.

People infected with the new coronavirus can be contagious without symptoms. It is estimated that up to 50% of people infected with coronavirus remain asymptomatic. However, these people are still contagious. One study found that people with no symptoms were the source of 44% of diagnosed COVID-19 cases.

A serologic test is a blood test that identifies antibodies against SARS-CoV-2, the virus that causes COVID-19. Antibodies are proteins created by your immune system to fight infections. Since it takes your body 5 to 10 days to produce enough antibodies to be detected in a test, serologic tests cannot be used to diagnose an active COVID-19 infection, even in patients with severe disease.

Serologic tests can be used to identify people who have been infected with the new coronavirus during the course of the pandemic. However, since the coronavirus that causes COVID-19 is new, there is still much we do not know about it. Scientists are working to determine if antibodies against SARS-CoV-2 provide protection against future infections by this virus. If antibodies do provide immunity, we do not know what amount, or titer, of antibodies would provide protection or for how long this protection would last.

There are currently no approved agents for the treatment or prevention of COVID-19.

In late April, the FDA issued a warning against the use of the anti-malarial medications hydroxychloroquine and chloroquine in patients not enrolled in clinical trials. Several studies have shown that these medications do not decrease the risk of death from COVID-19 and may increase the risk of life-threatening heart rhythms.

One clinical trial found that patients with COVID-19 who received remdesivir, an antiviral drug, recovered faster than patients who received a placebo. Several other drugs are also under investigation for the management of COVID-19. However, it may take up to a year before any drugs for the treatment of COVID-19 are available to the general public. Clinical trials must be performed to ensure that new medications are safe and effective and to determine what the proper dosage should be.

Use the Monoclonal Antibody Eligibility Tool to find out if you or someone you know are a candidate for this treatment.

Some doctors in France advise people against using ibuprofen (i.e., Advil®, Motrin®) to manage the symptoms of COVID-19. There were several reports of healthy patients with COVID-19 who were taking ibuprofen and developed severe disease, particularly pneumonia. However, there were no scientific studies to support this advice.

The World Health Organization (WHO) initially recommended using acetaminophen (i.e., Tylenol®) instead of ibuprofen to reduce the fever, aches, and pains related to coronavirus infection. However, the WHO now states that either acetaminophen or ibuprofen can be used. It is important to make sure that you do not exceed the maximum daily dose of 3,000 milligrams of acetaminophen per day.

References

Centers for Disease Control and Prevention. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19). Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html

He X, Lau EHY, Wu P, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nature Med. 2020;26:675.

Geleris J, Sun Y, Platt J, et al. Observational study of hydroxychloroquine in hospitalized patients with COVID-19. N Engl J Med. 2020;May 7: Epub ahead of print.

Infectious Disease Society of America (IDSA). IDSA COVID-19 Antibody Testing Primer. Available at https://www.idsociety.org/globalassets/idsa/public-health/covid-19/idsa-covid-19-antibody-testing-primer.pdf

National Institutes of Health (NIH). NIH clinical trial shows remdesivir accelerates recovery from advanced COVID-19. Available at www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19

Silva Borba MG, Almeida Val FF, Souza Sampaio V, et al. Effect of high vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Infection: a randomized clinical trial. JAMA Netw Open. 2020;3:e208857.

World Health Organization (WHO). The use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with COVID-19. Available at https://www.who.int/news-room/commentaries/detail/the-use-of-non-steroidal-anti-inflammatory-drugs-(nsaids)-in-patients-with-covid-19

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Patient Toolkit

The COVID FRONTLINE Patient Toolkit is a resource center for patients who have been diagnosed with or who are interested in learning about COVID-19. Choose from the options below to learn more.

This activity is provided by Med Learning Group. This activity is co-provided by Ultimate Medical Academy/CCM.
This activity is supported by educational grants from AbbVie, Astellas, Genentech, Lilly, Merck & Co., Inc., Pfizer and Regeneron Pharmaceuticals, Inc.

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Updates in the Treatment and Prevention of COVID-19​

Subcutaneous Administration of Casirivimab and Imdevimab Reduced the Risk of Symptomatic COVID-19 by 81% Among Household Contacts

Top-line results from a phase 3 trial showed that the combination of casirivimab and imdevimab reduced the risk of symptomatic infections by 81% among household contacts of SARS-CoV-2 infected individuals. The trial enrolled 1,505 individuals who did not have COVID-19 symptoms or anti-SARS-CoV-2 antibodies, but who lived in the same household as an individual who tested positive for SARS-CoV-2 within the prior 4 days. A single subcutaneous injection of casirivimab and imdevimab provided rapid protection to those with exposure to SARS-CoV-2 at home, with protection against symptomatic infections ranging from 72% in the first week to 93% in subsequent weeks. Individuals who developed symptomatic infections despite casirivimab and imdevimab therapy had a shorter duration of symptoms compared with those who received placebo (1 week vs 3 weeks, respectively). Infected individuals who received therapy also cleared the virus faster. Adverse events (AEs) occurred in 20% of patients receiving casirivimab and imdevimab and 29% of patients receiving placebo. Injection site reactions, all of which were grades 1-2, occurred in 4% of patients in the treatment group and 2% of placebo participants.

Casirivimab and Imdevimab Significantly Reduced Progression to Symptomatic COVID-19 in Recently Infected Asymptomatic Patients

In a phase 3 trial of 204 recently infected asymptomatic COVID-19 patients, subcutaneous administration of casirivimab and imdevimab reduced the overall risk of progressing to symptomatic COVID-19 by 31%, and by 76% after the third day. In addition to reducing the risk of symptomatic infections, the top-line results report that the combination of casirivimab and imdevimab shortened the total number of weeks patients experienced symptoms by 45% and reduced the viral burden by more than 90%. No patients withdrew from the trial due to AEs in either group. Casirivimab and imdevimab are investigational drugs with emergency use authorization for the treatment of individuals with mild-to-moderate COVID-19 who are at high-risk of progressing to severe COVID-19 or hospitalization. Casirivimab and imdevimab (REGEN-COV™) continues to be evaluated in clinical trials in multiple settings for COVID-19, including the open-label RECOVERY trial of hospitalized patients in the UK.

Johnson & Johnson COVID-19 Vaccine Administration Paused

The Centers for Disease Control and Prevention (CDC) and the Federal Drug Administration (FDA) are recommending a pause in the use of the Ad26.COV2.S vaccine developed by Johnson & Johnson (Janssen) as they review data involving 6 reported cases of a rare and severe type of blood clot in individuals after vaccination. The vaccine has been administered to more than 6.8 million individuals in the US. In all 6 reported cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) occurred in combination with low platelet levels (thrombocytopenia). Treatment of CVST differs from other blood clots and administration of heparin may be dangerous in these patients. All 6 cases occurred among women aged 18 to 48 years and symptoms usually occurred 6 to 13 days after vaccination. People who develop severe headache, abdominal pain, leg pain, or shortness of breath within 3 weeks after vaccination should contact their healthcare provider.

References:

Regeneron Press Release. Phase 3 Prevention Trial Showed 81% Reduced Risk of Symptomatic SARS-CoV-2 Infections with Subcutaneous Administration of REGEN-COV™ (Casirivimab and Imdevimab). April 12, 2021. Available at: https://investor.regeneron.com/news-releases/news-release-details/phase-3-prevention-trial-showed-81-reduced-risk-symptomatic-sars

Regeneron Press Release. Phase 3 Treatment Trial in Recently Infected Asymptomatic Patients Showed REGEN-COV™ (Casirivimab and Imdevimab) Significantly Reduced Progression to Symptomatic COVID-19. April 12, 2021. Available at: https://investor.regeneron.com/news-releases/news-release-details/phase-3-treatment-trial-recently-infected-asymptomatic-patients

FDA Statement. Joint CDC and FDA Statement on Johnson & Johnson COVID-19 Vaccine. April 13, 2021. Available at: https://www.fda.gov/news-events/press-announcements/joint-cdc-and-fda-statement-johnson-johnson-covid-19-vaccine