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| Boilerpipe Text | This article is about the disease itself. For the virus that caused the disease, see
SARS-CoV-2
. For the global pandemic caused by the disease, see
COVID-19 pandemic
. For other diseases caused by coronaviruses, see
Coronavirus diseases
.
Coronavirus disease 2019
(COVID-19)
Other names
COVID, (the) coronavirus
Transmission and life-cycle of
SARS-CoV-2
, which causes COVID-19
Pronunciation
[
1
]
Specialty
Infectious disease
Symptoms
Fever, cough, fatigue, shortness of breath, vomiting, loss of taste or smell; some cases asymptomatic
[
2
]
[
3
]
Complications
Pneumonia
,
sepsis
,
ARDS
,
kidney failure
,
respiratory failure
,
pulmonary fibrosis
,
CKS
,
MIS-C
,
long COVID
,
brain damage
Usual onset
2–14 days (typically 5)
after infection
Duration
5 days to
chronic
Causes
SARS-CoV-2
Diagnostic method
RT‑PCR testing
,
CT scan
,
rapid antigen test
Prevention
Vaccination
, face coverings,
quarantine
,
social distancing
, ventilation, hand washing
Treatment
Symptomatic and supportive
Frequency
779,056,637
[
4
]
confirmed cases (true case count is expected to be much higher
[
5
]
)
Deaths
7,111,504
[
4
]
(reported)
18.2–33.5 million
[
6
]
(estimated)
Coronavirus disease 2019
(
COVID-19
) is a
contagious disease
caused by the
coronavirus
SARS-CoV-2
. Starting in January 2020, the disease spread worldwide, resulting in the
COVID-19 pandemic
. In March 2020, the
World Health Organization
declared COVID-19 a
global health emergency
; they declared the end of the emergency in May 2023.
[
7
]
The
symptoms of COVID‑19
can vary but often include fever,
[
8
]
fatigue, cough,
breathing difficulties
,
loss of smell
, and
loss of taste
.
[
9
]
[
10
]
[
11
]
Symptoms may begin one to 14 days
after exposure
to the virus. At least a third of people who are infected
do not develop noticeable symptoms
.
[
12
]
[
13
]
Of those who develop symptoms noticeable enough to be classified as patients, most (81%) develop mild to moderate symptoms (up to mild
pneumonia
), while 14% develop severe symptoms (
dyspnea
,
hypoxia
, or more than 50% lung involvement on imaging), and 5% develop critical symptoms (
respiratory failure
,
shock
, or
multiorgan dysfunction
).
[
14
]
Older people have a higher risk of developing severe symptoms and dying. Some people experience persistent symptoms (
long COVID
), for months or years after infection, including
fatigue
, cognitive issues and
shortness of breath
. Damage to organs has been observed in a subset.
[
15
]
COVID‑19 transmission
occurs when infectious particles are breathed in or come into contact with the eyes, nose, or mouth. The risk is highest when people are in close proximity, but small
airborne
particles containing the virus can remain suspended in the air and travel over longer distances, particularly indoors. Transmission can also occur when people touch their eyes, nose, or mouth after touching surfaces or objects that have been contaminated by the virus. People remain contagious for up to 20 days and can spread the virus even if they do not develop symptoms.
[
16
]
There are two common
tests to detect COVID
. Antigen tests (also called
rapid lateral flow tests
) can be used at home. A positive test indicates an active infection. However, negative tests are not accurate, especially early or late in the infection. Health care providers can perform a more accurate
PCR test
, which is typically analysed in a laboratory.
[
17
]
[
18
]
Several
COVID-19 vaccines
have been approved and distributed in various countries, many of which have initiated
mass vaccination campaigns
. Other
preventive measures
include physical or
social distancing
,
quarantining
, ventilation of indoor spaces,
use of face masks or coverings
in public, covering coughs and sneezes,
hand washing
, and keeping unwashed hands away from the face. While
drugs have been developed
to inhibit the virus, the primary
treatment
is still
symptomatic
, managing the disease through
supportive care
,
isolation
, and
experimental measures
.
The first known case was
identified in Wuhan
, China, in December 2019.
[
19
]
Most scientists believe that the SARS-CoV-2 virus entered into human populations through natural
zoonosis
, similar to the
SARS-CoV-1
and
MERS-CoV
outbreaks, and consistent with other pandemics in human history.
[
20
]
[
21
]
Social and environmental factors including
climate change
,
natural ecosystem destruction
and
wildlife trade
increased the likelihood of such zoonotic spillover.
[
22
]
[
23
]
[
24
]
[
25
]
Nomenclature
During the initial outbreak in
Wuhan
, the virus was commonly called "coronavirus" and "Wuhan coronavirus",
[
26
]
[
27
]
[
28
]
and the disease was referred to by the same terms and sometimes as "Wuhan pneumonia".
[
29
]
[
30
]
In the past, many diseases have been named after geographical locations, such as the
Spanish flu
,
[
31
]
Middle East respiratory syndrome
, and
Zika virus
.
[
32
]
In January 2020, the
World Health Organization
(WHO) recommended 2019-nCoV
[
33
]
and 2019-nCoV acute respiratory disease
[
34
]
as interim names for the virus and disease per 2015 guidance and international guidelines against using geographical locations or groups of people in disease and virus names to prevent
social stigma
.
[
35
]
[
36
]
[
37
]
The official names COVID‑19 and SARS-CoV-2 were issued by the WHO on 11 February 2020 with COVID-19 being shorthand for "coronavirus disease 2019".
[
38
]
[
39
]
The WHO additionally uses "the COVID‑19 virus" and "the virus responsible for COVID‑19" in public communications.
[
38
]
[
40
]
Signs and symptoms
Symptoms
of COVID-19
The
symptoms of COVID-19
are variable depending on the
type of variant
contracted, ranging from mild
symptoms
to a potentially fatal illness.
[
41
]
[
42
]
Common symptoms include
coughing
,
fever
,
loss of smell
and
taste
, with less common ones including
headaches
,
nasal congestion
and
runny nose
,
muscle pain
,
sore throat
,
diarrhea
,
eye irritation
,
[
43
]
and toes swelling or turning purple,
[
44
]
and in moderate to severe cases,
breathing difficulties
.
[
45
]
People with the COVID-19 infection may have different symptoms, and their symptoms may change over time.
Three common clusters of symptoms have been identified: a respiratory symptom cluster with cough,
sputum
,
shortness of breath
, and fever; a musculoskeletal symptom cluster with
muscle
and joint pain, headache, and fatigue; and a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhea.
[
45
]
In people without prior ear, nose, or throat disorders,
loss of taste
combined with
loss of smell
is associated with COVID-19 and is reported in as many as 88% of symptomatic cases.
[
46
]
[
47
]
[
48
]
Of those who show symptoms, 81% develop only mild to moderate symptoms (up to mild
pneumonia
), while 14% develop severe symptoms (
dyspnea
,
hypoxia
, or more than 50% lung involvement on imaging) that require hospitalization, and 5% of patients develop critical symptoms (
respiratory failure
, septic
shock
, or
multiorgan dysfunction
) requiring ICU admission. As of 2024–2025, the majority of infections are characterized as mild or asymptomatic; however, risk remains stratified by age and underlying health conditions, with severe outcomes—including respiratory failure and multi-organ dysfunction—occurring in a significantly smaller percentage of the general vaccinated population than in early 2020.
[
49
]
[
50
]
[
51
]
[
52
]
Proportion of asymptomatic SARS-CoV-2 infection by age. About 44% of those infected with SARS-CoV-2 remained asymptomatic throughout the infection.
[
53
]
At least a third of the people who are infected with the virus do not develop noticeable symptoms at any point in time.
[
53
]
[
54
]
[
55
]
These
asymptomatic
carriers tend not to get tested and can still spread the disease.
[
55
]
[
56
]
[
57
]
[
58
]
Other infected people will develop symptoms later (called "pre-symptomatic") or have very mild symptoms and can also spread the virus.
[
58
]
As is common with infections, there is a delay, or
incubation period
, between the moment a person first becomes infected and the appearance of the first symptoms. The
median
delay for COVID-19 is four to five days
[
59
]
possibly being infectious on 1–4 of those days.
[
60
]
Most symptomatic people experience symptoms within two to seven days after exposure, and almost all will experience at least one symptom within 12 days.
[
59
]
[
61
]
Most people recover from the
acute
phase of the disease. However, some people continue to experience a range of effects, such as
fatigue
, for prolonged periods after an initial COVID-19 infection.
[
62
]
This is the result of a condition called
long COVID
, which can be described as a range of persistent symptoms that continue for months or years.
[
62
]
Long-term damage to organs has been observed after the onset of COVID-19. Multi-year studies are underway to further investigate the protracted effects of long COVID.
[
62
]
Reducing the risk of long COVID includes staying up to date on the most recent COVID-19 vaccine, practicing good hygiene, maintaining clean indoor air, and physical distancing from people infected with a respiratory virus.
[
62
]
The
Omicron variant
became dominant in the U.S. in December 2021. Symptoms with the Omicron variant are less severe than they are with other variants.
[
63
]
Complications
Mechanisms of SARS-CoV-2
cytokine storm
and complications
Complications may include
pneumonia
,
acute respiratory distress syndrome
(ARDS),
multi-organ failure
,
septic shock
, and death.
[
64
]
[
65
]
[
66
]
[
67
]
Cardiovascular complications may include heart failure,
arrhythmias
(including
atrial fibrillation
),
heart inflammation
,
thrombosis
, particularly
venous thromboembolism
,
[
68
]
[
69
]
[
70
]
[
71
]
[
72
]
[
73
]
and endothelial cell injury and dysfunction.
[
74
]
Approximately 20–30% of people who present with COVID‑19 have
elevated liver enzymes
, reflecting liver injury.
[
75
]
[
76
]
Neurologic manifestations include
seizure
, stroke,
encephalitis
, and
Guillain–Barré syndrome
(which includes
loss of motor functions
).
[
77
]
[
78
]
Following the infection, children may develop
paediatric multisystem inflammatory syndrome
, which has symptoms similar to
Kawasaki disease
, which can be fatal.
[
79
]
[
80
]
In very rare cases, acute
encephalopathy
can occur, and it can be considered in those who have been diagnosed with COVID‑19 and have an altered mental status.
[
81
]
According to the US
Centers for Disease Control and Prevention
, pregnant women are at increased risk of becoming seriously ill from COVID‑19.
[
82
]
This is because pregnant women with COVID‑19 appear to be more likely to develop respiratory and obstetric complications that can lead to
miscarriage
,
premature delivery
and
intrauterine growth restriction
.
[
82
]
Fungal infections such as
aspergillosis
,
candidiasis
,
cryptococcosis
and
mucormycosis
have been recorded in people recovering from COVID‑19.
[
83
]
[
84
]
Cause
COVID‑19 is caused by infection with a
strain
of
coronavirus
known as "severe acute respiratory syndrome coronavirus 2" (
SARS-CoV-2
).
[
85
]
Transmission
Transmission
of COVID‑19
COVID-19 is mainly transmitted from person to person through inhaling air contaminated by
droplets
/
aerosols
and small
airborne
particles containing the virus. Infected people exhale those particles as they breathe, talk, cough, sneeze, or sing.
[
86
]
[
87
]
[
88
]
[
89
]
Transmission is most likely at closer range but can also occur over longer distances, particularly indoors.
[
86
]
[
90
]
The virus spreads through virus-laden fluid particles, or droplets, which are created in the respiratory tract, and they are expelled by the mouth and the nose. There are three types of transmission: "droplet" and "contact", which are associated with large droplets, and "airborne", which is associated with small droplets.
[
91
]
If the droplets are above a certain critical size, they settle faster than they
evaporate
, and therefore they
contaminate
surfaces surrounding them.
[
91
]
Droplets that are below a certain critical size, generally thought to be <100μm diameter, evaporate faster than they settle; due to that fact, they form respiratory aerosol particles that remain airborne for a long period of time over extensive distances.
[
91
]
[
86
]
Infectivity
can begin four to five days before the onset of symptoms.
[
92
]
Infected people can spread the disease even if they are pre-symptomatic or
asymptomatic
.
[
93
]
Most commonly, the peak viral load in
upper respiratory tract
samples occurs close to the time of symptom onset and declines after the first week after symptoms begin.
[
93
]
Current evidence suggests a duration of viral shedding and the period of infectiousness of up to ten days following symptom onset for people with mild to moderate COVID-19, and up to 20 days for persons with severe COVID-19, including immunocompromised people.
[
94
]
[
93
]
Infectious particles range in size from
aerosols
that remain suspended in the air for long periods of time to larger
droplets
that remain airborne briefly or fall to the ground.
[
95
]
[
96
]
[
97
]
[
98
]
Additionally, COVID-19 research has redefined the traditional understanding of how respiratory viruses are transmitted.
[
98
]
[
99
]
The largest droplets of respiratory fluid do not travel far, but can be inhaled or land on mucous membranes on the eyes, nose, or mouth to infect.
[
97
]
Aerosols are highest in concentration when people are in close proximity, which leads to easier viral transmission when people are physically close,
[
97
]
[
98
]
[
99
]
but
airborne transmission
can occur at longer distances, mainly in locations that are poorly ventilated;
[
97
]
in those conditions small particles can remain suspended in the air for minutes to hours.
[
97
]
[
100
]
Virology
Illustration of
SARSr-CoV
virion
Severe acute respiratory syndrome coronavirus
2 (SARS-CoV-2) is a
novel
severe acute respiratory syndrome coronavirus. It was first isolated from three people with pneumonia connected to the
cluster
of acute respiratory illness cases in Wuhan.
[
101
]
All structural features of the novel SARS-CoV-2 virus particle occur in related
coronaviruses
in nature,
[
102
]
particularly in
Rhinolophus sinicus
(Chinese horseshoe bats).
[
103
]
Outside the human body, the virus is destroyed by household soap which bursts its
protective bubble
.
[
104
]
Hospital disinfectants, alcohols, heat,
povidone-iodine
, and
ultraviolet
-C (UV-C) irradiation are also effective disinfection methods for surfaces.
[
105
]
SARS-CoV-2 is closely related to the original
SARS-CoV
.
[
106
]
It is thought to have an animal (
zoonotic
) origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus
Betacoronavirus
, in subgenus
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
).
[
107
]
[
108
]
[
109
]
The structural proteins of SARS-CoV-2 include
membrane glycoprotein
(M),
envelope protein
(E),
nucleocapsid protein
(N), and the
spike protein
(S). The M protein of SARS-CoV-2 is about 98% similar to the M protein of bat SARS-CoV, maintains around 98% homology with pangolin SARS-CoV, and has 90% homology with the M protein of SARS-CoV; whereas, the similarity is only around 38% with the M protein of
MERS-CoV
.
[
110
]
SARS-CoV-2 variants
The many thousands of SARS-CoV-2 variants are grouped into either
clades
or
lineages
.
[
111
]
[
112
]
The WHO, in collaboration with partners, expert networks, national authorities, institutions and researchers, have established nomenclature systems for naming and tracking SARS-CoV-2 genetic lineages by
GISAID
,
Nextstrain
and
Pango
. The expert group convened by the WHO recommended the labelling of variants using letters of the
Greek alphabet
, for example,
Alpha
,
Beta
,
Delta
, and
Gamma
, giving the justification that they "will be easier and more practical to discussed by non-scientific audiences".
[
113
]
Nextstrain divides the variants into five clades (19A, 19B, 20A, 20B, and 20C), while GISAID divides them into seven (L, O, V, S, G, GH, and GR).
[
114
]
The Pango tool groups variants into lineages, with many circulating lineages being classed under the B.1 lineage.
[
112
]
[
115
]
Several notable variants of SARS-CoV-2 emerged throughout 2020.
[
116
]
[
117
]
Cluster 5
emerged among
minks
and mink farmers in
Denmark
.
[
118
]
After
strict quarantines
and the
slaughter of all the country's mink
, the cluster was assessed to no longer be circulating among humans in Denmark as of 1 February 2021.
[
119
]
As of December 2021
, there are five dominant variants of SARS-CoV-2 spreading among global populations: the
Alpha variant
(B.1.1.7, formerly called the UK variant), first found in London and Kent, the
Beta variant
(B.1.351, formerly called the South Africa variant), the
Gamma variant
(P.1, formerly called the Brazil variant), the
Delta variant
(B.1.617.2, formerly called the India variant),
[
120
]
and the
Omicron variant
(B.1.1.529), which had spread to 57 countries as of 7 December.
[
121
]
[
122
]
On 19 December 2023, the WHO declared that another distinctive variant, JN.1, had emerged as a "variant of interest". Though the WHO expected an increase in cases globally, particularly for countries entering winter, the overall global health risk was considered low.
[
123
]
[
124
]
Pathophysiology
COVID‑19
pathogenesis
The SARS-CoV-2 virus can infect a wide range of cells and systems of the body. COVID‑19 is most known for affecting the upper respiratory tract (sinuses, nose, and throat) and the lower respiratory tract (windpipe and lungs).
[
125
]
The lungs are the organs most affected by COVID‑19 because the virus accesses host cells via the
receptor
for the enzyme
angiotensin-converting enzyme 2
(ACE2), which is most abundant on the surface of
type II alveolar cells
of the lungs.
[
126
]
The virus uses a special surface glycoprotein called a "
spike
" to connect to the ACE2 receptor and enter the host cell.
[
127
]
Respiratory tract
Following viral entry, COVID‑19 infects the ciliated epithelium of the nasopharynx and upper airways.
[
128
]
Autopsies of people who died of COVID‑19 have found
diffuse alveolar damage
, and lymphocyte-containing inflammatory infiltrates within the lung.
[
129
]
From the
CT scans
of COVID-19 infected lungs, white patches were observed containing fluid known as
ground-glass opacity
(GGO) or simply ground glass.
[
130
]
This tended to correlate with the clear jelly liquid found in lung autopsies of people who died of COVID-19. One possibility addressed in medical research is that
hyuralonic acid
(HA) could be the leading factor for this observation of the clear jelly liquid found in the lungs, in what could be hyuralonic storm, in conjunction with
cytokine storm
.
[
131
]
Nervous system
One common symptom, loss of smell, results from
infection of the support cells of the olfactory epithelium
, with subsequent damage to the
olfactory neurons
.
[
132
]
The involvement of both the central and peripheral nervous system in COVID‑19 has been reported in many medical publications.
[
133
]
It is clear that many people with
COVID-19 exhibit neurological or mental health issues
. The virus is not detected in the
central nervous system
(CNS) of the majority of people with COVID-19 who also have
neurological issues
. However, SARS-CoV-2 has been detected at low levels in the brains of those who have died from COVID‑19, but these results need to be confirmed.
[
134
]
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.
[
135
]
[
136
]
[
137
]
The virus may also enter the bloodstream from the lungs and cross the blood–brain barrier to gain access to the CNS, possibly within an infected white blood cell.
[
134
]
Tropism
and
multiple organ injuries
in SARS-CoV-2 infection
Research conducted when Alpha was the dominant variant has suggested COVID-19 may cause brain damage.
[
138
]
Later research showed that all variants studied (including Omicron) killed brain cells, but the exact cells killed varied by variant.
[
139
]
It is unknown if such damage is temporary or permanent.
[
140
]
[
141
]
Observed individuals infected with COVID-19 (most with mild cases) experienced an additional 0.2% to 2% of brain tissue lost in regions of the brain connected to the sense of smell compared with uninfected individuals, and the overall effect on the brain was equivalent on average to at least one extra year of normal ageing; infected individuals also scored lower on several cognitive tests. All effects were more pronounced among older ages.
[
142
]
Gastrointestinal tract
The virus also affects gastrointestinal organs as ACE2 is abundantly expressed in the
glandular
cells of
gastric
,
duodenal
and
rectal
epithelium
[
143
]
as well as
endothelial
cells and
enterocytes
of the
small intestine
.
[
144
]
Cardiovascular system
The virus can cause
acute myocardial injury
and chronic damage to the
cardiovascular system
.
[
145
]
[
146
]
An acute cardiac injury was found in 12% of infected people admitted to the hospital in Wuhan, China,
[
147
]
and is more frequent in severe disease.
[
148
]
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.
[
146
]
ACE2 receptors are highly expressed in the heart and are involved in heart function.
[
146
]
[
149
]
A high incidence of
thrombosis
and
venous thromboembolism
occurs in people transferred to
intensive care units
with COVID‑19 infections, and may be related to poor prognosis.
[
150
]
Blood vessel dysfunction and clot formation (as suggested by high
D-dimer
levels caused by blood clots) may have a significant role in mortality, incidents of clots leading to
pulmonary embolisms
, and
ischaemic events
(strokes) within the brain found as complications leading to death in people infected with COVID‑19.
[
151
]
Infection may initiate a chain of
vasoconstrictive responses
within the body, including pulmonary vasoconstriction – a possible mechanism in which oxygenation decreases during pneumonia.
[
151
]
Furthermore, damage of
arterioles
and
capillaries
was found in brain tissue samples of people who died from COVID‑19.
[
152
]
[
153
]
COVID‑19 may also cause substantial structural changes to
blood cells
, sometimes persisting for months after hospital discharge.
[
154
]
A low level of blood lymphocytess
may result from the virus acting through ACE2-related entry into lymphocytes.
[
155
]
Kidneys
Another common cause of death is complications related to the
kidneys
.
[
151
]
Early reports show that up to 30% of people hospitalised with COVID-19 both in China and in New York have experienced some injury to their kidneys, including some persons with no previous kidney problems.
[
156
]
Immunopathology
Key components of the
adaptive immune response
to SARS-CoV-2
Although SARS-CoV-2 has a tropism for ACE2-expressing epithelial cells of the respiratory tract, people with severe COVID‑19 have symptoms of systemic hyperinflammation. Clinical laboratory findings of elevated
IL‑2
,
IL‑6
,
IL‑7
, as well as the following suggest an underlying immunopathology:
[
147
]
Granulocyte-macrophage colony-stimulating factor
(GM‑CSF)
Interferon gamma-induced protein
10
(IP‑10)
Monocyte chemoattractant protein
1
(MCP1)
Macrophage inflammatory protein 1‑alpha
(MIP‑1‑alpha)
Tumour necrosis factor
(TNF‑α) indicative of
cytokine release syndrome
(CRS)
Interferon alpha
plays a complex, Janus-faced role in the pathogenesis of COVID-19. Although it promotes the elimination of virus-infected cells, it also upregulates the expression of ACE-2, thereby facilitating the SARS-Cov2 virus to enter cells and to replicate.
[
157
]
[
158
]
A competition of negative feedback loops (via protective effects of interferon alpha) and positive feedback loops (via upregulation of ACE-2) is assumed to determine the fate of people with COVID-19.
[
159
]
[
needs update
]
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
.
[
160
]
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 people with COVID‑19.
[
161
]
Lymphocytic infiltrates have also been reported at autopsy.
[
129
]
Viral and host factors
Virus proteins
The association between SARS-CoV-2 and the
Renin-Angiotensin-Aldosterone System
(RAAS)
Multiple viral and host factors affect the pathogenesis of the virus. The
S-protein
, otherwise known as the spike protein, is the viral component that attaches to the host receptor via the
ACE2
receptors. It includes two subunits: S1 and S2.
S1 determines the virus-host range and cellular tropism via the receptor-binding domain.
S2 mediates the membrane fusion of the virus to its potential cell host via the H1 and HR2, which are
heptad repeat
regions.
Studies have shown that S1 domain induced
IgG
and
IgA
antibody levels at a much higher capacity. It is the focus spike proteins expression that are involved in many effective COVID‑19 vaccines.
[
162
]
The M protein is the viral protein responsible for the transmembrane transport of nutrients. It is the cause of the bud release and the formation of the viral envelope.
[
163
]
The N and E protein are accessory proteins that interfere with the host's immune response.
[
163
]
Host factors
Human
angiotensin converting enzyme 2
(hACE2) is the host factor that SARS-CoV-2 virus targets causing COVID‑19. Theoretically, the usage of
angiotensin receptor blockers
(ARB) and
ACE inhibitors
upregulating ACE2 expression might increase
morbidity
with COVID‑19, though animal data suggest some potential protective effect of ARB; however no clinical studies have proven susceptibility or outcomes. Until further data is available, guidelines and recommendations for people with hypertension remain.
[
164
]
The effect of the virus on ACE2 cell surfaces leads to leukocytic infiltration, increased blood vessel permeability, alveolar wall permeability, as well as decreased secretion of lung surfactants. These effects cause the majority of the respiratory symptoms. However, the aggravation of local inflammation causes a cytokine storm eventually leading to a
systemic inflammatory response syndrome
.
[
165
]
Among healthy adults not exposed to SARS-CoV-2, about 35% have
CD4
+
T cells
that recognise the SARS-CoV-2
S protein
(particularly the S2 subunit) and about 50% react to other proteins of the virus, suggesting
cross-reactivity
from previous
common colds
caused by other coronaviruses.
[
166
]
It is unknown whether different persons use similar antibody genes in response to COVID‑19.
[
167
]
Host cytokine response
Mild versus severe
immune response
during
virus infection
The severity of the inflammation can be attributed to the severity of what is known as the
cytokine storm
.
[
168
]
Levels of
interleukin
1B
,
interferon-gamma
, interferon-inducible protein 10, and monocyte chemoattractant protein
1 were all associated with COVID‑19 disease severity. Treatment has been proposed to combat the cytokine storm as it remains to be one of the leading causes of
morbidity
and mortality in COVID‑19 disease.
[
169
]
A cytokine storm is due to an acute hyperinflammatory response that is responsible for clinical illness in an array of diseases but in COVID‑19, it is related to worse prognosis and increased fatality. The storm causes acute respiratory distress syndrome, blood clotting events such as strokes,
myocardial infarction
,
encephalitis
,
acute kidney injury
, and
vasculitis
. The production of
IL-1
,
IL-2
,
IL-6
,
TNF-alpha
, and
interferon-gamma
, all crucial components of normal immune responses, inadvertently become the causes of a cytokine storm. The cells of the
central nervous system
, the
microglia
,
neurons
, and
astrocytes
, are also involved in the release of
pro-inflammatory cytokines
affecting the nervous system, and effects of cytokine storms toward the CNS are not uncommon.
[
170
]
Pregnancy response
There are many unknowns for pregnant women during the COVID-19 pandemic. Given that they are prone to have complications and severe disease infection with other types of coronaviruses, they have been identified as a vulnerable group and advised to take supplementary preventive measures.
[
171
]
Physiological responses to pregnancy can include:
Immunological: The immunological response to COVID-19, like other viruses, depends on a working immune system. It adapts during pregnancy to allow the development of the foetus whose genetic load is only partially shared with their mother, leading to a different immunological reaction to infections during the course of pregnancy.
[
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]
Respiratory: Many factors can make pregnant women more vulnerable to hard respiratory infections. One of them is the total reduction of the lungs' capacity and inability to clear secretions.
[
171
]
Coagulation: During pregnancy, there are higher levels of circulating coagulation factors, and the pathogenesis of SARS-CoV-2 infection can be implicated. The thromboembolic events with associated mortality are a risk for pregnant women.
[
171
]
However, from the evidence base, it is difficult to conclude whether pregnant women are at increased risk of grave consequences of this virus.
[
171
]
In addition to the above, other clinical studies have proved that SARS-CoV-2 can affect the period of pregnancy in different ways. On the one hand, there is little evidence of its impact up to 12 weeks gestation. On the other hand, COVID-19 infection may cause increased rates of unfavourable outcomes in the course of the pregnancy. Some examples of these could be foetal growth restriction, preterm birth, and perinatal mortality, which refers to the foetal death past 22 or 28 completed weeks of pregnancy as well as the death among live-born children up to seven completed days of life.
[
171
]
For preterm birth, a 2023 review indicates that there appears to be a correlation with COVID-19.
[
172
]
Unvaccinated women in later stages of pregnancy with COVID-19 are more likely than other people to need very intensive care. Babies born to mothers with COVID-19 are more likely to have breathing problems. Pregnant women are strongly encouraged to get
vaccinated
.
[
173
]
Diagnosis
COVID‑19 can provisionally be diagnosed on the basis of symptoms and confirmed using
reverse transcription polymerase chain reaction
(RT-PCR) or other
nucleic acid testing
of infected secretions.
[
174
]
[
175
]
Along with laboratory testing, chest CT scans may be helpful to diagnose COVID‑19 in individuals with a high clinical suspicion of infection.
[
176
]
Detection of a past infection is possible with
serological tests
, which detect
antibodies
produced by the body in response to the infection.
[
174
]
Viral testing
Demonstration of a
nasopharyngeal swab
for
COVID‑19 testing
The standard methods of testing for presence of SARS-CoV-2 are
nucleic acid tests
,
[
174
]
[
177
]
which detects the presence of viral RNA fragments.
[
178
]
As these tests detect RNA but not infectious virus, its "ability to determine duration of infectivity of patients is limited".
[
179
]
The test is typically done on respiratory samples obtained by a
nasopharyngeal swab
; however, a nasal swab or sputum sample may also be used.
[
180
]
[
181
]
Results are generally available within hours.
[
174
]
The WHO has published several testing protocols for the disease.
[
182
]
Several laboratories and companies have developed serological tests, which detect antibodies produced by the body in response to infection. Some have been evaluated by
Public Health England
and approved for use in the UK.
[
183
]
The
University of Oxford
's CEBM has pointed to mounting evidence
[
184
]
[
185
]
that "a good proportion of 'new' mild cases and people re-testing positives after quarantine or discharge from hospital are not infectious, but are simply clearing harmless virus particles which their immune system has efficiently dealt with" and have called for "an international effort to standardize and periodically calibrate testing"
[
186
]
In September 2020, the UK government issued "guidance for procedures to be implemented in laboratories to provide assurance of positive SARS-CoV-2 RNA results during periods of low prevalence, when there is a reduction in the predictive value of positive test results".
[
187
]
Imaging
A
CT
scan of a person with COVID-19 shows lesions (bright regions) in the lungs
CT scan of rapid progression stage of COVID-19
Chest X-ray showing COVID‑19 pneumonia
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.
[
176
]
[
188
]
Bilateral multilobar
ground-glass opacities
with a peripheral, asymmetric, and posterior distribution are common in early infection.
[
176
]
[
189
]
Subpleural dominance,
crazy paving
(lobular septal thickening with variable alveolar filling), and
consolidation
may appear as the disease progresses.
[
176
]
[
190
]
Characteristic imaging features on chest
radiographs
and
computed tomography
(CT) of people who are symptomatic include asymmetric peripheral ground-glass opacities without
pleural effusions
.
[
191
]
Many groups have created
COVID‑19 datasets
that include imagery such as the
Italian Radiological Society
which has compiled an international online database of imaging findings for confirmed cases.
[
192
]
Due to overlap with other infections such as
adenovirus
, imaging without confirmation by rRT-PCR is of limited
specificity
in identifying COVID‑19.
[
191
]
A large study in China compared chest CT results to PCR and demonstrated that though imaging is less specific for the infection, it is faster and more
sensitive
.
[
175
]
Coding
In late 2019, the WHO assigned emergency
ICD-10
disease codes 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.
[
193
]
Pathology
The main pathological findings at autopsy are:
Macroscopy
:
pericarditis
,
lung consolidation
and
pulmonary oedema
[
129
]
Lung findings:
Minor serous
exudation
, minor
fibrin
exudation
[
129
]
Pulmonary oedema,
pneumocyte
hyperplasia
, large atypical
pneumocytes
, interstitial
inflammation
with
lymphocytic
infiltration
and
multinucleated giant cell
formation
[
129
]
Diffuse alveolar damage
(DAD) with diffuse
alveolar
exudates
. DAD is the cause of
acute respiratory distress syndrome
(ARDS) and severe
hypoxaemia
.
[
129
]
Organisation
of
exudates
in
alveolar cavities
and
pulmonary interstitial fibrosis
[
129
]
Plasmocytosis
in
bronchoalveolar lavage
(BAL)
[
194
]
Blood and vessels:
disseminated intravascular coagulation
(DIC);
[
195
]
leukoerythroblastic
reaction,
[
196
]
endotheliitis
,
[
197
]
hemophagocytosis
[
197
]
Heart:
cardiac muscle cell
necrosis
[
197
]
Liver: microvesicular
steatosis
[
129
]
Nose:
shedding of olfactory epithelium
[
132
]
Brain:
infarction
[
197
]
Kidneys: acute tubular damage.
[
197
]
Spleen:
white pulp
depletion.
[
197
]
Prevention
Without pandemic containment measures – such as social distancing, vaccination, and face masks – pathogens can spread exponentially.
[
198
]
This graphic shows how early adoption of containment measures tends to protect wider swaths of the population.
Preventive measures to reduce the chances of infection include getting vaccinated, staying at home, wearing a mask in public, avoiding crowded places, keeping distance from others, ventilating indoor spaces, managing potential exposure durations,
[
199
]
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.
[
200
]
[
201
]
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.
[
202
]
[
203
]
The first
COVID‑19 vaccine
was granted regulatory approval on 2
December 2020 by the UK medicines regulator
MHRA
.
[
204
]
It was evaluated for
emergency use authorisation
(EUA) status by the US
FDA
, and in several other countries.
[
205
]
Initially, the US
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 the setting of a clinical trial.
[
206
]
[
76
]
Without a vaccine, other prophylactic measures, or effective treatments, a key part of managing COVID‑19 is trying to decrease and delay the epidemic peak, known as "flattening the
curve
".
[
207
]
This is done by slowing the infection rate to decrease the risk of health services being overwhelmed, allowing for better treatment of active cases, and delaying additional cases until effective treatments or a vaccine become available.
[
207
]
[
208
]
Vaccine
Different vaccine candidate types in development for SARS-CoV-2
Death rates for unvaccinated Americans substantially exceeded those who were vaccinated, with bivalent boosters further reducing the death rate.
[
209
]
Major vaccines include the
Pfizer–BioNTech mRNA vaccine
,
Moderna mRNA vaccine
, and the
Novavax protein subunit vaccine
.
[
210
]
With the emergence of new
SARS-CoV-2 variants
, the original vaccines—particularly
Pfizer
–
BioNTech
and
Moderna
vaccines—have been updated. These "variant-adapted" vaccines are offered as
booster doses
.
[
210
]
The immunity from the vaccines also wanes over time, requiring people to get boosters to maintain protection.
[
211
]
Common side effects of COVID‑19 vaccines include soreness, fatigue, headache,
myalgia
(muscle pain), and
arthralgia
(joint pain), which resolve without medical treatment within a few days.
[
212
]
COVID‑19 vaccination is safe for people who are pregnant or are breastfeeding.
[
213
]
The COVID‑19 vaccines are widely credited for their role in reducing the spread of COVID‑19 and reducing the severity and death caused by COVID‑19.
[
211
]
[
214
]
Many countries implemented phased distribution plans that prioritized those at highest risk of complications, such as the elderly, and those at high risk of exposure, such as
healthcare workers
.
[
215
]
[
216
]
By December 2020, more than 10 billion vaccine doses had been preordered,
[
217
]
with about half of the doses purchased by
high-income countries
comprising 14% of the world's population.
[
218
]
As of August 2024
, over 13
billion doses of COVID‑19 vaccines have been administered worldwide.
[
219
]
Face masks and respiratory hygiene
Masks with an exhalation valve. The valves are a weak point that can transmit the viruses outwards.
In community and healthcare settings, the use of face masks is intended as
source control
to limit
transmission
of the virus and for personal protection to prevent infection.
[
220
]
Properly worn masks both limit the
respiratory droplets
and
aerosols
spread by infected individuals and help protect healthy individuals from infection.
[
221
]
[
222
]
Reviews of various kinds of scientific studies have concluded that masking is effective in protecting the individual against COVID-19.
[
221
]
[
223
]
[
224
]
Various
case-control
and population-based studies have also shown that increased levels of masking in a community reduces the spread of SARS-CoV-2,
[
223
]
[
224
]
though there is a paucity of evidence from
randomized controlled trials
(RCTs).
[
225
]
[
226
]
Masks vary in how well they work. Fitted
N95s
outperform surgical masks,
[
227
]
[
228
]
while cloth masks provide marginal protection.
[
229
]
[
230
]
During the public health emergency, governments widely recommended and mandated mask-wearing, and prominent national and intergovernmental health agencies and their leaders recommended the use of masks to reduce transmission, including the
WHO
,
American
,
European
, and
Chinese
Centers for Disease Control and Prevention.
Indoor ventilation and avoiding crowded indoor spaces
The CDC states that avoiding crowded indoor spaces reduces the risk of COVID-19 infection.
[
231
]
When indoors, increasing the rate of air change, decreasing recirculation of air and increasing the use of outdoor air can reduce transmission.
[
231
]
[
232
]
The WHO recommends
ventilation
and
air filtration
in public spaces to help clear out infectious aerosols.
[
233
]
[
234
]
[
235
]
Exhaled respiratory particles can build-up within enclosed spaces with inadequate
ventilation
. The risk of COVID‑19 infection increases especially in spaces where people engage in physical exertion or raise their voice (e.g., exercising, shouting, singing) as this increases exhalation of respiratory droplets. Prolonged exposure to these conditions, typically more than 15 minutes, leads to higher risk of infection.
[
231
]
Displacement ventilation
with large natural inlets can move stale air directly to the exhaust in
laminar flow
while significantly reducing the concentration of droplets and particles.
Passive ventilation
reduces energy consumption and maintenance costs but may lack
controllability
and
heat recovery
. Displacement ventilation can also be achieved mechanically with higher energy and maintenance costs. The use of large ducts and openings helps to prevent mixing in closed environments. Recirculation and mixing should be avoided because recirculation prevents dilution of harmful particles and redistributes possibly contaminated air, and mixing increases the concentration and range of infectious particles and keeps larger particles in the air.
[
236
]
Hand-washing and hygiene
Students in
Rwanda
hand washing and wearing face masks during the
COVID‑19 pandemic in the country
Thorough hand hygiene after any cough or sneeze is required.
[
237
]
The WHO 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.
[
238
]
When soap and water are not available, the CDC recommends using an alcohol-based
hand sanitiser
with at least 60% alcohol.
[
239
]
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
.
[
240
]
Social distancing (also known as physical distancing) includes
infection control
actions intended to slow the spread of the disease by minimising close contact between individuals. Methods include quarantines; travel restrictions; and the closing of schools, workplaces, stadiums, theatres, or shopping centres. Individuals may apply social distancing methods by staying at home, limiting travel, avoiding crowded areas, using no-contact greetings, and physically distancing themselves from others.
[
241
]
In 2020, outbreaks occurred in prisons due to crowding and an inability to enforce adequate social distancing.
[
242
]
[
243
]
In the United States, the prisoner population is ageing 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.
[
242
]
Surface cleaning
After being expelled from the body, coronaviruses can survive on surfaces for hours to days. If a person touches the dirty surface, they may deposit the virus at the eyes, nose, or mouth where it can enter the body and cause infection.
[
244
]
Evidence indicates that contact with infected surfaces is not the main driver of COVID‑19,
[
245
]
[
246
]
[
247
]
leading to recommendations for optimised disinfection procedures to avoid issues such as the increase of
antimicrobial resistance
through the use of inappropriate cleaning products and processes.
[
248
]
[
249
]
Deep cleaning
and other surface sanitation has been criticised as
hygiene theatre
, giving a false sense of security against something primarily spread through the air.
[
250
]
[
251
]
The amount of time that the virus can survive depends significantly on the type of surface, the temperature, and the humidity.
[
252
]
Coronaviruses die very quickly when exposed to the
UV light
in
sunlight
.
[
252
]
Like other enveloped viruses, SARS-CoV-2 survives longest when the temperature is at
room temperature
or lower, and when the
relative humidity
is low (<50%).
[
252
]
On many surfaces, including glass, some types of plastic, stainless steel, and skin, the virus can remain infective for several days indoors at room temperature, or even about a week under ideal conditions.
[
252
]
[
253
]
On some surfaces, including cotton fabric and copper, the virus usually dies after a few hours.
[
252
]
The virus dies faster on porous surfaces than on non-porous surfaces due to capillary action within pores and faster aerosol droplet evaporation.
[
254
]
[
247
]
[
252
]
However, of the many surfaces tested, two with the longest survival times are N95 respirator masks and surgical masks, both of which are considered porous surfaces.
[
252
]
The CDC says that in most situations, cleaning surfaces with soap or detergent, not disinfecting, is enough to reduce risk of transmission.
[
247
]
[
255
]
The CDC recommends that if a COVID‑19 case is suspected or confirmed at a facility such as an office or day care, all areas such as offices, bathrooms, common areas, shared electronic equipment like tablets, touch screens, keyboards, remote controls, and ATMs used by the ill persons should be disinfected.
[
256
]
Surfaces may be decontaminated with the following:
62–71%
ethanol
50–100%
isopropanol
0.1%
sodium hypochlorite
0.5%
hydrogen peroxide
0.2–7.5%
povidone-iodine
50–200 ppm
hypochlorous acid
Other solutions, such as
benzalkonium chloride
and
chlorhexidine gluconate
, are less effective.
Ultraviolet germicidal irradiation
may also be used,
[
233
]
although popular devices require
5–10 min
exposure and may deteriorate some materials over time.
[
257
]
Self-isolation
Self-isolation
at home has been recommended for those diagnosed with COVID‑19 and those who suspect they have been infected. Health agencies have issued detailed instructions for proper self-isolation.
[
258
]
Many governments have mandated or recommended self-quarantine for entire populations. The strongest self-quarantine instructions have been issued to those in high-risk groups.
[
259
]
Those who may have been exposed to someone with COVID‑19 and those who have recently travelled to a country or region with the widespread transmission have been advised to self-quarantine for 14 days from the time of last possible exposure.
[
260
]
A 2021 Cochrane rapid review found that based upon low-certainty evidence, international travel-related control measures such as restricting cross-border travel may help to contain the spread of COVID‑19.
[
261
]
Additionally, symptom/exposure-based screening measures at borders may miss many positive cases.
[
261
]
While test-based border screening measures may be more effective, it could also miss many positive cases if only conducted upon arrival without follow-up. The review concluded that a minimum 10-day quarantine may be beneficial in preventing the spread of COVID‑19 and may be more effective if combined with an additional control measure like border screening.
[
261
]
Treatment
The
treatment and management of COVID-19
combines both
supportive care
, which includes treatment to
relieve symptoms
,
fluid therapy
,
oxygen support
as needed,
[
262
]
[
263
]
[
264
]
and a growing list of approved medications. Highly effective vaccines have reduced mortality related to SARS-CoV-2; for those awaiting vaccination, as well as for the estimated millions of immunocompromised persons who are unlikely to respond robustly to vaccination, treatment remains important.
[
265
]
Some people may experience persistent symptoms or disability after recovery from the infection, known as
long COVID
, but there is still limited information on the best management and rehabilitation for this condition.
[
266
]
Most cases of COVID-19 are mild. In these, supportive care includes medication such as
paracetamol
or
NSAIDs
to relieve symptoms (fever, body aches, cough), proper intake of fluids, rest, and
nasal breathing
.
[
267
]
[
268
]
[
269
]
[
270
]
Good personal hygiene and a
healthy diet
are also recommended.
[
271
]
As of April 2020 the U.S.
Centers for Disease Control and Prevention
(CDC) recommended that those who suspect they are carrying the virus isolate themselves at home and wear a face mask.
[
272
]
As of November 2020 use of the
glucocorticoid
dexamethasone
had been strongly recommended in those severe cases treated in hospital with low oxygen levels, to reduce the risk of death.
[
273
]
[
274
]
[
275
]
Noninvasive ventilation
and, ultimately, admission to an
intensive care unit
for
mechanical ventilation
may be required to support breathing.
[
266
]
Extracorporeal membrane oxygenation
(ECMO) has been used to address respiratory failure, but its benefits are still under consideration.
[
276
]
[
277
]
Some of the cases of severe disease course are caused by systemic hyper-inflammation, the so-called
cytokine storm
.
[
278
]
Although several medications have been approved in different countries as of April 2022, not all countries have these medications. Patients with mild to moderate symptoms who are in the risk groups can take
nirmatrelvir/ritonavir
(marketed as Paxlovid) or
remdesivir
, either of which reduces the risk of serious illness or hospitalization.
[
279
]
[
280
]
In the US, the
Biden Administration COVID-19 action plan
includes the Test to Treat initiative, where people can go to a pharmacy, take a COVID test, and immediately receive free Paxlovid if they test positive.
[
281
]
In November 2021, the UK approved the use of
molnupiravir
as a COVID treatment for vulnerable patients recently diagnosed with the disease.
[
282
]
Several
experimental treatments
are being actively studied in
clinical trials
.
[
283
]
Others were thought to be promising early in the pandemic, such as
hydroxychloroquine
and
lopinavir/ritonavir
, but later research found them to be ineffective or even harmful,
[
283
]
[
284
]
[
285
]
like
fluvoxamine
, a cheap and widely available
antidepressant
;
[
286
]
As of December 2020, there was not enough high-quality evidence to recommend so-called early treatment.
[
284
]
[
285
]
In December 2020, two
monoclonal antibody
-based therapies were available in the United States, for early use in cases thought to be at high risk of progression to severe disease.
[
285
]
The antiviral
remdesivir
has been available in the U.S., Canada, Australia, and several other countries, with varying restrictions; it is not recommended for people needing mechanical ventilation and has been discouraged altogether by the
World Health Organization
(WHO),
[
287
]
due to limited evidence of its efficacy.
[
283
]
Prognosis and risk factors
Medical professionals treating a COVID-19 patient in critical condition in an
intensive care unit
in May 2020.
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
. In 3–4% of cases (7.4% for those over age 65) symptoms are severe enough to cause hospitalisation.
[
288
]
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.
[
107
]
The Italian
Istituto Superiore di Sanità
reported that the median time between the onset of symptoms and death was twelve days, with seven being hospitalised. However, people transferred to an ICU had a median time of ten days between hospitalisation and death.
[
289
]
Abnormal sodium levels during hospitalisation with COVID-19 are associated with poor prognoses: high sodium with a greater risk of death, and low sodium with an increased chance of needing ventilator support.
[
290
]
[
291
]
Prolonged
prothrombin
time and elevated
C-reactive protein
levels on admission to the hospital are associated with severe course of COVID‑19 and with a transfer to ICU.
[
292
]
[
293
]
Some early studies suggest 10% to 20% of people with COVID‑19 will experience
symptoms lasting longer than a month
.
[
294
]
[
295
]
A majority of those who were admitted to hospital with severe disease report long-term problems including fatigue and shortness of breath.
[
296
]
On 30 October 2020, WHO chief
Tedros Adhanom
warned that "to a significant number of people, the COVID virus poses a range of serious long-term effects". He has described the vast spectrum of COVID‑19 symptoms that fluctuate over time as "really concerning". They range from fatigue, a cough and shortness of breath, to inflammation and injury of major organs – including the lungs and heart, and also neurological and psychologic effects. Symptoms often overlap and can affect any system in the body. Infected people have reported cyclical bouts of fatigue, headaches, months of complete exhaustion, mood swings, and other symptoms. Tedros therefore concluded that a strategy of achieving
herd immunity
by infection, rather than vaccination, is "morally unconscionable and unfeasible".
[
297
]
In terms of hospital readmissions about 9% of 106,000 individuals had to return for hospital treatment within two months of discharge. The average to readmit was eight days since first hospital visit. There are several risk factors that have been identified as being a cause of multiple admissions to a hospital facility. Among these are advanced age (above 65 years of age) and presence of a chronic condition such as diabetes, COPD, heart failure or chronic kidney disease.
[
298
]
[
299
]
According to
scientific reviews
smokers are more likely to require intensive care or die compared to non-smokers.
[
300
]
[
301
]
Acting on the same ACE2 pulmonary receptors affected by smoking, air pollution has been correlated with the disease.
[
301
]
Short-term
[
302
]
and chronic
[
303
]
exposure to air pollution seems to enhance morbidity and mortality from COVID‑19.
[
304
]
[
305
]
[
306
]
Pre-existing heart and lung diseases
[
307
]
and also
obesity
, especially in conjunction with
fatty liver disease
, contributes to an increased health risk of COVID‑19.
[
301
]
[
308
]
[
309
]
[
310
]
It is also assumed that those that are immunocompromised are at higher risk of getting severely sick from SARS-CoV-2.
[
311
]
One research study that looked into the COVID‑19 infections in hospitalised kidney transplant recipients found a mortality rate of 11%.
[
312
]
Men with untreated
hypogonadism
were 2.4 times more likely than men with eugonadism to be hospitalised if they contracted COVID-19; Hypogonad men treated with
testosterone
were less likely to be hospitalised for COVID-19 than men who were not treated for hypogonadism.
[
313
]
Genetic risk factors
Genetics
plays an important role in the ability to fight off Covid.
[
314
]
For instance, those that do not produce detectable
type I interferons
or produce
auto-antibodies
against these may get much sicker from COVID‑19.
[
315
]
[
316
]
Genetic screening
is able to detect
interferon
effector genes.
[
317
]
Some genetic variants are risk factors in specific populations. For instance, an
allele
of the
DOCK2
gene (dedicator of cytokinesis 2 gene) is a common risk factor in Asian populations but much less common in Europe. The mutation leads to lower expression of DOCK2 especially in younger people with severe COVID-19 infections.
[
318
]
In fact, many other genes and genetic variants have been found that determine the outcome of SARS-CoV-2 infections.
[
319
]
Blood group
A series of studies have examined a potential
relationship between blood group and COVID-19
. Initial research conducted by scientists in
Wuhan
,
China
, on thousands of infected patients suggested that individuals with
blood group
A were more likely to experience severe symptoms of COVID-19 infection compared to those with blood group O.
[
320
]
[
321
]
Other blood types fell between these two in terms of relative risk.
A second study, published in the
New England Journal of Medicine
, did not establish a
causal relationship
between blood type and the severity of COVID-19, but it did support the earlier findings from Chinese researchers.
[
322
]
However, later studies conducted in other countries did not confirm a significant or meaningful link between blood type and disease severity, calling into question the universality of the initial findings.
Children
While very young children have experienced lower rates of infection, older children have a rate of infection that is similar to the population as a whole.
[
323
]
[
324
]
Children are likely to have milder symptoms and are at lower risk of severe disease than adults.
[
325
]
The CDC reports that in the US roughly a third of hospitalised children were admitted to the ICU,
[
326
]
while a European multinational study of hospitalised children from June 2020, found that about 8% of children admitted to a hospital needed intensive care.
[
327
]
Four of the 582 children (0.7%) in the European study died, but the actual mortality rate may be "substantially lower" since milder cases that did not seek medical help were not included in the study.
[
328
]
[
329
]
Long-term effects
Around 10% to 30% of non-hospitalised people with COVID-19 go on to develop
long COVID
. For those that do need hospitalisation, the incidence of long-term effects is over 50%.
[
15
]
Long COVID is an often severe multisystem disease with a large set of symptoms. Common symptoms are
fatigue
,
post-exertional malaise
,
cognitive issues
,
shortness of breath
and pain. There are likely various, possibly coinciding, causes.
[
15
]
Organ damage from the acute infection can explain a part of the symptoms, but long COVID is also observed in people where organ damage seems to be absent.
[
330
]
By a variety of mechanisms, the lungs are the organs most affected in COVID‑19.
[
331
]
In people requiring hospital admission, up to 98% of CT scans performed show lung abnormalities after 28 days of illness even if they had clinically improved.
[
332
]
People with advanced age, severe disease, prolonged ICU stays, or who smoke are more likely to have long-lasting effects, including pulmonary fibrosis.
[
333
]
Overall, approximately one-third of those investigated after four weeks will have findings of
pulmonary fibrosis
or reduced lung function as measured by
DLCO
, even in asymptomatic people, but with the suggestion of continuing improvement with the passing of more time.
[
331
]
After severe disease, lung function can take anywhere from three months to a year or more to return to previous levels.
[
334
]
The risks of
cognitive deficit
,
dementia
, psychotic disorders, and
epilepsy
or seizures persists at an increased level two years after infection.
[
335
]
Immunity
Human
antibody response
to SARS-CoV-2 infection
The
immune response
by humans to SARS-CoV-2 virus occurs as a combination of the
cell-mediated immunity
and antibody production,
[
336
]
just as with most other infections.
[
337
]
B cells interact with T cells and begin dividing before selection into the plasma cell, partly on the basis of their affinity for antigen.
[
338
]
Since SARS-CoV-2 has been in the human population only since December 2019, it remains unknown if the
immunity
is long-lasting in people who recover from the disease.
[
339
]
The presence of neutralising antibodies in blood strongly correlates with protection from infection, but the level of neutralising antibody declines with time. Those with asymptomatic or mild disease had undetectable levels of neutralising antibody two months after infection. In another study, the level of neutralising antibodies fell four-fold one to four months after the onset of symptoms. However, the lack of antibodies in the blood does not mean antibodies will not be rapidly produced upon reexposure to SARS-CoV-2. Memory B cells specific for the spike and nucleocapsid proteins of SARS-CoV-2 last for at least six months after the appearance of symptoms.
[
339
]
As of August 2021, reinfection with COVID‑19 was possible but uncommon. The first case of reinfection was documented in August 2020.
[
340
]
A systematic review found 17 cases of confirmed reinfection in medical literature as of May 2021.
[
340
]
With the Omicron variant, as of 2022, reinfections have become common, albeit it is unclear how common.
[
341
]
COVID-19 reinfections
are thought to likely be less severe than primary infections, especially if one was previously infected by the same variant.
[
341
]
[
additional citation(s) needed
]
Mortality
Several measures are commonly used to quantify mortality.
[
342
]
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.
[
343
]
The
mortality rate
reflects the number of deaths within a specific demographic group divided by the population of that demographic group. Consequently, the mortality rate reflects the prevalence as well as the severity of the disease within a given population. Mortality rates are highly correlated to age, with relatively low rates for young people and relatively high rates among the elderly.
[
344
]
[
345
]
[
346
]
In fact, one relevant factor of mortality rates is the age structure of the countries' populations. For example, the case fatality rate for COVID‑19 is lower in India than in the US since India's younger population represents a larger percentage than in the US.
[
347
]
Case fatality rate
The
case fatality rate
(CFR) 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
1.02% (6,881,955/676,609,955) as of 10 March 2023.
[
348
]
The number varies by region.
[
349
]
[
343
]
Total confirmed cases over time
Total confirmed cases of COVID‑19 per million people
[
350
]
Total confirmed deaths over time
Total confirmed deaths due to COVID‑19 per million people
[
351
]
Infection fatality rate
A key metric in gauging the severity of COVID‑19 is the
infection fatality rate
(IFR), also referred to as the
infection fatality ratio
or
infection fatality risk
.
[
352
]
[
353
]
[
354
]
This metric is calculated by dividing the total number of deaths from the disease by the total number of infected individuals; hence, in contrast to the
CFR
, the IFR incorporates asymptomatic and undiagnosed infections as well as reported cases.
[
355
]
Estimates
The red line shows the estimate of infection fatality rate (IFR), in percentage terms, as a function of age. The shaded region depicts the 95% confidence interval for that estimate. Markers denotes specific observations used in the meta-analysis.
[
356
]
The same relationship plotted on a log scale
A December 2020 systematic review and meta-analysis estimated that population IFR during the first wave of the pandemic was about 0.5% to 1% in many locations (including France, Netherlands, New Zealand, and Portugal), 1% to 2% in other locations (Australia, England, Lithuania, and Spain), and exceeded 2% in Italy.
[
356
]
That study also found that most of these differences in IFR reflected corresponding differences in the age composition of the population and age-specific infection rates; in particular, the metaregression estimate of IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85.
[
356
]
These results were also highlighted in a December 2020 report issued by the WHO.
[
357
]
IFR estimate per age group
(to December 2020)
[
356
]
Age group
IFR
0–34
0.004%
35–44
0.068%
45–54
0.23%
55–64
0.75%
65–74
2.5%
75–84
8.5%
85 +
28.3%
An analysis of those IFR rates indicates that COVID‑19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate of COVID-19 is two orders of magnitude greater than the annualised risk of a fatal automobile accident and far more dangerous than seasonal
influenza
.
[
356
]
Earlier estimates of IFR
At an early stage of the pandemic, the World Health Organization reported estimates of IFR between 0.3% and 1%.
[
358
]
[
359
]
On 2
July, The WHO's chief scientist reported that the average IFR estimate presented at a two-day WHO expert forum was about 0.6%.
[
360
]
[
361
]
In August, the WHO found that studies incorporating data from broad serology testing in Europe showed IFR estimates converging at approximately 0.5–1%.
[
362
]
Firm lower limits of IFRs have been established in a number of locations such as New York City and Bergamo in Italy since the IFR cannot be less than the population fatality rate. (After sufficient time however, people can get reinfected).
[
363
]
As of 10 July, in New York City, with a population of 8.4 million, 23,377 individuals (18,758 confirmed and 4,619 probable) have died with COVID‑19 (0.3% of the population).
[
364
]
Antibody testing in New York City suggested an IFR of ≈0.9%,
[
365
]
and ≈1.4%.
[
366
]
In
Bergamo province
, 0.6% of the population has died.
[
367
]
In September 2020, the U.S. Centers for Disease Control and Prevention (CDC) reported preliminary estimates of age-specific IFRs for public health planning purposes.
[
368
]
Sex differences
Estimated prognosis by age and sex
based on cases from
France
and
Diamond Princess ship
[
369
]
Percentage of infected people who are hospitalised
0–19
20–29
30–39
40–49
50–59
60–69
70–79
80+
Total
Female
0.1
(0.07–0.2)
0.5
(0.3–0.8)
0.9
(0.5–1.5)
1.3
(0.7–2.1)
2.6
(1.5–4.2)
5.1
(2.9–8.3)
7.8
(4.4–12.8)
19.3
(10.9–31.6)
2.6
(1.5–4.3)
Male
0.2
(0.08–0.2)
0.6
(0.3–0.9)
1.2
(0.7–1.9)
1.6
(0.9–2.6)
3.2
(1.8–5.2)
6.7
(3.7–10.9)
11.0
(6.2–17.9)
37.6
(21.1–61.3)
3.3
(1.8–5.3)
Total
0.1
(0.08–0.2)
0.5
(0.3–0.8)
1.1
(0.6–1.7)
1.4
(0.8–2.3)
2.9
(1.6–4.7)
5.8
(3.3–9.5)
9.3
(5.2–15.1)
26.2
(14.8–42.7)
2.9
(1.7–4.8)
Percentage of hospitalised people who go to Intensive Care Unit
0–19
20–29
30–39
40–49
50–59
60–69
70–79
80+
Total
Female
16.7
(14.3–19.3)
8.7
(7.5–9.9)
11.9
(10.9–13.0)
16.6
(15.6–17.7)
20.7
(19.8–21.6)
23.1
(22.2–24.0)
18.7
(18.0–19.5)
4.2
(4.0–4.5)
14.3
(13.9–14.7)
Male
26.9
(23.1–31.1)
14.0
(12.2–16.0)
19.2
(17.6–20.9)
26.9
(25.4–28.4)
33.4
(32.0–34.8)
37.3
(36.0–38.6)
30.2
(29.1–31.3)
6.8
(6.5–7.2)
23.1
(22.6–23.6)
Total
22.2
(19.1–25.7)
11.6
(10.1–13.2)
15.9
(14.5–17.3)
22.2
(21.0–23.5)
27.6
(26.5–28.7)
30.8
(29.8–31.8)
24.9
(24.1–25.8)
5.6
(5.3–5.9)
19.0
(18.7–19.44)
Percent of hospitalised people who die
0–19
20–29
30–39
40–49
50–59
60–69
70–79
80+
Total
Female
0.5
(0.2–1.0)
0.9
(0.5–1.3)
1.5
(1.2–1.9)
2.6
(2.3–3.0)
5.2
(4.8–5.6)
10.1
(9.5–10.6)
16.7
(16.0–17.4)
25.2
(24.4–26.0)
14.4
(14.0–14.8)
Male
0.7
(0.3–1.5)
1.3
(0.8–1.9)
2.2
(1.7–2.7)
3.8
(3.3–4.4)
7.6
(7.0–8.2)
14.8
(14.1–15.6)
24.6
(23.7–25.6)
37.1
(36.1–38.2)
21.2
(20.8–21.7)
Total
0.6
(0.2–1.3)
1.1
(0.7–1.6)
1.9
(1.5–2.3)
3.3
(2.9–3.8)
6.5
(6.0–7.0)
12.6
(12.0–13.2)
21.0
(20.3–21.7)
31.6
(30.9–32.4)
18.1
(17.8–18.4)
Percent of infected people who die – infection fatality rate (IFR)
0–19
20–29
30–39
40–49
50–59
60–69
70–79
80+
Total
Female
0.001
(<0.001–0.002)
0.004
(0.002–0.007)
0.01
(0.007–0.02)
0.03
(0.02–0.06)
0.1
(0.08–0.2)
0.5
(0.3–0.8)
1.3
(0.7–2.1)
4.9
(2.7–8.0)
0.4
(0.2–0.6)
Male
0.001
(<0.001–0.003)
0.007
(0.003–0.01)
0.03
(0.02–0.05)
0.06
(0.03–0.1)
0.2
(0.1–0.4)
1.0
(0.6–1.6)
2.7
(1.5–1.4)
14.0
(7.9–22.7)
0.7
(0.4–1.1)
Total
0.001
(<0.001–0.002)
0.005
(0.003–0.01)
0.02
(0.01–0.03)
0.05
(0.03–0.08)
0.2
(0.1–0.3)
0.7
(0.4–1.2)
1.9
(1.1–3.2)
8.3
(4.7–13.5)
0.5
(0.3–0.9)
Numbers in parentheses are 95%
credible intervals
for the estimates.
COVID‑19
case fatality rates
are higher among men than women in most countries. However, in a few countries like India, Nepal, Vietnam, and Slovenia the fatality cases are higher in women than men.
[
347
]
Globally, men are more likely to be admitted to the
ICU
and more likely to die.
[
370
]
[
371
]
One meta-analysis found that globally, men were more likely to get COVID‑19 than women; there were approximately 55 men and 45 women per 100 infections (
CI
: 51.43–56.58).
[
372
]
The
Chinese Center for Disease Control and Prevention
reported the death rate was 2.8% for men and 1.7% for women.
[
373
]
Later reviews in June 2020 indicated that there is no significant difference in susceptibility or in CFR between genders.
[
374
]
[
375
]
One review acknowledges the different mortality rates in Chinese men, suggesting that it may be attributable to lifestyle choices such as smoking and drinking alcohol rather than genetic factors.
[
376
]
Smoking, which in some countries like China is mainly a male activity, is a habit that contributes to increasing significantly the case fatality rates among men.
[
347
]
Sex-based immunological differences, lesser 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.
[
377
]
In Europe as of February 2020, 57% of the infected people were men and 72% of those died with COVID‑19 were men.
[
378
]
As of April 2020, the US government is not tracking sex-related data of COVID‑19 infections.
[
379
]
Research has shown that viral illnesses like Ebola, HIV, influenza and SARS affect men and women differently.
[
379
]
Ethnic differences
In the US, a greater proportion of deaths due to COVID‑19 have occurred among African Americans and other minority groups.
[
380
]
Structural factors that prevent them from practising social distancing include their concentration in crowded substandard housing and in "essential" occupations such as retail grocery workers, public transit employees, health-care workers and custodial staff. Greater prevalence of lacking
health insurance
and care of underlying conditions such as
diabetes
,
[
381
]
hypertension, and
heart disease
also increase their risk of death.
[
382
]
Similar issues affect
Native American
and
Latino
communities.
[
380
]
On the one hand, in the Dominican Republic there is a clear example of both gender and ethnic inequality. In this Latin American territory, there is great inequality and precariousness that especially affects Dominican women, with greater emphasis on those of Haitian descent.
[
383
]
According to a US health policy non-profit, 34% of American Indian and Alaska Native People (AIAN) non-elderly adults are at risk of serious illness compared to 21% of white non-elderly adults.
[
384
]
The source attributes it to disproportionately high rates of many health conditions that may put them at higher risk as well as living conditions like lack of access to clean water.
[
384
]
Leaders have called for efforts to research and address the disparities.
[
385
]
In the UK, a greater proportion of deaths due to COVID‑19 have occurred in those of a
Black
,
Asian
, and other ethnic minority background.
[
386
]
[
387
]
[
388
]
More severe impacts upon patients including the relative incidence of the necessity of hospitalisation requirements, and vulnerability to the disease has been associated via DNA analysis to be expressed in genetic variants at chromosomal region 3, features that are associated with European
Neanderthal
heritage. That structure imposes greater risks that those affected will develop a more severe form of the disease.
[
389
]
The findings are from Professor Svante Pääbo and researchers he leads at the
Max Planck Institute for Evolutionary Anthropology
and the
Karolinska Institutet
.
[
389
]
This admixture of modern human and Neanderthal genes is estimated to have occurred roughly between 50,000 and 60,000 years ago in Southern Europe.
[
389
]
Comorbidities
Biological
factors (immune response) and the general behaviour (habits) can strongly determine the consequences of COVID‑19.
[
347
]
Most of those who die of COVID‑19 have
pre-existing (underlying) conditions
, including hypertension,
diabetes mellitus
,
[
381
]
and
cardiovascular disease
.
[
390
]
According to March data from the United States, 89% of those hospitalised had preexisting conditions.
[
391
]
The Italian Istituto Superiore di Sanità reported that out of 8.8% of deaths where
medical charts
were available, 96.1% of people had at least one
comorbidity
with the average person having 3.4 diseases.
[
289
]
According to this report the most common comorbidities are hypertension (66% of deaths),
type 2 diabetes
(29.8% of deaths),
ischaemic heart disease
(27.6% of deaths),
atrial fibrillation
(23.1% of deaths) and
chronic renal failure
(20.2% of deaths).
Most critical respiratory comorbidities according to the US Centers for Disease Control and Prevention (CDC), are: moderate or severe
asthma
, pre-existing
COPD
,
pulmonary fibrosis
, and
cystic fibrosis
.
[
392
]
Evidence stemming from
meta-analysis
of several smaller research papers also suggests that smoking can be associated with worse outcomes.
[
393
]
[
394
]
When someone with existing respiratory problems is infected with COVID‑19, they might be at greater risk for severe symptoms.
[
392
]
COVID‑19 also poses a greater risk to people who
misuse opioids
and
amphetamines
, insofar as their drug use may have caused lung damage.
[
395
]
In August 2020, the CDC issued a caution that
tuberculosis
(TB) infections could increase the risk of severe illness or death. The WHO recommended that people with respiratory symptoms be screened for both diseases, as testing positive for COVID‑19 could not rule out co-infections. Some projections have estimated that reduced TB detection due to the pandemic could result in 6.3 million additional TB cases and 1.4 million TB-related deaths by 2025.
[
396
]
History
This section needs to be
updated
. The reason given is:
excessive detail about the very early pandemic while missing an overview of the later pandemic
.
Please help update this article to reflect recent events or newly available information.
(
July 2023
)
The virus is thought to be of natural animal origin, most likely through
spillover infection
.
[
102
]
[
397
]
[
398
]
A joint-study conducted in early 2021 by the People's Republic of China and the World Health Organization indicated that the virus descended from a coronavirus that infects wild bats, and likely spread to humans through an intermediary wildlife host.
[
399
]
There are several theories about where the
index case
originated and
investigations into the origin of the pandemic
are ongoing.
[
400
]
According to articles published in July 2022 in
Science
, virus transmission into humans occurred through two spillover events in November 2019 and was likely due to live wildlife trade on the
Huanan wet market
in the city of
Wuhan
(Hubei, China).
[
401
]
[
402
]
[
403
]
Doubts about the conclusions have mostly centered on the precise site of spillover.
[
404
]
Earlier
phylogenetics
estimated that SARS-CoV-2 arose in October or November 2019.
[
102
]
[
405
]
[
406
]
A phylogenetic algorithm analysis suggested that the virus may have been circulating in
Guangdong
before Wuhan.
[
407
]
Most scientists believe the virus spilled into human populations through natural
zoonosis
, similar to the
SARS-CoV-1
and
MERS-CoV
outbreaks, and consistent with other pandemics in human history.
[
20
]
[
21
]
According to the
Intergovernmental Panel on Climate Change
several social and environmental factors including
climate change
,
natural ecosystem destruction
and
wildlife trade
increased the likelihood of such zoonotic spillover.
[
22
]
[
23
]
One study made with the support of the
European Union
found climate change increased the likelihood of the pandemic by influencing distribution of bat species.
[
24
]
[
25
]
Available evidence suggests that the SARS-CoV-2 virus was originally harboured by bats, and spread to humans multiple times from infected wild animals at the
Huanan Seafood Market
in
Wuhan
in December 2019.
[
20
]
[
21
]
A minority of scientists and some members of the
U.S intelligence community
believe the virus may have been
unintentionally leaked
from a laboratory such as the
Wuhan Institute of Virology
.
[
408
]
[
409
]
The US intelligence community has mixed views on the issue,
[
410
]
[
411
]
but overall agrees with the scientific consensus that the virus was not developed as a
biological weapon
and is unlikely to have been
genetically engineered
.
[
412
]
[
413
]
[
414
]
[
415
]
There is no evidence SARS-CoV-2 existed in any laboratory prior to the pandemic.
[
416
]
[
417
]
[
418
]
The first confirmed human infections were in Wuhan. A study of the first 41 cases of confirmed COVID‑19, published in January 2020 in
The Lancet
, reported the earliest date of onset of symptoms as 1
December 2019.
[
419
]
[
420
]
[
421
]
Official publications from the WHO reported the earliest onset of symptoms as 8
December 2019.
[
422
]
Human-to-human transmission was confirmed by the WHO and Chinese authorities by 20 January 2020.
[
423
]
[
424
]
According to official Chinese sources, these were mostly linked to the
Huanan Seafood Wholesale Market
, which also sold live animals.
[
425
]
In May 2020,
George Gao
, the director of the CDC, said animal samples collected from the seafood market had tested negative for the virus, indicating that the market was the site of an early
superspreading event
, but that it was not the site of the initial outbreak.
[
426
]
Traces of the virus have been found in wastewater samples that were collected in
Milan
and
Turin
, Italy, on 18 December 2019.
[
427
]
By December 2019, the spread of infection was almost entirely driven by human-to-human transmission.
[
373
]
[
428
]
The number of COVID-19 cases in Hubei gradually increased, reaching 60 by 20 December,
[
429
]
and at least 266 by 31 December.
[
430
]
On 24 December,
Wuhan Central Hospital
sent a
bronchoalveolar lavage fluid
(BAL) sample from an unresolved clinical case to sequencing company Vision Medicals. On 27 and 28 December, Vision Medicals informed the Wuhan Central Hospital and the Chinese CDC of the results of the test, showing a new coronavirus.
[
431
]
A pneumonia cluster of unknown cause was observed on 26 December and treated by the doctor
Zhang Jixian
in Hubei Provincial Hospital, who informed the Wuhan Jianghan CDC on 27 December.
[
432
]
On 30 December, a test report addressed to Wuhan Central Hospital, from company CapitalBio Medlab, stated an erroneous positive result for
SARS
, causing a group of doctors at Wuhan Central Hospital to alert their colleagues and relevant hospital authorities of the result. The Wuhan Municipal Health Commission issued a notice to various medical institutions on "the treatment of pneumonia of unknown cause" that same evening.
[
433
]
Eight of these doctors, including
Li Wenliang
(punished on 3
January),
[
434
]
were later admonished by the police for spreading false rumours and another,
Ai Fen
, was reprimanded by her superiors for raising the alarm.
[
435
]
The Wuhan Municipal Health Commission made the first public announcement of a pneumonia outbreak of unknown cause on 31 December, confirming 27 cases
[
436
]
[
437
]
[
438
]
– enough to trigger an investigation.
[
439
]
During the early stages of the outbreak, the number of cases doubled approximately every seven and a half days.
[
440
]
In early and mid-January 2020, the virus spread to other
Chinese provinces
, helped by the
Chinese New Year migration
and Wuhan being a transport hub and major rail interchange.
[
107
]
On 20 January, China reported nearly 140 new cases in one day, including two people in Beijing and one in
Shenzhen
.
[
441
]
Later official data shows 6,174 people had already developed symptoms by then,
[
373
]
and more may have been infected.
[
442
]
A report in
The Lancet
on 24 January indicated human transmission, strongly recommended personal protective equipment for health workers, and said testing for the virus was essential due to its "pandemic potential".
[
147
]
[
443
]
On 30 January, the WHO declared COVID-19 a
Public Health Emergency of International Concern
.
[
442
]
By this time, the outbreak spread by a factor of 100 to 200 times.
[
444
]
Italy had its first confirmed cases on 31 January 2020, two tourists from China.
[
445
]
Italy overtook China as the country with the most deaths on 19 March 2020.
[
446
]
By 26 March the United States had overtaken China and Italy with the highest number of confirmed cases in the world.
[
447
]
Research on coronavirus genomes indicates the majority of COVID-19 cases in
New York
came from European travellers, rather than directly from China or any other Asian country.
[
448
]
Retesting of prior samples found a person in France who had the virus on 27 December 2019,
[
449
]
[
450
]
and a person in the United States who died from the disease on 6
February 2020.
[
451
]
RT-PCR testing of untreated wastewater samples from Brazil and Italy have suggested detection of SARS-CoV-2 as early as November and December 2019, respectively, but the methods of such sewage studies have not been optimised, many have not been peer-reviewed, details are often missing, and there is a risk of false positives due to contamination or if only one gene target is detected.
[
452
]
A September 2020 review journal article said, "The possibility that the COVID‑19 infection had already spread to Europe at the end of last year is now indicated by abundant, even if partially circumstantial, evidence", including pneumonia case numbers and radiology in France and Italy in November and December.
[
453
]
As of 1 October 2021
,
Reuters
reported that it had estimated the worldwide total number of deaths due to COVID‑19 to have exceeded five million.
[
454
]
The Public Health Emergency of International Concern for COVID-19 ended on 5 May 2023. By this time, everyday life in most countries had returned to how it was before the pandemic.
[
455
]
[
456
]
Misinformation
After the initial outbreak of COVID‑19,
misinformation
and
disinformation
regarding the origin, scale, prevention, treatment, and other aspects of the disease rapidly spread online.
[
457
]
[
458
]
[
459
]
In September 2020, the US Centers for Disease Control and Prevention (CDC) published preliminary estimates of the risk of death by age groups in the United States, but those estimates were widely misreported and misunderstood.
[
368
]
[
460
]
Other species
Humans appear to be capable of spreading the virus to some other animals,
[
461
]
[
462
]
a type of disease transmission referred to as
zooanthroponosis
.
[
463
]
[
464
]
Some pets, especially cats and
ferrets
, can catch this virus from infected humans.
[
465
]
[
466
]
Symptoms in cats include
respiratory
(such as a cough) and digestive symptoms.
[
465
]
Cats can spread the virus to other cats, and may be able to spread the virus to humans, but cat-to-human transmission of SARS-CoV-2 has not been proven.
[
465
]
[
467
]
Compared to cats, dogs are less susceptible to this infection.
[
467
]
Behaviours which increase the risk of transmission include kissing, licking, and petting the animal.
[
467
]
The virus does not appear to be able to infect
pigs
,
ducks
, or chickens at all.
[
465
]
Mice
, rats, and rabbits, if they can be infected at all, are unlikely to be involved in spreading the virus.
[
467
]
Tigers and lions in zoos have become infected as a result of contact with infected humans.
[
467
]
As expected, monkeys and
great ape
species such as
orangutans
can also be infected with the COVID‑19 virus.
[
467
]
Minks
, which are in the
same family
as ferrets, have been infected.
[
467
]
Minks may be asymptomatic, and can also spread the virus to humans.
[
467
]
Multiple countries have identified infected animals in
mink farms
.
[
468
]
Denmark
, a major producer of mink pelts, ordered the slaughter of all minks over fears of viral mutations,
[
468
]
following an outbreak referred to as
Cluster 5
. A vaccine for mink and other animals is being researched.
[
468
]
Research
International research on vaccines and medicines in COVID‑19 is underway by government organisations, academic groups, and industry researchers.
[
469
]
[
470
]
The CDC has classified it to require a
BSL3
grade laboratory.
[
471
]
There has been a great deal of COVID‑19 research, involving accelerated research processes and publishing shortcuts to meet the global demand.
[
472
]
As of December 2020
, hundreds of
clinical trials
have been undertaken, with research happening on every continent except
Antarctica
.
[
473
]
As of November 2020
, more than 200 possible treatments have been studied in humans.
[
474
]
Transmission and prevention research
Modelling
research has been conducted with several objectives, including predictions of the dynamics of transmission,
[
475
]
diagnosis and prognosis of infection,
[
476
]
estimation of the impact of interventions,
[
477
]
[
478
]
or allocation of resources.
[
479
]
Modelling studies are mostly based on
compartmental models in epidemiology
,
[
480
]
estimating the number of infected people over time under given conditions. Several other types of models have been developed and used during the COVID‑19 pandemic including
computational fluid dynamics
models to study the flow physics of COVID‑19,
[
481
]
retrofits of crowd movement models to study occupant exposure,
[
482
]
mobility-data based models to investigate transmission,
[
483
]
or the use of
macroeconomic
models to assess the economic impact of the pandemic.
[
484
]
Seven possible drug targets in viral replication process and drugs
Repurposed
antiviral drugs
make up most of the research into COVID‑19 treatments.
[
485
]
[
486
]
Other candidates in trials include
vasodilators
,
corticosteroids
, immune therapies,
lipoic acid
,
bevacizumab
, and
recombinant
angiotensin-converting enzyme 2.
[
486
]
In March 2020, the World Health Organization (WHO) initiated the
Solidarity trial
to assess the treatment effects of some promising drugs:
[
487
]
[
488
]
An
experimental drug
called
remdesivir
Anti-malarial
drugs
chloroquine
and
hydroxychloroquine
Two
anti-HIV drugs
,
lopinavir/ritonavir
and
interferon-beta
More than 300 active clinical trials are underway as of April 2020.
[
76
]
Research on the antimalarial drugs hydroxychloroquine and chloroquine showed that they were ineffective at best,
[
489
]
[
490
]
and that they may reduce the antiviral activity of remdesivir.
[
491
]
By May 2020
, France, Italy, and Belgium had banned the use of hydroxychloroquine as a COVID‑19 treatment.
[
492
]
In June, initial results from the randomised
RECOVERY Trial
in the United Kingdom showed that dexamethasone reduced mortality by one third for people who are critically ill on ventilators and one fifth for those receiving supplemental oxygen.
[
493
]
Because this is a well-tested and widely available treatment, it was welcomed by the WHO, which is in the process of updating treatment guidelines to include dexamethasone and other steroids.
[
494
]
[
495
]
Based on those preliminary results, dexamethasone treatment has been recommended by the NIH for peoples with COVID‑19 who are mechanically ventilated or who require supplemental oxygen but not in people with COVID‑19 who do not require supplemental oxygen.
[
496
]
In September 2020, the WHO released updated guidance on using corticosteroids for COVID‑19.
[
497
]
[
498
]
The WHO recommends systemic corticosteroids rather than no systemic corticosteroids for the treatment of people with severe and critical COVID‑19 (strong recommendation, based on moderate certainty evidence).
[
497
]
The WHO suggests not to use corticosteroids in the treatment of people with non-severe COVID‑19 (conditional recommendation, based on low certainty evidence).
[
497
]
The updated guidance was based on a meta-analysis of clinical trials of people critically ill with COVID‑19.
[
499
]
[
500
]
In September 2020, the
European Medicines Agency
(EMA) endorsed the use of dexamethasone in adults and adolescents from 12 years of age and weighing at least 40 kilograms (88 lb) who require supplemental oxygen therapy.
[
501
]
[
502
]
Dexamethasone can be taken
by mouth
or given as an injection or
infusion (drip) into a vein
.
[
501
]
In November 2020, the US
Food and Drug Administration
(FDA) issued an emergency use authorisation for the investigational monoclonal antibody therapy
bamlanivimab
for the treatment of mild-to-moderate COVID‑19.
[
503
]
Bamlanivimab is authorised for people with positive results of direct SARS-CoV-2 viral testing who are twelve years of age and older weighing at least 40 kilograms (88 lb), and who are at high risk for progressing to severe COVID‑19 or hospitalisation.
[
503
]
This includes those who are 65 years of age or older, or who have chronic medical conditions.
[
503
]
In February 2021, the FDA issued an emergency use authorisation (EUA) for bamlanivimab and
etesevimab
administered together for the treatment of mild to moderate COVID‑19 in people twelve years of age or older weighing at least 40 kilograms (88 lb) who test positive for SARS‑CoV‑2 and who are at high risk for progressing to severe COVID‑19. The authorised use includes treatment for those who are 65 years of age or older or who have certain chronic medical conditions.
[
504
]
In April 2021, the FDA revoked the emergency use authorisation (EUA) that allowed for the investigational monoclonal antibody therapy bamlanivimab, when administered alone, to be used for the treatment of mild-to-moderate COVID‑19 in adults and certain paediatric patients.
[
505
]
Cytokine storm
Various therapeutic strategies for targeting cytokine storm
A
cytokine storm
can be a complication in the later stages of severe COVID‑19. A cytokine storm is a potentially deadly immune reaction where a large amount of pro-inflammatory cytokines and
chemokines
are released too quickly. A cytokine storm can lead to ARDS and multiple organ failure.
[
506
]
Data collected from Jin Yin-tan Hospital in Wuhan, China indicates that people who had more severe responses to COVID‑19 had greater amounts of pro-inflammatory cytokines and chemokines in their system than people who had milder responses. These high levels of pro-inflammatory cytokines and chemokines indicate presence of a cytokine storm.
[
507
]
Tocilizumab
has been included in treatment guidelines by China's
National Health Commission
after a small study was completed.
[
508
]
[
509
]
It is undergoing a
Phase
II
non-randomised trial at the national level in Italy after showing positive results in people with severe disease.
[
510
]
[
511
]
Combined with a serum
ferritin
blood test to identify a cytokine storm (also called cytokine storm syndrome, not to be confused with
cytokine release syndrome
), it is meant to counter such developments, which are thought to be the cause of death in some affected people.
[
512
]
The
interleukin-6 receptor
(IL-6R)
antagonist
was approved by the FDA to undergo a Phase
III clinical trial assessing its effectiveness on COVID‑19 based on retrospective case studies for the treatment of steroid-refractory cytokine release syndrome induced by a different cause,
CAR T cell
therapy
, in 2017.
[
513
]
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 effect on the incidence of CRS.
[
514
]
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.
[
515
]
Passive antibodies
Overview of the application and use of
convalescent plasma
therapy
Transferring purified and concentrated
antibodies
produced by the immune systems of those who have recovered from COVID‑19 to people who need them is being investigated as a non-vaccine method of
passive immunisation
.
[
516
]
[
517
]
Viral neutralisation
is the anticipated
mechanism of action
by which passive antibody therapy can mediate defence against SARS-CoV-2. The spike protein of SARS-CoV-2 is the primary target for neutralising antibodies.
[
518
]
As of 8
August 2020, eight neutralising antibodies targeting the spike protein of SARS-CoV-2 have entered clinical studies.
[
519
]
It has been proposed that selection of broad-neutralising antibodies against SARS-CoV-2 and SARS-CoV might be useful for treating not only COVID‑19 but also future SARS-related CoV infections.
[
518
]
Other mechanisms, however, such as
antibody-dependant cellular cytotoxicity
or
phagocytosis
, may be possible.
[
516
]
Other forms of passive antibody therapy, for example, using manufactured monoclonal antibodies, are in development.
[
516
]
The use of passive antibodies to treat people with active COVID‑19 is also being studied. This involves the production of
convalescent serum
, which consists of the liquid portion of the blood from people who recovered from the infection and contains antibodies specific to this virus, which is then administered to active patients.
[
516
]
This strategy was tried for SARS with inconclusive results.
[
516
]
An updated Cochrane review in May 2023 found high certainty evidence that, for the treatment of people with moderate to severe COVID‑19, convalescent plasma did not reduce mortality or bring about symptom improvement.
[
517
]
There continues to be uncertainty about the safety of convalescent plasma administration to people with COVID‑19 and differing outcomes measured in different studies limits their use in determining efficacy.
[
517
]
Bioethics
Since the outbreak of the COVID‑19 pandemic, scholars have explored the
bioethics
,
normative economics
, and
political theories
of
healthcare policies
related to the public health crisis.
[
520
]
Academics have pointed to the moral distress of healthcare workers, ethics of distributing scarce healthcare resources such as ventilators,
[
521
]
and the global justice of vaccine diplomacies.
[
522
]
[
523
]
The socio-economic inequalities between genders,
[
524
]
races,
[
525
]
groups with disabilities,
[
526
]
communities,
[
527
]
regions, countries,
[
528
]
and continents have also drawn attention in academia and the general public.
[
529
]
[
530
]
See also
Coronavirus diseases
, a group of closely related syndromes
Disease X
, a WHO term
Law of declining virulence
– Disproved hypothesis of epidemiologist Theobald Smith
Theory of virulence
– Theory by biologist Paul W. Ewald
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External links
Health agencies
Coronavirus disease (COVID‑19)
Facts
by the World Health Organization (WHO)
Coronavirus (COVID‑19)
by the UK
National Health Service
(NHS)
Coronavirus 2019 (COVID-19)
by the US
Centers for Disease Control and Prevention
(CDC)
Directories
Coronavirus Resource Center
at the
Center for Inquiry
COVID‑19 Information on FireMountain.net
Archived
13 January 2022 at the
Wayback Machine
COVID‑19 Resource Directory on OpenMD
Medical journals
BMJ's Coronavirus (covid‑19) Hub
by the
BMJ
Coronavirus (Covid‑19)
by
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by
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by
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Covid‑19: Novel Coronavirus
;
Archived
24 September 2020 at the
Wayback Machine
by
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by
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Treatment guidelines
"Bouncing Back from COVID-19: Your Guide to Restoring Movement"
(PDF)
. Johns Hopkins Medicine. Archived from
the original
(PDF)
on 29 June 2020.
"Coronavirus Disease 2019 (COVID-19) Treatment Guidelines"
(PDF)
. National Institutes of Health.
"Guidelines on the Treatment and Management of Patients with COVID-19"
. Infectious Diseases Society of America.
"JHMI Clinical Recommendations for Available Pharmacologic Therapies for COVID-19"
(PDF)
. Johns Hopkins Medicine.
National Guidance for post-COVID syndrome assessment clinics
(Report). NHS England. 28 July 2022.
Therapeutics and COVID-19: living guideline, 14 January 2022
(Report). World Health Organization. 2022.
hdl
:
10665/351006
. WHO/2019-nCoV/therapeutics/2022.1. |
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## Contents
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- [(Top)](https://en.wikipedia.org/wiki/COVID-19)
- [1 Nomenclature](https://en.wikipedia.org/wiki/COVID-19#Nomenclature)
- [2 Signs and symptoms](https://en.wikipedia.org/wiki/COVID-19#Signs_and_symptoms)
Toggle Signs and symptoms subsection
- [2\.1 Complications](https://en.wikipedia.org/wiki/COVID-19#Complications)
- [3 Cause](https://en.wikipedia.org/wiki/COVID-19#Cause)
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- [3\.1 Transmission](https://en.wikipedia.org/wiki/COVID-19#Transmission)
- [3\.2 Virology](https://en.wikipedia.org/wiki/COVID-19#Virology)
- [3\.3 SARS-CoV-2 variants](https://en.wikipedia.org/wiki/COVID-19#SARS-CoV-2_variants)
- [4 Pathophysiology](https://en.wikipedia.org/wiki/COVID-19#Pathophysiology)
Toggle Pathophysiology subsection
- [4\.1 Respiratory tract](https://en.wikipedia.org/wiki/COVID-19#Respiratory_tract)
- [4\.2 Nervous system](https://en.wikipedia.org/wiki/COVID-19#Nervous_system)
- [4\.3 Gastrointestinal tract](https://en.wikipedia.org/wiki/COVID-19#Gastrointestinal_tract)
- [4\.4 Cardiovascular system](https://en.wikipedia.org/wiki/COVID-19#Cardiovascular_system)
- [4\.5 Kidneys](https://en.wikipedia.org/wiki/COVID-19#Kidneys)
- [4\.6 Immunopathology](https://en.wikipedia.org/wiki/COVID-19#Immunopathology)
- [4\.7 Viral and host factors](https://en.wikipedia.org/wiki/COVID-19#Viral_and_host_factors)
- [4\.7.1 Virus proteins](https://en.wikipedia.org/wiki/COVID-19#Virus_proteins)
- [4\.7.2 Host factors](https://en.wikipedia.org/wiki/COVID-19#Host_factors)
- [4\.8 Host cytokine response](https://en.wikipedia.org/wiki/COVID-19#Host_cytokine_response)
- [4\.9 Pregnancy response](https://en.wikipedia.org/wiki/COVID-19#Pregnancy_response)
- [5 Diagnosis](https://en.wikipedia.org/wiki/COVID-19#Diagnosis)
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- [5\.1 Viral testing](https://en.wikipedia.org/wiki/COVID-19#Viral_testing)
- [5\.2 Imaging](https://en.wikipedia.org/wiki/COVID-19#Imaging)
- [5\.3 Coding](https://en.wikipedia.org/wiki/COVID-19#Coding)
- [5\.4 Pathology](https://en.wikipedia.org/wiki/COVID-19#Pathology)
- [6 Prevention](https://en.wikipedia.org/wiki/COVID-19#Prevention)
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- [6\.1 Vaccine](https://en.wikipedia.org/wiki/COVID-19#Vaccine)
- [6\.2 Face masks and respiratory hygiene](https://en.wikipedia.org/wiki/COVID-19#Face_masks_and_respiratory_hygiene)
- [6\.3 Indoor ventilation and avoiding crowded indoor spaces](https://en.wikipedia.org/wiki/COVID-19#Indoor_ventilation_and_avoiding_crowded_indoor_spaces)
- [6\.4 Hand-washing and hygiene](https://en.wikipedia.org/wiki/COVID-19#Hand-washing_and_hygiene)
- [6\.5 Social distancing](https://en.wikipedia.org/wiki/COVID-19#Social_distancing)
- [6\.6 Surface cleaning](https://en.wikipedia.org/wiki/COVID-19#Surface_cleaning)
- [6\.7 Self-isolation](https://en.wikipedia.org/wiki/COVID-19#Self-isolation)
- [6\.8 International travel-related control measures](https://en.wikipedia.org/wiki/COVID-19#International_travel-related_control_measures)
- [7 Treatment](https://en.wikipedia.org/wiki/COVID-19#Treatment)
- [8 Prognosis and risk factors](https://en.wikipedia.org/wiki/COVID-19#Prognosis_and_risk_factors)
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- [8\.1 Genetic risk factors](https://en.wikipedia.org/wiki/COVID-19#Genetic_risk_factors)
- [8\.1.1 Blood group](https://en.wikipedia.org/wiki/COVID-19#Blood_group)
- [8\.2 Children](https://en.wikipedia.org/wiki/COVID-19#Children)
- [8\.3 Long-term effects](https://en.wikipedia.org/wiki/COVID-19#Long-term_effects)
- [8\.4 Immunity](https://en.wikipedia.org/wiki/COVID-19#Immunity)
- [9 Mortality](https://en.wikipedia.org/wiki/COVID-19#Mortality)
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- [9\.1 Case fatality rate](https://en.wikipedia.org/wiki/COVID-19#Case_fatality_rate)
- [9\.2 Infection fatality rate](https://en.wikipedia.org/wiki/COVID-19#Infection_fatality_rate)
- [9\.2.1 Estimates](https://en.wikipedia.org/wiki/COVID-19#Estimates)
- [9\.2.2 Earlier estimates of IFR](https://en.wikipedia.org/wiki/COVID-19#Earlier_estimates_of_IFR)
- [9\.3 Sex differences](https://en.wikipedia.org/wiki/COVID-19#Sex_differences)
- [9\.4 Ethnic differences](https://en.wikipedia.org/wiki/COVID-19#Ethnic_differences)
- [9\.5 Comorbidities](https://en.wikipedia.org/wiki/COVID-19#Comorbidities)
- [10 History](https://en.wikipedia.org/wiki/COVID-19#History)
- [11 Misinformation](https://en.wikipedia.org/wiki/COVID-19#Misinformation)
- [12 Other species](https://en.wikipedia.org/wiki/COVID-19#Other_species)
- [13 Research](https://en.wikipedia.org/wiki/COVID-19#Research)
Toggle Research subsection
- [13\.1 Transmission and prevention research](https://en.wikipedia.org/wiki/COVID-19#Transmission_and_prevention_research)
- [13\.2 Treatment-related research](https://en.wikipedia.org/wiki/COVID-19#Treatment-related_research)
- [13\.2.1 Cytokine storm](https://en.wikipedia.org/wiki/COVID-19#Cytokine_storm)
- [13\.2.2 Passive antibodies](https://en.wikipedia.org/wiki/COVID-19#Passive_antibodies)
- [13\.3 Bioethics](https://en.wikipedia.org/wiki/COVID-19#Bioethics)
- [14 See also](https://en.wikipedia.org/wiki/COVID-19#See_also)
- [15 References](https://en.wikipedia.org/wiki/COVID-19#References)
- [16 Further reading](https://en.wikipedia.org/wiki/COVID-19#Further_reading)
- [17 External links](https://en.wikipedia.org/wiki/COVID-19#External_links)
Toggle External links subsection
- [17\.1 Health agencies](https://en.wikipedia.org/wiki/COVID-19#Health_agencies)
- [17\.2 Directories](https://en.wikipedia.org/wiki/COVID-19#Directories)
- [17\.3 Medical journals](https://en.wikipedia.org/wiki/COVID-19#Medical_journals)
- [17\.4 Treatment guidelines](https://en.wikipedia.org/wiki/COVID-19#Treatment_guidelines)
Toggle the table of contents
# COVID-19
205 languages
- [Afrikaans](https://af.wikipedia.org/wiki/Koronavirussiekte-2019 "Koronavirussiekte-2019 – Afrikaans")
- [አማርኛ](https://am.wikipedia.org/wiki/%E1%8A%AE%E1%89%AA%E1%8B%B5_19 "ኮቪድ 19 – Amharic")
- [Pangcah](https://ami.wikipedia.org/wiki/%E6%96%B0%E5%86%A0%E8%82%BA%E7%82%8E "新冠肺炎 – Amis")
- [Aragonés](https://an.wikipedia.org/wiki/COVID-19 "COVID-19 – Aragonese")
- [Ænglisc](https://ang.wikipedia.org/wiki/Wuhanes_feforadl "Wuhanes feforadl – Old English")
- [अंगिका](https://anp.wikipedia.org/wiki/%E0%A4%95%E0%A5%8B%E0%A4%B0%E0%A5%8B%E0%A4%A8%E0%A4%BE%E0%A4%B5%E0%A4%BE%E0%A4%AF%E0%A4%B0%E0%A4%B8_%E0%A4%B0%E0%A5%8B%E0%A4%97_2019 "कोरोनावायरस रोग 2019 – Angika")
- [العربية](https://ar.wikipedia.org/wiki/%D9%85%D8%B1%D8%B6_%D9%81%D9%8A%D8%B1%D9%88%D8%B3_%D9%83%D9%88%D8%B1%D9%88%D9%86%D8%A7_2019 "مرض فيروس كورونا 2019 – Arabic")
- [الدارجة](https://ary.wikipedia.org/wiki/%D9%83%D9%88%DA%A4%D9%8A%D8%AF-19 "كوڤيد-19 – Moroccan Arabic")
- [مصرى](https://arz.wikipedia.org/wiki/%D9%83%D9%88%DA%A4%D9%8A%D8%AF-19 "كوڤيد-19 – Egyptian Arabic")
- [অসমীয়া](https://as.wikipedia.org/wiki/%E0%A6%95%E0%A7%B0%27%E0%A6%A8%E0%A6%BE%E0%A6%AD%E0%A6%BE%E0%A6%87%E0%A7%B0%E0%A6%BE%E0%A6%9B_%E0%A7%B0%E0%A7%8B%E0%A6%97_%E0%A7%A8%E0%A7%A6%E0%A7%A7%E0%A7%AF "কৰ'নাভাইৰাছ ৰোগ ২০১৯ – Assamese")
- [Asturianu](https://ast.wikipedia.org/wiki/COVID-19 "COVID-19 – Asturian")
- [Atikamekw](https://atj.wikipedia.org/wiki/Mantcoc_\(Coronavirus_Covid-19\) "Mantcoc (Coronavirus Covid-19) – Atikamekw")
- [Авар](https://av.wikipedia.org/wiki/COVID-19 "COVID-19 – Avaric")
- [अवधी](https://awa.wikipedia.org/wiki/%E0%A4%95%E0%A5%8B%E0%A4%B0%E0%A5%8B%E0%A4%A8%E0%A4%BE_%E0%A4%AD%E0%A4%BE%E0%A4%87%E0%A4%B0%E0%A4%B8 "कोरोना भाइरस – Awadhi")
- [Azərbaycanca](https://az.wikipedia.org/wiki/Koronavirus_x%C9%99st%C9%99liyi_2019 "Koronavirus xəstəliyi 2019 – Azerbaijani")
- [تۆرکجه](https://azb.wikipedia.org/wiki/%DA%A9%D8%B1%D9%88%D9%86%D8%A7_%D9%88%DB%8C%D8%B1%D9%88%D8%B3_%D8%AE%D8%B3%D8%AA%D9%87%E2%80%8C%D9%84%DB%8C%D8%BA%DB%8C_%DB%B2%DB%B0%DB%B1%DB%B9 "کرونا ویروس خستهلیغی ۲۰۱۹ – South Azerbaijani")
- [Bikol Central](https://bcl.wikipedia.org/wiki/COVID-19 "COVID-19 – Central Bikol")
- [Беларуская (тарашкевіца)](https://be-tarask.wikipedia.org/wiki/%D0%9A%D0%B0%D1%80%D0%B0%D0%BD%D0%B0%D0%B2%D1%96%D1%80%D1%83%D1%81%D0%BD%D0%B0%D1%8F_%D1%96%D0%BD%D1%84%D1%8D%D0%BA%D1%86%D1%8B%D1%8F_\(2019\) "Каранавірусная інфэкцыя (2019) – Belarusian (Taraškievica orthography)")
- [Беларуская](https://be.wikipedia.org/wiki/COVID-19 "COVID-19 – Belarusian")
- [Български](https://bg.wikipedia.org/wiki/%D0%9A%D0%BE%D1%80%D0%BE%D0%BD%D0%B0%D0%B2%D0%B8%D1%80%D1%83%D1%81%D0%BD%D0%B0_%D0%B1%D0%BE%D0%BB%D0%B5%D1%81%D1%82_2019 "Коронавирусна болест 2019 – Bulgarian")
- [भोजपुरी](https://bh.wikipedia.org/wiki/%E0%A4%95%E0%A5%8B%E0%A4%B5%E0%A4%BF%E0%A4%A1-19 "कोविड-19 – Bhojpuri")
- [Banjar](https://bjn.wikipedia.org/wiki/Panyakit_koronavirus_2019 "Panyakit koronavirus 2019 – Banjar")
- [ပအိုဝ်ႏဘာႏသာႏ](https://blk.wikipedia.org/wiki/%E1%80%80%E1%80%AD%E1%80%AF%E1%80%97%E1%80%85%E1%80%BA_%E1%81%81%E1%81%89 "ကိုဗစ် ၁၉ – Pa'O")
- [বাংলা](https://bn.wikipedia.org/wiki/%E0%A6%95%E0%A7%8B%E0%A6%AD%E0%A6%BF%E0%A6%A1-%E0%A7%A7%E0%A7%AF "কোভিড-১৯ – Bangla")
- [བོད་ཡིག](https://bo.wikipedia.org/wiki/%E0%BD%8F%E0%BD%BC%E0%BD%82%E0%BC%8B%E0%BD%91%E0%BD%96%E0%BE%B1%E0%BD%B2%E0%BD%96%E0%BD%A6%E0%BC%8B%E0%BD%93%E0%BD%91%E0%BC%8B%E0%BD%91%E0%BD%B4%E0%BD%82 "ཏོག་དབྱིབས་ནད་དུག – Tibetan")
- [Brezhoneg](https://br.wikipedia.org/wiki/COVID-19 "COVID-19 – Breton")
- [Bosanski](https://bs.wikipedia.org/wiki/COVID-19 "COVID-19 – Bosnian")
- [Batak Mandailing](https://btm.wikipedia.org/wiki/Covid-19 "Covid-19 – Batak Mandailing")
- [Basa Ugi](https://bug.wikipedia.org/wiki/%E1%A8%8C%E1%A8%9A%E1%A8%93%E1%A8%97%E1%A8%89-19 "ᨌᨚᨓᨗᨉ-19 – Buginese")
- [Буряад](https://bxr.wikipedia.org/wiki/COVID-19 "COVID-19 – Russia Buriat")
- [Català](https://ca.wikipedia.org/wiki/COVID-19 "COVID-19 – Catalan")
- [閩東語 / Mìng-dĕ̤ng-ngṳ̄](https://cdo.wikipedia.org/wiki/COVID-19 "COVID-19 – Mindong")
- [ᏣᎳᎩ](https://chr.wikipedia.org/wiki/%E1%8E%AA%E1%8F%AB%E1%8F%9B-19 "ᎪᏫᏛ-19 – Cherokee")
- [کوردی](https://ckb.wikipedia.org/wiki/%D9%86%DB%95%D8%AE%DB%86%D8%B4%DB%8C%DB%8C_%DA%A4%D8%A7%DB%8C%D8%B1%DB%86%D8%B3%DB%8C_%DA%A9%DB%86%D8%B1%DB%86%D9%86%D8%A7%DB%8C_%D9%A2%D9%A0%D9%A1%D9%A9 "نەخۆشیی ڤایرۆسی کۆرۆنای ٢٠١٩ – Central Kurdish")
- [Qırımtatarca](https://crh.wikipedia.org/wiki/Koronavirus_2019 "Koronavirus 2019 – Crimean Tatar")
- [Čeština](https://cs.wikipedia.org/wiki/Covid-19 "Covid-19 – Czech")
- [Словѣньскъ / ⰔⰎⰑⰂⰡⰐⰠⰔⰍⰟ](https://cu.wikipedia.org/wiki/COVID-19 "COVID-19 – Church Slavic")
- [Чӑвашла](https://cv.wikipedia.org/wiki/COVID-19_%D0%BA%D0%BE%D1%80%D0%BE%D0%BD%D0%B0%D0%B2%D0%B8%D1%80%D1%83%D1%81%D0%BB%D0%B0_%D0%B8%D0%BD%D1%84%D0%B5%D0%BA%D1%86%D0%B8 "COVID-19 коронавирусла инфекци – Chuvash")
- [Cymraeg](https://cy.wikipedia.org/wiki/COVID-19 "COVID-19 – Welsh")
- [Dansk](https://da.wikipedia.org/wiki/COVID-19 "COVID-19 – Danish")
- [Dagbanli](https://dag.wikipedia.org/wiki/Coronavirus "Coronavirus – Dagbani")
- [Deutsch](https://de.wikipedia.org/wiki/COVID-19 "COVID-19 – German")
- [Thuɔŋjäŋ](https://din.wikipedia.org/wiki/Tuaany_%C3%AB_koronabair%C3%A4th_2019 "Tuaany ë koronabairäth 2019 – Dinka")
- [Zazaki](https://diq.wikipedia.org/wiki/Covid_19 "Covid 19 – Dimli")
- [ދިވެހިބަސް](https://dv.wikipedia.org/wiki/%DE%86%DE%AF%DE%88%DE%A8%DE%91%DE%B0-19 "ކޯވިޑް-19 – Divehi")
- [ཇོང་ཁ](https://dz.wikipedia.org/wiki/%E0%BD%80%E0%BD%BC%E0%BC%8B%E0%BD%96%E0%BD%B2%E0%BD%8A%E0%BC%8B%E0%BC%A1%E0%BC%A9 "ཀོ་བིཊ་༡༩ – Dzongkha")
- [Ελληνικά](https://el.wikipedia.org/wiki/COVID-19 "COVID-19 – Greek")
- [Emiliàn e rumagnòl](https://eml.wikipedia.org/wiki/COVID-19 "COVID-19 – Emiliano-Romagnolo")
- [Esperanto](https://eo.wikipedia.org/wiki/Kronvirusa_malsano_de_2019 "Kronvirusa malsano de 2019 – Esperanto")
- [Español](https://es.wikipedia.org/wiki/COVID-19 "COVID-19 – Spanish")
- [Eesti](https://et.wikipedia.org/wiki/COVID-19 "COVID-19 – Estonian")
- [Euskara](https://eu.wikipedia.org/wiki/COVID-19 "COVID-19 – Basque")
- [فارسی](https://fa.wikipedia.org/wiki/%DA%A9%D9%88%D9%88%DB%8C%D8%AF_%DB%B1%DB%B9 "کووید ۱۹ – Persian")
- [Fulfulde](https://ff.wikipedia.org/wiki/Nawnaare_korona_hitande_2019 "Nawnaare korona hitande 2019 – Fula")
- [Suomi](https://fi.wikipedia.org/wiki/COVID-19 "COVID-19 – Finnish")
- [Fɔ̀ngbè](https://fon.wikipedia.org/wiki/COVID-19 "COVID-19 – Fon")
- [Français](https://fr.wikipedia.org/wiki/Maladie_%C3%A0_coronavirus_2019 "Maladie à coronavirus 2019 – French")
- [Arpetan](https://frp.wikipedia.org/wiki/Cr%C3%A8va_de_coronavirus_2019 "Crèva de coronavirus 2019 – Arpitan")
- [Nordfriisk](https://frr.wikipedia.org/wiki/COVID-19 "COVID-19 – Northern Frisian")
- [Frysk](https://fy.wikipedia.org/wiki/COVID-19 "COVID-19 – Western Frisian")
- [Gaeilge](https://ga.wikipedia.org/wiki/COVID-19 "COVID-19 – Irish")
- [贛語](https://gan.wikipedia.org/wiki/2019%E5%86%A0%E7%8A%B6%E7%97%85%E6%AF%92%E7%97%85 "2019冠状病毒病 – Gan")
- [Galego](https://gl.wikipedia.org/wiki/COVID-19 "COVID-19 – Galician")
- [Avañe'ẽ](https://gn.wikipedia.org/wiki/COVID-19 "COVID-19 – Guarani")
- [Bahasa Hulontalo](https://gor.wikipedia.org/wiki/COVID-19 "COVID-19 – Gorontalo")
- [Ghanaian Pidgin](https://gpe.wikipedia.org/wiki/COVID-19 "COVID-19 – Ghanaian Pidgin")
- [ગુજરાતી](https://gu.wikipedia.org/wiki/%E0%AA%95%E0%AB%8B%E0%AA%B0%E0%AB%8B%E0%AA%A8%E0%AA%BE%E0%AA%B5%E0%AA%BE%E0%AA%AF%E0%AA%B0%E0%AA%B8_%E0%AA%B0%E0%AB%8B%E0%AA%97_%E0%AB%A8%E0%AB%A6%E0%AB%A7%E0%AB%AF "કોરોનાવાયરસ રોગ ૨૦૧૯ – Gujarati")
- [Wayuunaiki](https://guc.wikipedia.org/wiki/COVID_19 "COVID 19 – Wayuu")
- [Gungbe](https://guw.wikipedia.org/wiki/Az%E1%BB%8D%CC%80nylankan_COVID-19 "Azọ̀nylankan COVID-19 – Gun")
- [Gaelg](https://gv.wikipedia.org/wiki/COVID-19 "COVID-19 – Manx")
- [Hausa](https://ha.wikipedia.org/wiki/Koronavirus_2019 "Koronavirus 2019 – Hausa")
- [客家語 / Hak-kâ-ngî](https://hak.wikipedia.org/wiki/COVID-19 "COVID-19 – Hakka Chinese")
- [Hawaiʻi](https://haw.wikipedia.org/wiki/Maladie_%C3%A0_coronavirus_2019 "Maladie à coronavirus 2019 – Hawaiian")
- [עברית](https://he.wikipedia.org/wiki/%D7%9E%D7%97%D7%9C%D7%AA_%D7%A0%D7%92%D7%99%D7%A3_%D7%A7%D7%95%D7%A8%D7%95%D7%A0%D7%94_2019 "מחלת נגיף קורונה 2019 – Hebrew")
- [हिन्दी](https://hi.wikipedia.org/wiki/%E0%A4%95%E0%A5%8B%E0%A4%B0%E0%A5%8B%E0%A4%A8%E0%A4%BE%E0%A4%B5%E0%A4%BE%E0%A4%AF%E0%A4%B0%E0%A4%B8_%E0%A4%B0%E0%A5%8B%E0%A4%97_2019 "कोरोनावायरस रोग 2019 – Hindi")
- [Fiji Hindi](https://hif.wikipedia.org/wiki/COVID-19_Coronavirus_bemari "COVID-19 Coronavirus bemari – Fiji Hindi")
- [Hrvatski](https://hr.wikipedia.org/wiki/COVID-19 "COVID-19 – Croatian")
- [Kreyòl ayisyen](https://ht.wikipedia.org/wiki/Maladi_kowonaviris_2019 "Maladi kowonaviris 2019 – Haitian Creole")
- [Magyar](https://hu.wikipedia.org/wiki/Covid19 "Covid19 – Hungarian")
- [Հայերեն](https://hy.wikipedia.org/wiki/COVID-19 "COVID-19 – Armenian")
- [Interlingua](https://ia.wikipedia.org/wiki/COVID-19 "COVID-19 – Interlingua")
- [Bahasa Indonesia](https://id.wikipedia.org/wiki/Covid-19 "Covid-19 – Indonesian")
- [Ido](https://io.wikipedia.org/wiki/KOVID-19 "KOVID-19 – Ido")
- [Íslenska](https://is.wikipedia.org/wiki/COVID-19 "COVID-19 – Icelandic")
- [Italiano](https://it.wikipedia.org/wiki/COVID-19 "COVID-19 – Italian")
- [ᐃᓄᒃᑎᑐᑦ / inuktitut](https://iu.wikipedia.org/wiki/%E1%93%84%E1%95%99%E1%92%A1%E1%94%AA%E1%90%8A%E1%95%90%E1%93%87%E1%96%85-19 "ᓄᕙᒡᔪᐊᕐᓇᖅ-19 – Inuktitut")
- [日本語](https://ja.wikipedia.org/wiki/%E6%96%B0%E5%9E%8B%E3%82%B3%E3%83%AD%E3%83%8A%E3%82%A6%E3%82%A4%E3%83%AB%E3%82%B9%E6%84%9F%E6%9F%93%E7%97%87_\(2019%E5%B9%B4\) "新型コロナウイルス感染症 (2019年) – Japanese")
- [Jawa](https://jv.wikipedia.org/wiki/Lelara_koronavirus_2019 "Lelara koronavirus 2019 – Javanese")
- [ქართული](https://ka.wikipedia.org/wiki/COVID-19 "COVID-19 – Georgian")
- [Taqbaylit](https://kab.wikipedia.org/wiki/A%E1%B9%AD%E1%B9%ADan_n_Coronavirus_2019 "Aṭṭan n Coronavirus 2019 – Kabyle")
- [Tyap](https://kcg.wikipedia.org/wiki/Koronavirut_2019 "Koronavirut 2019 – Tyap")
- [Gĩkũyũ](https://ki.wikipedia.org/wiki/Corona\(covid_19\) "Corona(covid 19) – Kikuyu")
- [Қазақша](https://kk.wikipedia.org/wiki/%D0%9A%D0%BE%D1%80%D0%BE%D0%BD%D0%B0%D0%B2%D0%B8%D1%80%D1%83%D1%81%D1%82%D1%8B%D2%9B_%D0%B8%D0%BD%D1%84%D0%B5%D0%BA%D1%86%D0%B8%D1%8F_Covid-19 "Коронавирустық инфекция Covid-19 – Kazakh")
- [ភាសាខ្មែរ](https://km.wikipedia.org/wiki/%E1%9E%87%E1%9F%86%E1%9E%84%E1%9E%BA%E1%9E%80%E1%9E%BC%E1%9E%9A%E1%9F%89%E1%9E%BC%E1%9E%8E%E1%9E%B6%E1%9E%9C%E1%9E%B8%E1%9E%9A%E1%9E%BB%E1%9E%9F%E1%9F%A2%E1%9F%A0%E1%9F%A1%E1%9F%A9 "ជំងឺកូរ៉ូណាវីរុស២០១៩ – Khmer")
- [ಕನ್ನಡ](https://kn.wikipedia.org/wiki/%E0%B2%95%E0%B3%8B%E0%B2%B5%E0%B2%BF%E0%B2%A1%E0%B3%8D-%E0%B3%A7%E0%B3%AF "ಕೋವಿಡ್-೧೯ – Kannada")
- [Yerwa Kanuri](https://knc.wikipedia.org/wiki/COVID-19 "COVID-19 – Central Kanuri")
- [한국어](https://ko.wikipedia.org/wiki/%EC%BD%94%EB%A1%9C%EB%82%98%EB%B0%94%EC%9D%B4%EB%9F%AC%EC%8A%A4%EA%B0%90%EC%97%BC%EC%A6%9D-19 "코로나바이러스감염증-19 – Korean")
- [کٲشُر](https://ks.wikipedia.org/wiki/%DA%A9%D9%88%D8%B1%D9%88%D9%86%D8%A7 "کورونا – Kashmiri")
- [Kurdî](https://ku.wikipedia.org/wiki/Nexwe%C5%9Fiya_Koronay%C3%AA_2019-2020 "Nexweşiya Koronayê 2019-2020 – Kurdish")
- [Кыргызча](https://ky.wikipedia.org/wiki/COVID-19 "COVID-19 – Kyrgyz")
- [Latina](https://la.wikipedia.org/wiki/COVID-19 "COVID-19 – Latin")
- [Lëtzebuergesch](https://lb.wikipedia.org/wiki/COVID-19 "COVID-19 – Luxembourgish")
- [Limburgs](https://li.wikipedia.org/wiki/COVID-19 "COVID-19 – Limburgish")
- [Lombard](https://lmo.wikipedia.org/wiki/COVID-19 "COVID-19 – Lombard")
- [Lingála](https://ln.wikipedia.org/wiki/Bok%C9%94n%C9%94%CC%81_bwa_Sika_2019_Vil%C3%BAsu_Kol%C3%B3n%C3%A1 "Bokɔnɔ́ bwa Sika 2019 Vilúsu Kolóná – Lingala")
- [ລາວ](https://lo.wikipedia.org/wiki/%E0%BB%82%E0%BA%84%E0%BA%A7%E0%BA%B4%E0%BA%94-19 "ໂຄວິດ-19 – Lao")
- [Lietuvių](https://lt.wikipedia.org/wiki/COVID-19 "COVID-19 – Lithuanian")
- [Latviešu](https://lv.wikipedia.org/wiki/COVID-19 "COVID-19 – Latvian")
- [मैथिली](https://mai.wikipedia.org/wiki/%E0%A4%95%E0%A5%8B%E0%A4%B0%E0%A5%8B%E0%A4%A8%E0%A4%BE_%E0%A4%AD%E0%A4%BE%E0%A4%87%E0%A4%B0%E0%A4%B8_%E0%A4%B0%E0%A5%8B%E0%A4%97_\(%E0%A4%95%E0%A5%8B%E0%A4%AD%E0%A4%BF%E0%A4%A1-%E0%A5%A7%E0%A5%AF\) "कोरोना भाइरस रोग (कोभिड-१९) – Maithili")
- [Malagasy](https://mg.wikipedia.org/wiki/Mpikambana:Bluerose25/COVID_19 "Mpikambana:Bluerose25/COVID 19 – Malagasy")
- [Олык марий](https://mhr.wikipedia.org/wiki/COVID-19 "COVID-19 – Eastern Mari")
- [Māori](https://mi.wikipedia.org/wiki/KOWHEORI-19 "KOWHEORI-19 – Māori")
- [Minangkabau](https://min.wikipedia.org/wiki/Panyakik_koronavirus_2019 "Panyakik koronavirus 2019 – Minangkabau")
- [Македонски](https://mk.wikipedia.org/wiki/%D0%9A%D0%9E%D0%92%D0%98%D0%94-19 "КОВИД-19 – Macedonian")
- [മലയാളം](https://ml.wikipedia.org/wiki/%E0%B4%95%E0%B5%8B%E0%B4%B5%E0%B4%BF%E0%B4%A1%E0%B5%8D-19 "കോവിഡ്-19 – Malayalam")
- [Монгол](https://mn.wikipedia.org/wiki/COVID-19 "COVID-19 – Mongolian")
- [ꯃꯤꯇꯩ ꯂꯣꯟ](https://mni.wikipedia.org/wiki/%EA%AF%80%EA%AF%A3%EA%AF%94%EA%AF%A3%EA%AF%85%EA%AF%A5_%EA%AF%9A%EA%AF%A5%EA%AF%8F%EA%AF%94%EA%AF%81_%EA%AF%82%EA%AF%A9%EA%AF%85%EA%AF%A5_%EA%AF%B2%EA%AF%B0%EA%AF%B1%EA%AF%B9 "ꯀꯣꯔꯣꯅꯥ ꯚꯥꯏꯔꯁ ꯂꯩꯅꯥ ꯲꯰꯱꯹ – Manipuri")
- [ဘာသာမန်](https://mnw.wikipedia.org/wiki/%E1%80%9A%E1%80%B2%E1%80%80%E1%80%9D%E1%80%BA%E1%80%9B%E1%80%9D%E1%80%BA%E1%80%94%E1%80%AC%E1%80%9D%E1%80%B3%E1%80%9B%E1%80%AF%E1%80%9E%E1%80%BA_%E1%81%82%E1%81%80%E1%81%81%E1%81%89 "ယဲကဝ်ရဝ်နာဝဳရုသ် ၂၀၁၉ – Mon")
- [मराठी](https://mr.wikipedia.org/wiki/%E0%A4%95%E0%A5%8B%E0%A4%B5%E0%A4%BF%E0%A4%A1-%E0%A5%A7%E0%A5%AF "कोविड-१९ – Marathi")
- [Bahasa Melayu](https://ms.wikipedia.org/wiki/Penyakit_koronavirus_2019 "Penyakit koronavirus 2019 – Malay")
- [မြန်မာဘာသာ](https://my.wikipedia.org/wiki/%E1%80%80%E1%80%AD%E1%80%AF%E1%80%97%E1%80%85%E1%80%BA_%E1%81%81%E1%81%89 "ကိုဗစ် ၁၉ – Burmese")
- [مازِرونی](https://mzn.wikipedia.org/wiki/%DA%A9%D9%88%D9%88%DB%8C%D8%AF_%DB%B1%DB%B9 "کووید ۱۹ – Mazanderani")
- [Nedersaksies](https://nds-nl.wikipedia.org/wiki/COVID-19 "COVID-19 – Low Saxon")
- [Plattdüütsch](https://nds.wikipedia.org/wiki/COVID-19 "COVID-19 – Low German")
- [नेपाली](https://ne.wikipedia.org/wiki/%E0%A4%95%E0%A5%8B%E0%A4%B0%E0%A5%8B%E0%A4%A8%E0%A4%BE%E0%A4%AD%E0%A4%BE%E0%A4%87%E0%A4%B0%E0%A4%B8_%E0%A4%B0%E0%A5%8B%E0%A4%97_%E0%A5%A8%E0%A5%A6%E0%A5%A7%E0%A5%AF "कोरोनाभाइरस रोग २०१९ – Nepali")
- [Nederlands](https://nl.wikipedia.org/wiki/COVID-19 "COVID-19 – Dutch")
- [Norsk nynorsk](https://nn.wikipedia.org/wiki/Covid-19 "Covid-19 – Norwegian Nynorsk")
- [Norsk bokmål](https://no.wikipedia.org/wiki/Covid-19 "Covid-19 – Norwegian Bokmål")
- [IsiNdebele seSewula](https://nr.wikipedia.org/wiki/Ingogwana_ye_covid-19 "Ingogwana ye covid-19 – South Ndebele")
- [Nouormand](https://nrm.wikipedia.org/wiki/COVID-19 "COVID-19 – Norman")
- [Chi-Chewa](https://ny.wikipedia.org/wiki/Kachilombo_ka_Korona "Kachilombo ka Korona – Nyanja")
- [Occitan](https://oc.wikipedia.org/wiki/Malauti%C3%A1_de_coronavirus_de_2019 "Malautiá de coronavirus de 2019 – Occitan")
- [ଓଡ଼ିଆ](https://or.wikipedia.org/wiki/%E0%AC%95%E0%AD%8B%E0%AC%AD%E0%AC%BF%E0%AC%A1-%E0%AD%A7%E0%AD%AF "କୋଭିଡ-୧୯ – Odia")
- [ਪੰਜਾਬੀ](https://pa.wikipedia.org/wiki/%E0%A8%95%E0%A9%8B%E0%A8%B0%E0%A9%8B%E0%A8%A8%E0%A8%BE%E0%A8%B5%E0%A8%BE%E0%A8%87%E0%A8%B0%E0%A8%B8_%E0%A8%AE%E0%A8%B9%E0%A8%BE%E0%A8%AE%E0%A8%BE%E0%A8%B0%E0%A9%80_2019 "ਕੋਰੋਨਾਵਾਇਰਸ ਮਹਾਮਾਰੀ 2019 – Punjabi")
- [Papiamentu](https://pap.wikipedia.org/wiki/COVID-19 "COVID-19 – Papiamento")
- [Polski](https://pl.wikipedia.org/wiki/COVID-19 "COVID-19 – Polish")
- [پنجابی](https://pnb.wikipedia.org/wiki/%DA%A9%D9%88%D8%B1%D9%88%D9%86%D8%A7_%D9%88%D8%A7%D8%A6%D8%B1%D8%B3_%D8%AF%D8%A7_%D9%85%D8%B1%D8%B6_%DB%B2%DB%B0%DB%B1%DB%B9%D8%A1 "کورونا وائرس دا مرض ۲۰۱۹ء – Western Punjabi")
- [Nawat](https://ppl.wikipedia.org/wiki/Coronavirus_de_2019 "Coronavirus de 2019 – Nawat")
- [پښتو](https://ps.wikipedia.org/wiki/%DA%A9%D9%88%DB%8C%DA%89%E2%80%9319 "کویډ–19 – Pashto")
- [Português](https://pt.wikipedia.org/wiki/COVID-19 "COVID-19 – Portuguese")
- [Pinayuanan](https://pwn.wikipedia.org/wiki/COVID-19 "COVID-19 – Paiwan")
- [Runa Simi](https://qu.wikipedia.org/wiki/2019_Kurunawirus_unquy "2019 Kurunawirus unquy – Quechua")
- [Rumantsch](https://rm.wikipedia.org/wiki/COVID-19 "COVID-19 – Romansh")
- [Română](https://ro.wikipedia.org/wiki/COVID-19 "COVID-19 – Romanian")
- [Armãneashti](https://roa-rup.wikipedia.org/wiki/COVID-19 "COVID-19 – Aromanian")
- [Русский](https://ru.wikipedia.org/wiki/COVID-19 "COVID-19 – Russian")
- [Русиньскый](https://rue.wikipedia.org/wiki/COVID-19 "COVID-19 – Rusyn")
- [Ikinyarwanda](https://rw.wikipedia.org/wiki/COVID-19 "COVID-19 – Kinyarwanda")
- [Саха тыла](https://sah.wikipedia.org/wiki/COVID-19 "COVID-19 – Yakut")
- [ᱥᱟᱱᱛᱟᱲᱤ](https://sat.wikipedia.org/wiki/%E1%B1%A0%E1%B1%9A%E1%B1%A8%E1%B1%B3%E1%B1%B1%E1%B1%9F%E1%B1%B5%E1%B1%B7%E1%B1%9F%E1%B1%AD%E1%B1%A8%E1%B1%9F%E1%B1%A5_%E1%B1%9F%E1%B1%A1%E1%B1%9F%E1%B1%A8_%E1%B1%92%E1%B1%90%E1%B1%91%E1%B1%99 "ᱠᱚᱨᱳᱱᱟᱵᱷᱟᱭᱨᱟᱥ ᱟᱡᱟᱨ ᱒᱐᱑᱙ – Santali")
- [Sardu](https://sc.wikipedia.org/wiki/COVID-19 "COVID-19 – Sardinian")
- [Sicilianu](https://scn.wikipedia.org/wiki/COVID-19 "COVID-19 – Sicilian")
- [Scots](https://sco.wikipedia.org/wiki/COVID-19 "COVID-19 – Scots")
- [سنڌي](https://sd.wikipedia.org/wiki/%DA%AA%D9%88%D8%B1%D9%88%D9%86%D8%A7%D9%88%D8%A7%D8%A6%D8%B1%D8%B3_%D8%B1%D9%88%DA%B3_2019 "ڪوروناوائرس روڳ 2019 – Sindhi")
- [Srpskohrvatski / српскохрватски](https://sh.wikipedia.org/wiki/COVID-19 "COVID-19 – Serbo-Croatian")
- [တႆး](https://shn.wikipedia.org/wiki/%E1%80%90%E1%81%A2%E1%80%84%E1%80%BA%E1%80%B8%E1%80%95%E1%80%B5%E1%81%BC%E1%80%BA_%E1%80%9D%E1%81%A2%E1%82%86%E1%80%B8%E1%80%9B%E1%82%85%E1%80%90%E1%80%BA%E1%82%89%E1%81%B6%E1%80%B0%E1%80%9D%E1%80%BA%E1%82%87%E1%80%9B%E1%80%B0%E1%80%9D%E1%80%BA%E1%82%87%E1%81%BC%E1%82%83%E1%82%87_2019 "တၢင်းပဵၼ် ဝၢႆးရႅတ်ႉၶူဝ်ႇရူဝ်ႇၼႃႇ 2019 – Shan")
- [සිංහල](https://si.wikipedia.org/wiki/%E0%B6%9A%E0%B7%9C%E0%B7%80%E0%B7%92%E0%B6%A9%E0%B7%8A-19 "කොවිඩ්-19 – Sinhala")
- [Simple English](https://simple.wikipedia.org/wiki/COVID-19 "COVID-19 – Simple English")
- [Slovenčina](https://sk.wikipedia.org/wiki/COVID-19 "COVID-19 – Slovak")
- [Slovenščina](https://sl.wikipedia.org/wiki/Covid-19 "Covid-19 – Slovenian")
- [ChiShona](https://sn.wikipedia.org/wiki/Dzihwamupengo "Dzihwamupengo – Shona")
- [Shqip](https://sq.wikipedia.org/wiki/COVID-19 "COVID-19 – Albanian")
- [Српски / srpski](https://sr.wikipedia.org/wiki/%D0%9A%D0%BE%D0%B2%D0%B8%D0%B4_19 "Ковид 19 – Serbian")
- [SiSwati](https://ss.wikipedia.org/wiki/Sifo_seKhorona_yango-2019 "Sifo seKhorona yango-2019 – Swati")
- [Sesotho](https://st.wikipedia.org/wiki/Coronavirus "Coronavirus – Southern Sotho")
- [Sunda](https://su.wikipedia.org/wiki/COVID-19 "COVID-19 – Sundanese")
- [Svenska](https://sv.wikipedia.org/wiki/Covid-19 "Covid-19 – Swedish")
- [Kiswahili](https://sw.wikipedia.org/wiki/COVID-19 "COVID-19 – Swahili")
- [ꠍꠤꠟꠐꠤ](https://syl.wikipedia.org/wiki/%EA%A0%87%EA%A0%9E%EA%A0%98%EA%A0%A3_%EA%A0%9B%EA%A0%A6%EA%A0%9D%EA%A0%A3%EA%A0%9E "ꠇꠞꠘꠣ ꠛꠦꠝꠣꠞ – Sylheti")
- [Ślůnski](https://szl.wikipedia.org/wiki/COVID-19 "COVID-19 – Silesian")
- [Sakizaya](https://szy.wikipedia.org/wiki/COVID-19 "COVID-19 – Sakizaya")
- [தமிழ்](https://ta.wikipedia.org/wiki/%E0%AE%95%E0%AF%8B%E0%AE%B5%E0%AE%BF%E0%AE%9F%E0%AF%8D-19 "கோவிட்-19 – Tamil")
- [Tayal](https://tay.wikipedia.org/wiki/COVID-19 "COVID-19 – Atayal")
- [ತುಳು](https://tcy.wikipedia.org/wiki/%E0%B2%95%E0%B3%8A%E0%B2%B0%E0%B3%8B%E0%B2%A8%E0%B2%BE%E0%B2%B5%E0%B3%88%E0%B2%B0%E0%B2%B8%E0%B3%8D_%E0%B2%B8%E0%B3%80%E0%B2%95%E0%B3%8D_%E0%B3%A8%E0%B3%A6%E0%B3%A7%E0%B3%AF "ಕೊರೋನಾವೈರಸ್ ಸೀಕ್ ೨೦೧೯ – Tulu")
- [ᥖᥭᥰ ᥖᥬᥲ ᥑᥨᥒᥰ](https://tdd.wikipedia.org/wiki/%E1%A5%94%E1%A5%A4%E1%A5%A2_%E1%A5%90%E1%A5%A9%E1%A5%A2_%E1%A5%9C%E1%A5%AB%E1%A5%AD%E1%A5%B1_%E1%A5%95%E1%A5%A6%E1%A5%A2%E1%A5%B2 "ᥔᥤᥢ ᥐᥩᥢ ᥜᥫᥭᥱ ᥕᥦᥢᥲ – Tai Nuea")
- [తెలుగు](https://te.wikipedia.org/wiki/%E0%B0%95%E0%B1%8B%E0%B0%B5%E0%B0%BF%E0%B0%A1%E0%B1%8D-19_%E0%B0%B5%E0%B1%8D%E0%B0%AF%E0%B0%BE%E0%B0%A7%E0%B0%BF "కోవిడ్-19 వ్యాధి – Telugu")
- [Tetun](https://tet.wikipedia.org/wiki/COVID-19 "COVID-19 – Tetum")
- [ไทย](https://th.wikipedia.org/wiki/%E0%B9%82%E0%B8%A3%E0%B8%84%E0%B8%95%E0%B8%B4%E0%B8%94%E0%B9%80%E0%B8%8A%E0%B8%B7%E0%B9%89%E0%B8%AD%E0%B9%84%E0%B8%A7%E0%B8%A3%E0%B8%B1%E0%B8%AA%E0%B9%82%E0%B8%84%E0%B9%82%E0%B8%A3%E0%B8%99%E0%B8%B2_2019 "โรคติดเชื้อไวรัสโคโรนา 2019 – Thai")
- [Türkmençe](https://tk.wikipedia.org/wiki/COVID "COVID – Turkmen")
- [Tagalog](https://tl.wikipedia.org/wiki/COVID-19 "COVID-19 – Tagalog")
- [Lea faka-Tonga](https://to.wikipedia.org/wiki/KOVITI-19 "KOVITI-19 – Tongan")
- [Toki pona](https://tok.wikipedia.org/wiki/jaki_Kolona_pi_tenpo_sike_nanpa_2019 "jaki Kolona pi tenpo sike nanpa 2019 – Toki Pona")
- [Türkçe](https://tr.wikipedia.org/wiki/COVID-19 "COVID-19 – Turkish")
- [Seediq](https://trv.wikipedia.org/wiki/COVID-19 "COVID-19 – Taroko")
- [Xitsonga](https://ts.wikipedia.org/wiki/Vuvabyi_bya_Khorona_bya_2019 "Vuvabyi bya Khorona bya 2019 – Tsonga")
- [Татарча / tatarça](https://tt.wikipedia.org/wiki/COVID-19_%D0%BA%D0%BE%D1%80%D0%BE%D0%BD%D0%B0%D0%B2%D0%B8%D1%80%D1%83%D1%81_%D0%B0%D0%B2%D1%8B%D1%80%D1%83%D1%8B "COVID-19 коронавирус авыруы – Tatar")
- [ChiTumbuka](https://tum.wikipedia.org/wiki/Covid-19 "Covid-19 – Tumbuka")
- [Twi](https://tw.wikipedia.org/wiki/%C6%90nsa_Hohorow "Ɛnsa Hohorow – Twi")
- [ئۇيغۇرچە / Uyghurche](https://ug.wikipedia.org/wiki/%D9%8A%DB%90%DA%AD%D9%89_%D8%AA%D9%89%D9%BE%D8%AA%D9%89%D9%83%D9%89_%D8%AA%D8%A7%D8%AC%D8%B3%D9%89%D9%85%D8%A7%D9%86_%DB%8B%D9%89%D8%B1%DB%87%D8%B3_%D9%83%DB%90%D8%B3%D9%89%D9%84%D9%89\(%D9%83%D9%88%DB%8B%D9%89%D8%AF-19_%D9%83%DB%90%D8%B3%D9%89%D9%84%D9%89\) "يېڭى تىپتىكى تاجسىمان ۋىرۇس كېسىلى(كوۋىد-19 كېسىلى) – Uyghur")
- [Українська](https://uk.wikipedia.org/wiki/%D0%9A%D0%BE%D1%80%D0%BE%D0%BD%D0%B0%D0%B2%D1%96%D1%80%D1%83%D1%81%D0%BD%D0%B0_%D1%85%D0%B2%D0%BE%D1%80%D0%BE%D0%B1%D0%B0_2019 "Коронавірусна хвороба 2019 – Ukrainian")
- [اردو](https://ur.wikipedia.org/wiki/%DA%A9%D9%88%D8%B1%D9%88%D9%86%D8%A7_%D9%88%D8%A7%D8%A6%D8%B1%D8%B3_%DA%A9%D8%A7_%D9%85%D8%B1%D8%B6 "کورونا وائرس کا مرض – Urdu")
- [Oʻzbekcha / ўзбекча](https://uz.wikipedia.org/wiki/COVID-19_koronavirus_infeksiyasi "COVID-19 koronavirus infeksiyasi – Uzbek")
- [Tiếng Việt](https://vi.wikipedia.org/wiki/COVID-19 "COVID-19 – Vietnamese")
- [Walon](https://wa.wikipedia.org/wiki/Maladeye_%C3%A5_cronivir%C3%BBsse_2019 "Maladeye å cronivirûsse 2019 – Walloon")
- [Winaray](https://war.wikipedia.org/wiki/COVID-19 "COVID-19 – Waray")
- [吴语](https://wuu.wikipedia.org/wiki/2019%E5%86%A0%E7%8A%B6%E7%97%85%E6%AF%92%E7%97%85 "2019冠状病毒病 – Wu")
- [მარგალური](https://xmf.wikipedia.org/wiki/COVID-19 "COVID-19 – Mingrelian")
- [Yorùbá](https://yo.wikipedia.org/wiki/%C3%80r%C3%BAn_%C3%A8r%C3%A0nk%C3%B2r%C3%B3n%C3%A0_%E1%BB%8Dd%C3%BAn_2019 "Àrún èrànkòrónà ọdún 2019 – Yoruba")
- [Vahcuengh](https://za.wikipedia.org/wiki/Bwtbingh_binghdoeg_gvanhcang_yienghmoq "Bwtbingh binghdoeg gvanhcang yienghmoq – Zhuang")
- [ⵜⴰⵎⴰⵣⵉⵖⵜ ⵜⴰⵏⴰⵡⴰⵢⵜ](https://zgh.wikipedia.org/wiki/%E2%B4%B0%E2%B5%9F%E2%B5%9F%E2%B4%B0%E2%B5%8F_%E2%B5%8F_%E2%B4%BD%E2%B5%93%E2%B5%94%E2%B5%93%E2%B5%8F%E2%B4%B0%E2%B4%BC%E2%B5%89%E2%B5%94%E2%B5%93%E2%B5%99_2019 "ⴰⵟⵟⴰⵏ ⵏ ⴽⵓⵔⵓⵏⴰⴼⵉⵔⵓⵙ 2019 – Standard Moroccan Tamazight")
- [文言](https://zh-classical.wikipedia.org/wiki/%E4%BA%8C%E3%80%87%E4%B8%80%E4%B9%9D%E5%86%A0%E7%8B%80%E7%97%85%E6%AF%92%E7%97%85 "二〇一九冠狀病毒病 – Literary Chinese")
- [閩南語 / Bân-lâm-gí](https://zh-min-nan.wikipedia.org/wiki/COVID-19 "COVID-19 – Minnan")
- [粵語](https://zh-yue.wikipedia.org/wiki/%E6%AD%A6%E6%BC%A2%E8%82%BA%E7%82%8E "武漢肺炎 – Cantonese")
- [中文](https://zh.wikipedia.org/wiki/2019%E5%86%A0%E7%8A%B6%E7%97%85%E6%AF%92%E7%97%85 "2019冠状病毒病 – Chinese")
- [IsiZulu](https://zu.wikipedia.org/wiki/Coronavirus_disease_2019 "Coronavirus disease 2019 – Zulu")
[Edit links](https://www.wikidata.org/wiki/Special:EntityPage/Q84263196#sitelinks-wikipedia "Edit interlanguage links")
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English
- [Read](https://en.wikipedia.org/wiki/COVID-19)
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From Wikipedia, the free encyclopedia
Contagious disease caused by SARS-CoV-2
This article is about the disease itself. For the virus that caused the disease, see [SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2"). For the global pandemic caused by the disease, see [COVID-19 pandemic](https://en.wikipedia.org/wiki/COVID-19_pandemic "COVID-19 pandemic"). For other diseases caused by coronaviruses, see [Coronavirus diseases](https://en.wikipedia.org/wiki/Coronavirus_diseases "Coronavirus diseases").
Medical condition
| Coronavirus disease 2019 (COVID-19) | |
|---|---|
| Other names | COVID, (the) coronavirus |
| [](https://en.wikipedia.org/wiki/File:Fphar-11-00937-g001.jpg) | |
| Transmission and life-cycle of [SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2"), which causes COVID-19 | |
| Pronunciation | [/kəˈroʊnəvaɪrəs/](https://en.wikipedia.org/wiki/Help:IPA/English "Help:IPA/English") [/ˌkoʊvɪdnaɪnˈtiːn, ˌkɒvɪd\-/](https://en.wikipedia.org/wiki/Help:IPA/English "Help:IPA/English")[\[1\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-1) |
| [Specialty](https://en.wikipedia.org/wiki/Medical_specialty "Medical specialty") | [Infectious disease](https://en.wikipedia.org/wiki/Infectious_disease_\(medical_specialty\) "Infectious disease (medical specialty)") |
| [Symptoms](https://en.wikipedia.org/wiki/Signs_and_symptoms "Signs and symptoms") | [Fever, cough, fatigue, shortness of breath, vomiting, loss of taste or smell; some cases asymptomatic](https://en.wikipedia.org/wiki/Symptoms_of_COVID-19 "Symptoms of COVID-19")[\[2\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC2020Sym-2)[\[3\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO2020QA-3) |
| [Complications](https://en.wikipedia.org/wiki/Complication_\(medicine\) "Complication (medicine)") | [Pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia"), [sepsis](https://en.wikipedia.org/wiki/Sepsis "Sepsis"), [ARDS](https://en.wikipedia.org/wiki/Acute_respiratory_distress_syndrome "Acute respiratory distress syndrome"), [kidney failure](https://en.wikipedia.org/wiki/Kidney_failure "Kidney failure"), [respiratory failure](https://en.wikipedia.org/wiki/Respiratory_failure "Respiratory failure"), [pulmonary fibrosis](https://en.wikipedia.org/wiki/Pulmonary_fibrosis "Pulmonary fibrosis"), [CKS](https://en.wikipedia.org/wiki/Cytokine_release_syndrome "Cytokine release syndrome"), [MIS-C](https://en.wikipedia.org/wiki/Pediatric_multisystem_inflammatory_syndrome "Pediatric multisystem inflammatory syndrome"), [long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID"), [brain damage](https://en.wikipedia.org/wiki/Brain_damage "Brain damage") |
| Usual onset | 2–14 days (typically 5) after infection |
| Duration | 5 days to [chronic](https://en.wikipedia.org/wiki/Long_COVID "Long COVID") |
| [Causes](https://en.wikipedia.org/wiki/Cause_\(medicine\) "Cause (medicine)") | [SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2") |
| [Diagnostic method](https://en.wikipedia.org/wiki/Medical_diagnosis "Medical diagnosis") | [RT‑PCR testing](https://en.wikipedia.org/wiki/Reverse_transcription_polymerase_chain_reaction "Reverse transcription polymerase chain reaction"), [CT scan](https://en.wikipedia.org/wiki/CT_scan "CT scan"), [rapid antigen test](https://en.wikipedia.org/wiki/Rapid_antigen_test "Rapid antigen test") |
| Prevention | [Vaccination](https://en.wikipedia.org/wiki/COVID-19_vaccine "COVID-19 vaccine"), face coverings, [quarantine](https://en.wikipedia.org/wiki/Quarantine "Quarantine"), [social distancing](https://en.wikipedia.org/wiki/Social_distancing "Social distancing"), ventilation, hand washing |
| Treatment | [Symptomatic and supportive](https://en.wikipedia.org/wiki/Management_of_COVID-19 "Management of COVID-19") |
| Frequency | 779,056,637[\[4\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Template:COVID-19_data-4) confirmed cases (true case count is expected to be much higher[\[5\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-5)) |
| Deaths | 7,111,504[\[4\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Template:COVID-19_data-4) (reported) 18\.2–33.5 million[\[6\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-6) (estimated) |
**Coronavirus disease 2019** (**COVID-19**) is a [contagious disease](https://en.wikipedia.org/wiki/Contagious_disease "Contagious disease") caused by the [coronavirus](https://en.wikipedia.org/wiki/Coronavirus "Coronavirus") [SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2"). Starting in January 2020, the disease spread worldwide, resulting in the [COVID-19 pandemic](https://en.wikipedia.org/wiki/COVID-19_pandemic "COVID-19 pandemic"). In March 2020, the [World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization "World Health Organization") declared COVID-19 a [global health emergency](https://en.wikipedia.org/wiki/Public_health_emergency_of_international_concern "Public health emergency of international concern"); they declared the end of the emergency in May 2023.[\[7\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-7)
The [symptoms of COVID‑19](https://en.wikipedia.org/wiki/Symptoms_of_COVID%E2%80%9119 "Symptoms of COVID‑19") can vary but often include fever,[\[8\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-8) fatigue, cough, [breathing difficulties](https://en.wikipedia.org/wiki/Breathing_difficulties "Breathing difficulties"), [loss of smell](https://en.wikipedia.org/wiki/Anosmia "Anosmia"), and [loss of taste](https://en.wikipedia.org/wiki/Ageusia "Ageusia").[\[9\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-9)[\[10\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-10)[\[11\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-11) Symptoms may begin one to 14 days [after exposure](https://en.wikipedia.org/wiki/Incubation_period "Incubation period") to the virus. At least a third of people who are infected [do not develop noticeable symptoms](https://en.wikipedia.org/wiki/Asymptomatic "Asymptomatic").[\[12\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-12)[\[13\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-13) Of those who develop symptoms noticeable enough to be classified as patients, most (81%) develop mild to moderate symptoms (up to mild [pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia")), while 14% develop severe symptoms ([dyspnea](https://en.wikipedia.org/wiki/Dyspnea "Dyspnea"), [hypoxia](https://en.wikipedia.org/wiki/Hypoxia_\(medical\) "Hypoxia (medical)"), or more than 50% lung involvement on imaging), and 5% develop critical symptoms ([respiratory failure](https://en.wikipedia.org/wiki/Respiratory_failure "Respiratory failure"), [shock](https://en.wikipedia.org/wiki/Shock_\(circulatory\) "Shock (circulatory)"), or [multiorgan dysfunction](https://en.wikipedia.org/wiki/Organ_dysfunction "Organ dysfunction")).[\[14\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC_Interim_Guidance-14) Older people have a higher risk of developing severe symptoms and dying. Some people experience persistent symptoms ([long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID")), for months or years after infection, including [fatigue](https://en.wikipedia.org/wiki/Fatigue "Fatigue"), cognitive issues and [shortness of breath](https://en.wikipedia.org/wiki/Shortness_of_breath "Shortness of breath"). Damage to organs has been observed in a subset.[\[15\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-davis-15)
[COVID‑19 transmission](https://en.wikipedia.org/wiki/Transmission_of_COVID-19 "Transmission of COVID-19") occurs when infectious particles are breathed in or come into contact with the eyes, nose, or mouth. The risk is highest when people are in close proximity, but small [airborne](https://en.wikipedia.org/wiki/Airborne_transmission "Airborne transmission") particles containing the virus can remain suspended in the air and travel over longer distances, particularly indoors. Transmission can also occur when people touch their eyes, nose, or mouth after touching surfaces or objects that have been contaminated by the virus. People remain contagious for up to 20 days and can spread the virus even if they do not develop symptoms.[\[16\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-16)
There are two common [tests to detect COVID](https://en.wikipedia.org/wiki/COVID-19_testing "COVID-19 testing"). Antigen tests (also called [rapid lateral flow tests](https://en.wikipedia.org/wiki/COVID-19_rapid_antigen_test "COVID-19 rapid antigen test")) can be used at home. A positive test indicates an active infection. However, negative tests are not accurate, especially early or late in the infection. Health care providers can perform a more accurate [PCR test](https://en.wikipedia.org/wiki/PCR_test "PCR test"), which is typically analysed in a laboratory.[\[17\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-17)[\[18\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-18)
Several [COVID-19 vaccines](https://en.wikipedia.org/wiki/COVID-19_vaccine "COVID-19 vaccine") have been approved and distributed in various countries, many of which have initiated [mass vaccination campaigns](https://en.wikipedia.org/wiki/Deployment_of_COVID-19_vaccines "Deployment of COVID-19 vaccines"). Other [preventive measures](https://en.wikipedia.org/wiki/Pandemic_prevention "Pandemic prevention") include physical or [social distancing](https://en.wikipedia.org/wiki/Social_distancing "Social distancing"), [quarantining](https://en.wikipedia.org/wiki/Quarantine "Quarantine"), ventilation of indoor spaces, [use of face masks or coverings](https://en.wikipedia.org/wiki/Face_masks_during_the_COVID-19_pandemic "Face masks during the COVID-19 pandemic") in public, covering coughs and sneezes, [hand washing](https://en.wikipedia.org/wiki/Hand_washing "Hand washing"), and keeping unwashed hands away from the face. While [drugs have been developed](https://en.wikipedia.org/wiki/COVID-19_drug_development "COVID-19 drug development") to inhibit the virus, the primary [treatment](https://en.wikipedia.org/wiki/Treatment_and_management_of_COVID-19 "Treatment and management of COVID-19") is still [symptomatic](https://en.wikipedia.org/wiki/Symptomatic_treatment "Symptomatic treatment"), managing the disease through [supportive care](https://en.wikipedia.org/wiki/Symptomatic_treatment "Symptomatic treatment"), [isolation](https://en.wikipedia.org/wiki/Isolation_\(health_care\) "Isolation (health care)"), and [experimental measures](https://en.wikipedia.org/wiki/Medical_research "Medical research").
The first known case was [identified in Wuhan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Hubei "COVID-19 pandemic in Hubei"), China, in December 2019.[\[19\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WSJ-20210226-19) Most scientists believe that the SARS-CoV-2 virus entered into human populations through natural [zoonosis](https://en.wikipedia.org/wiki/Zoonosis "Zoonosis"), similar to the [SARS-CoV-1](https://en.wikipedia.org/wiki/SARS-CoV-1 "SARS-CoV-1") and [MERS-CoV](https://en.wikipedia.org/wiki/MERS-CoV "MERS-CoV") outbreaks, and consistent with other pandemics in human history.[\[20\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pekar-20)[\[21\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-jiang_wang-21) Social and environmental factors including [climate change](https://en.wikipedia.org/wiki/Climate_change "Climate change"), [natural ecosystem destruction](https://en.wikipedia.org/wiki/Environmental_degradation "Environmental degradation") and [wildlife trade](https://en.wikipedia.org/wiki/Wildlife_trade_and_zoonoses "Wildlife trade and zoonoses") increased the likelihood of such zoonotic spillover.[\[22\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-IPCC-2022a-22)[\[23\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-IPCC-2022b-23)[\[24\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-University-of-Cambridge-2021-24)[\[25\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-European-Commission-25)
## Nomenclature
Main article: [COVID-19 naming](https://en.wikipedia.org/wiki/COVID-19_naming "COVID-19 naming")
During the initial outbreak in [Wuhan](https://en.wikipedia.org/wiki/Wuhan "Wuhan"), the virus was commonly called "coronavirus" and "Wuhan coronavirus",[\[26\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-26)[\[27\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-27)[\[28\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-28) and the disease was referred to by the same terms and sometimes as "Wuhan pneumonia".[\[29\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-29)[\[30\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-30) In the past, many diseases have been named after geographical locations, such as the [Spanish flu](https://en.wikipedia.org/wiki/Spanish_flu "Spanish flu"),[\[31\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-31) [Middle East respiratory syndrome](https://en.wikipedia.org/wiki/Middle_East_respiratory_syndrome "Middle East respiratory syndrome"), and [Zika virus](https://en.wikipedia.org/wiki/Zika_virus "Zika virus").[\[32\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Nature_Stop-32) In January 2020, the [World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization "World Health Organization") (WHO) recommended 2019-nCoV[\[33\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-33) and 2019-nCoV acute respiratory disease[\[34\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-34) as interim names for the virus and disease per 2015 guidance and international guidelines against using geographical locations or groups of people in disease and virus names to prevent [social stigma](https://en.wikipedia.org/wiki/Social_stigma "Social stigma").[\[35\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-35)[\[36\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-veconomist-36)[\[37\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-37) The official names COVID‑19 and SARS-CoV-2 were issued by the WHO on 11 February 2020 with COVID-19 being shorthand for "coronavirus disease 2019".[\[38\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO-naming-38)[\[39\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-39) The WHO additionally uses "the COVID‑19 virus" and "the virus responsible for COVID‑19" in public communications.[\[38\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO-naming-38)[\[40\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-40)
## Signs and symptoms
Main article: [Symptoms of COVID-19](https://en.wikipedia.org/wiki/Symptoms_of_COVID-19 "Symptoms of COVID-19")
[](https://en.wikipedia.org/wiki/File:Symptoms_of_coronavirus_disease_2019_4.0.svg)
[Symptoms](https://en.wikipedia.org/wiki/Signs_and_symptoms "Signs and symptoms") of COVID-19
The [symptoms of COVID-19](https://en.wikipedia.org/wiki/Symptoms_of_COVID-19 "Symptoms of COVID-19") are variable depending on the [type of variant](https://en.wikipedia.org/wiki/COVID_variant "COVID variant") contracted, ranging from mild [symptoms](https://en.wikipedia.org/wiki/Symptom "Symptom") to a potentially fatal illness.[\[41\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_CDC2020Sym-41)[\[42\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Grant_et_al_2020-42) Common symptoms include [coughing](https://en.wikipedia.org/wiki/Cough "Cough"), [fever](https://en.wikipedia.org/wiki/Fever "Fever"), [loss of smell](https://en.wikipedia.org/wiki/Anosmia "Anosmia") and [taste](https://en.wikipedia.org/wiki/Ageusia "Ageusia"), with less common ones including [headaches](https://en.wikipedia.org/wiki/Headache "Headache"), [nasal congestion](https://en.wikipedia.org/wiki/Nasal_congestion "Nasal congestion") and [runny nose](https://en.wikipedia.org/wiki/Rhinorrhea "Rhinorrhea"), [muscle pain](https://en.wikipedia.org/wiki/Muscle_pain "Muscle pain"), [sore throat](https://en.wikipedia.org/wiki/Sore_throat "Sore throat"), [diarrhea](https://en.wikipedia.org/wiki/Diarrhea "Diarrhea"), [eye irritation](https://en.wikipedia.org/wiki/Eye_irritation "Eye irritation"),[\[43\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-43) and toes swelling or turning purple,[\[44\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-44) and in moderate to severe cases, [breathing difficulties](https://en.wikipedia.org/wiki/Breathing_difficulties "Breathing difficulties").[\[45\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_ECDC-45) People with the COVID-19 infection may have different symptoms, and their symptoms may change over time.
Three common clusters of symptoms have been identified: a respiratory symptom cluster with cough, [sputum](https://en.wikipedia.org/wiki/Sputum "Sputum"), [shortness of breath](https://en.wikipedia.org/wiki/Shortness_of_breath "Shortness of breath"), and fever; a musculoskeletal symptom cluster with [muscle](https://en.wikipedia.org/wiki/Skeletal_muscle "Skeletal muscle") and joint pain, headache, and fatigue; and a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhea.[\[45\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_ECDC-45) In people without prior ear, nose, or throat disorders, [loss of taste](https://en.wikipedia.org/wiki/Hypogeusia "Hypogeusia") combined with [loss of smell](https://en.wikipedia.org/wiki/Hyposmia "Hyposmia") is associated with COVID-19 and is reported in as many as 88% of symptomatic cases.[\[46\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Paderno_2020-46)[\[47\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Chabot_2021-47)[\[48\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_pmid32483687-48)
Of those who show symptoms, 81% develop only mild to moderate symptoms (up to mild [pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia")), while 14% develop severe symptoms ([dyspnea](https://en.wikipedia.org/wiki/Dyspnea "Dyspnea"), [hypoxia](https://en.wikipedia.org/wiki/Hypoxia_\(medical\) "Hypoxia (medical)"), or more than 50% lung involvement on imaging) that require hospitalization, and 5% of patients develop critical symptoms ([respiratory failure](https://en.wikipedia.org/wiki/Respiratory_failure "Respiratory failure"), septic [shock](https://en.wikipedia.org/wiki/Shock_\(circulatory\) "Shock (circulatory)"), or [multiorgan dysfunction](https://en.wikipedia.org/wiki/Organ_dysfunction "Organ dysfunction")) requiring ICU admission. As of 2024–2025, the majority of infections are characterized as mild or asymptomatic; however, risk remains stratified by age and underlying health conditions, with severe outcomes—including respiratory failure and multi-organ dysfunction—occurring in a significantly smaller percentage of the general vaccinated population than in early 2020.[\[49\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-49)[\[50\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-50)[\[51\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_CDC_Interim_Guidance-51)[\[52\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-52)
[](https://en.wikipedia.org/wiki/File:Asymptomatic_COVID_by_age.jpg)
Proportion of asymptomatic SARS-CoV-2 infection by age. About 44% of those infected with SARS-CoV-2 remained asymptomatic throughout the infection.[\[53\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Wang2023-53)
At least a third of the people who are infected with the virus do not develop noticeable symptoms at any point in time.[\[53\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Wang2023-53)[\[54\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-54)[\[55\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Asymptomatic-55) These [asymptomatic](https://en.wikipedia.org/wiki/Asymptomatic "Asymptomatic") carriers tend not to get tested and can still spread the disease.[\[55\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Asymptomatic-55)[\[56\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-56)[\[57\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-57)[\[58\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Furukawa_2020-58) Other infected people will develop symptoms later (called "pre-symptomatic") or have very mild symptoms and can also spread the virus.[\[58\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Furukawa_2020-58)
As is common with infections, there is a delay, or [incubation period](https://en.wikipedia.org/wiki/Incubation_period "Incubation period"), between the moment a person first becomes infected and the appearance of the first symptoms. The [median](https://en.wikipedia.org/wiki/Median "Median") delay for COVID-19 is four to five days[\[59\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_pmid32329974-59) possibly being infectious on 1–4 of those days.[\[60\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-60) Most symptomatic people experience symptoms within two to seven days after exposure, and almost all will experience at least one symptom within 12 days.[\[59\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_pmid32329974-59)[\[61\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-61)
Most people recover from the [acute](https://en.wikipedia.org/wiki/Acute_\(medicine\) "Acute (medicine)") phase of the disease. However, some people continue to experience a range of effects, such as [fatigue](https://en.wikipedia.org/wiki/Fatigue "Fatigue"), for prolonged periods after an initial COVID-19 infection.[\[62\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_cdc24-62) This is the result of a condition called [long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID"), which can be described as a range of persistent symptoms that continue for months or years.[\[62\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_cdc24-62) Long-term damage to organs has been observed after the onset of COVID-19. Multi-year studies are underway to further investigate the protracted effects of long COVID.[\[62\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_cdc24-62) Reducing the risk of long COVID includes staying up to date on the most recent COVID-19 vaccine, practicing good hygiene, maintaining clean indoor air, and physical distancing from people infected with a respiratory virus.[\[62\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_cdc24-62)
The [Omicron variant](https://en.wikipedia.org/wiki/SARS-CoV-2_Omicron_variant "SARS-CoV-2 Omicron variant") became dominant in the U.S. in December 2021. Symptoms with the Omicron variant are less severe than they are with other variants.[\[63\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-63)
### Complications
[](https://en.wikipedia.org/wiki/File:Fimmu-11-01648-g001.jpg)
Mechanisms of SARS-CoV-2 [cytokine storm](https://en.wikipedia.org/wiki/Cytokine_storm "Cytokine storm") and complications
Complications may include [pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia"), [acute respiratory distress syndrome](https://en.wikipedia.org/wiki/Acute_respiratory_distress_syndrome "Acute respiratory distress syndrome") (ARDS), [multi-organ failure](https://en.wikipedia.org/wiki/Multiple_organ_dysfunction_syndrome "Multiple organ dysfunction syndrome"), [septic shock](https://en.wikipedia.org/wiki/Septic_shock "Septic shock"), and death.[\[64\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Hui14Jan2020-64)[\[65\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-65)[\[66\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-StatPearls-66)[\[67\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Heymann_Shindo_2020_pp._542%E2%80%93545222-67) Cardiovascular complications may include heart failure, [arrhythmias](https://en.wikipedia.org/wiki/Arrhythmia "Arrhythmia") (including [atrial fibrillation](https://en.wikipedia.org/wiki/Atrial_fibrillation "Atrial fibrillation")), [heart inflammation](https://en.wikipedia.org/wiki/Myocarditis "Myocarditis"), [thrombosis](https://en.wikipedia.org/wiki/Thrombosis "Thrombosis"), particularly [venous thromboembolism](https://en.wikipedia.org/wiki/Venous_thromboembolism "Venous thromboembolism"),[\[68\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-68)[\[69\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-69)[\[70\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Long-2020-70)[\[71\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-71)[\[72\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-72)[\[73\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-73) and endothelial cell injury and dysfunction.[\[74\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-74) Approximately 20–30% of people who present with COVID‑19 have [elevated liver enzymes](https://en.wikipedia.org/wiki/Elevated_transaminases "Elevated transaminases"), reflecting liver injury.[\[75\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-75)[\[76\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Sanders202022-76)
Neurologic manifestations include [seizure](https://en.wikipedia.org/wiki/Seizure "Seizure"), stroke, [encephalitis](https://en.wikipedia.org/wiki/Encephalitis "Encephalitis"), and [Guillain–Barré syndrome](https://en.wikipedia.org/wiki/Guillain%E2%80%93Barr%C3%A9_syndrome "Guillain–Barré syndrome") (which includes [loss of motor functions](https://en.wikipedia.org/wiki/Hemiparesis "Hemiparesis")).[\[77\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Carod-Artal-2020-77)[\[78\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-78) Following the infection, children may develop [paediatric multisystem inflammatory syndrome](https://en.wikipedia.org/wiki/Paediatric_multisystem_inflammatory_syndrome "Paediatric multisystem inflammatory syndrome"), which has symptoms similar to [Kawasaki disease](https://en.wikipedia.org/wiki/Kawasaki_disease "Kawasaki disease"), which can be fatal.[\[79\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-79)[\[80\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-80) In very rare cases, acute [encephalopathy](https://en.wikipedia.org/wiki/Encephalopathy "Encephalopathy") can occur, and it can be considered in those who have been diagnosed with COVID‑19 and have an altered mental status.[\[81\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-81)
According to the US [Centers for Disease Control and Prevention](https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention "Centers for Disease Control and Prevention"), pregnant women are at increased risk of becoming seriously ill from COVID‑19.[\[82\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cordoba-Vives-2020-82) This is because pregnant women with COVID‑19 appear to be more likely to develop respiratory and obstetric complications that can lead to [miscarriage](https://en.wikipedia.org/wiki/Miscarriage "Miscarriage"), [premature delivery](https://en.wikipedia.org/wiki/Premature_delivery "Premature delivery") and [intrauterine growth restriction](https://en.wikipedia.org/wiki/Intrauterine_growth_restriction "Intrauterine growth restriction").[\[82\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cordoba-Vives-2020-82)
Fungal infections such as [aspergillosis](https://en.wikipedia.org/wiki/Aspergillosis "Aspergillosis"), [candidiasis](https://en.wikipedia.org/wiki/Candidiasis "Candidiasis"), [cryptococcosis](https://en.wikipedia.org/wiki/Cryptococcosis "Cryptococcosis") and [mucormycosis](https://en.wikipedia.org/wiki/Mucormycosis "Mucormycosis") have been recorded in people recovering from COVID‑19.[\[83\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-83)[\[84\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-84)
## Cause
COVID‑19 is caused by infection with a [strain](https://en.wikipedia.org/wiki/Strain_\(biology\)#Microbiology_and_virology "Strain (biology)") of [coronavirus](https://en.wikipedia.org/wiki/Coronavirus "Coronavirus") known as "severe acute respiratory syndrome coronavirus 2" ([SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2")).[\[85\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-85)
### Transmission
Main article: [Transmission of COVID-19](https://en.wikipedia.org/wiki/Transmission_of_COVID-19 "Transmission of COVID-19")
[](https://en.wikipedia.org/wiki/File:Transmission_of_COVID-19.jpg)
[Transmission](https://en.wikipedia.org/wiki/Transmission_\(medicine\) "Transmission (medicine)") of COVID‑19
COVID-19 is mainly transmitted from person to person through inhaling air contaminated by [droplets](https://en.wikipedia.org/wiki/Drop_\(liquid\) "Drop (liquid)")/[aerosols](https://en.wikipedia.org/wiki/Aerosol "Aerosol") and small [airborne](https://en.wikipedia.org/wiki/Airborne_transmission "Airborne transmission") particles containing the virus. Infected people exhale those particles as they breathe, talk, cough, sneeze, or sing.[\[86\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Wang_2021-86)[\[87\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Greenhalgh_2021-87)[\[88\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_AR2021-88)[\[89\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-89) Transmission is most likely at closer range but can also occur over longer distances, particularly indoors.[\[86\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Wang_2021-86)[\[90\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Miller_2021-90)
The virus spreads through virus-laden fluid particles, or droplets, which are created in the respiratory tract, and they are expelled by the mouth and the nose. There are three types of transmission: "droplet" and "contact", which are associated with large droplets, and "airborne", which is associated with small droplets.[\[91\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_:1-91) If the droplets are above a certain critical size, they settle faster than they [evaporate](https://en.wikipedia.org/wiki/Evaporate "Evaporate"), and therefore they [contaminate](https://en.wikipedia.org/wiki/Contaminate "Contaminate") surfaces surrounding them.[\[91\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_:1-91) Droplets that are below a certain critical size, generally thought to be \<100μm diameter, evaporate faster than they settle; due to that fact, they form respiratory aerosol particles that remain airborne for a long period of time over extensive distances.[\[91\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_:1-91)[\[86\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Wang_2021-86)
[Infectivity](https://en.wikipedia.org/wiki/Infectivity "Infectivity") can begin four to five days before the onset of symptoms.[\[92\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_HeCorrection-92) Infected people can spread the disease even if they are pre-symptomatic or [asymptomatic](https://en.wikipedia.org/wiki/Asymptomatic "Asymptomatic").[\[93\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_CDNASoNG-93) Most commonly, the peak viral load in [upper respiratory tract](https://en.wikipedia.org/wiki/Upper_respiratory_tract "Upper respiratory tract") samples occurs close to the time of symptom onset and declines after the first week after symptoms begin.[\[93\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_CDNASoNG-93) Current evidence suggests a duration of viral shedding and the period of infectiousness of up to ten days following symptom onset for people with mild to moderate COVID-19, and up to 20 days for persons with severe COVID-19, including immunocompromised people.[\[94\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_CDCClinicalQuestions-94)[\[93\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_CDNASoNG-93)
Infectious particles range in size from [aerosols](https://en.wikipedia.org/wiki/Aerosol "Aerosol") that remain suspended in the air for long periods of time to larger [droplets](https://en.wikipedia.org/wiki/Respiratory_droplet "Respiratory droplet") that remain airborne briefly or fall to the ground.[\[95\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_CDCScientificBriefTransmission-95)[\[96\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_who_transmitted-96)[\[97\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_WHO-ECDC-CDC-UK-Ca-Aus-Annals-97)[\[98\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Tang_2021-98) Additionally, COVID-19 research has redefined the traditional understanding of how respiratory viruses are transmitted.[\[98\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Tang_2021-98)[\[99\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Morawska_2021-99) The largest droplets of respiratory fluid do not travel far, but can be inhaled or land on mucous membranes on the eyes, nose, or mouth to infect.[\[97\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_WHO-ECDC-CDC-UK-Ca-Aus-Annals-97) Aerosols are highest in concentration when people are in close proximity, which leads to easier viral transmission when people are physically close,[\[97\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_WHO-ECDC-CDC-UK-Ca-Aus-Annals-97)[\[98\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Tang_2021-98)[\[99\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Morawska_2021-99) but [airborne transmission](https://en.wikipedia.org/wiki/Airborne_transmission "Airborne transmission") can occur at longer distances, mainly in locations that are poorly ventilated;[\[97\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_WHO-ECDC-CDC-UK-Ca-Aus-Annals-97) in those conditions small particles can remain suspended in the air for minutes to hours.[\[97\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_WHO-ECDC-CDC-UK-Ca-Aus-Annals-97)[\[100\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-100)
### Virology
Main article: [SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2")
[](https://en.wikipedia.org/wiki/File:Coronavirus_virion_structure.svg)
Illustration of [SARSr-CoV](https://en.wikipedia.org/wiki/SARSr-CoV "SARSr-CoV") [virion](https://en.wikipedia.org/wiki/Virus "Virus")
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a [novel](https://en.wikipedia.org/wiki/Novel_virus "Novel virus") severe acute respiratory syndrome coronavirus. It was first isolated from three people with pneumonia connected to the [cluster](https://en.wikipedia.org/wiki/Disease_cluster "Disease cluster") of acute respiratory illness cases in Wuhan.[\[101\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-ECDC_risk_assessment-101) All structural features of the novel SARS-CoV-2 virus particle occur in related [coronaviruses](https://en.wikipedia.org/wiki/Coronavirus "Coronavirus") in nature,[\[102\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NM-20200317-102) particularly in *[Rhinolophus sinicus](https://en.wikipedia.org/wiki/Rhinolophus_sinicus "Rhinolophus sinicus")* (Chinese horseshoe bats).[\[103\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-zhou20-103)
Outside the human body, the virus is destroyed by household soap which bursts its [protective bubble](https://en.wikipedia.org/wiki/Viral_envelope "Viral envelope").[\[104\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NatGeoSoap-104) Hospital disinfectants, alcohols, heat, [povidone-iodine](https://en.wikipedia.org/wiki/Povidone-iodine "Povidone-iodine"), and [ultraviolet](https://en.wikipedia.org/wiki/Ultraviolet "Ultraviolet")\-C (UV-C) irradiation are also effective disinfection methods for surfaces.[\[105\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-105)
SARS-CoV-2 is closely related to the original [SARS-CoV](https://en.wikipedia.org/wiki/SARS-CoV "SARS-CoV").[\[106\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Zhu24Jan2020-106) It is thought to have an animal ([zoonotic](https://en.wikipedia.org/wiki/Zoonosis "Zoonosis")) origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus *[Betacoronavirus](https://en.wikipedia.org/wiki/Betacoronavirus "Betacoronavirus")*, in subgenus *[Sarbecovirus](https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome%E2%80%93related_coronavirus "Severe acute respiratory syndrome–related coronavirus")* (lineage B) together with two bat-derived strains. It is 96% identical at the whole [genome](https://en.wikipedia.org/wiki/Genome "Genome") level to other bat coronavirus samples (BatCov [RaTG13](https://en.wikipedia.org/wiki/RaTG13 "RaTG13")).[\[107\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHOReport24Feb2020-107)[\[108\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-108)[\[109\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-RathoreSingh-109) The structural proteins of SARS-CoV-2 include [membrane glycoprotein](https://en.wikipedia.org/wiki/Coronavirus_membrane_protein "Coronavirus membrane protein") (M), [envelope protein](https://en.wikipedia.org/wiki/Coronavirus_envelope_protein "Coronavirus envelope protein") (E), [nucleocapsid protein](https://en.wikipedia.org/wiki/Coronavirus_nucleocapsid_protein "Coronavirus nucleocapsid protein") (N), and the [spike protein](https://en.wikipedia.org/wiki/Coronavirus_spike_protein "Coronavirus spike protein") (S). The M protein of SARS-CoV-2 is about 98% similar to the M protein of bat SARS-CoV, maintains around 98% homology with pangolin SARS-CoV, and has 90% homology with the M protein of SARS-CoV; whereas, the similarity is only around 38% with the M protein of [MERS-CoV](https://en.wikipedia.org/wiki/MERS-CoV "MERS-CoV").[\[110\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-110)
### SARS-CoV-2 variants
Main article: [Variants of SARS-CoV-2](https://en.wikipedia.org/wiki/Variants_of_SARS-CoV-2 "Variants of SARS-CoV-2")
The many thousands of SARS-CoV-2 variants are grouped into either [clades](https://en.wikipedia.org/wiki/Clade "Clade") or [lineages](https://en.wikipedia.org/wiki/Lineage_\(evolution\) "Lineage (evolution)").[\[111\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-111)[\[112\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Rambaut-2020-112) The WHO, in collaboration with partners, expert networks, national authorities, institutions and researchers, have established nomenclature systems for naming and tracking SARS-CoV-2 genetic lineages by [GISAID](https://en.wikipedia.org/wiki/GISAID "GISAID"), [Nextstrain](https://en.wikipedia.org/wiki/Nextstrain "Nextstrain") and [Pango](https://en.wikipedia.org/wiki/Phylogenetic_Assignment_of_Named_Global_Outbreak_Lineages "Phylogenetic Assignment of Named Global Outbreak Lineages"). The expert group convened by the WHO recommended the labelling of variants using letters of the [Greek alphabet](https://en.wikipedia.org/wiki/Greek_alphabet "Greek alphabet"), for example, [Alpha](https://en.wikipedia.org/wiki/SARS-CoV-2_Alpha_variant "SARS-CoV-2 Alpha variant"), [Beta](https://en.wikipedia.org/wiki/SARS-CoV-2_Beta_variant "SARS-CoV-2 Beta variant"), [Delta](https://en.wikipedia.org/wiki/SARS-CoV-2_Delta_variant "SARS-CoV-2 Delta variant"), and [Gamma](https://en.wikipedia.org/wiki/SARS-CoV-2_Gamma_variant "SARS-CoV-2 Gamma variant"), giving the justification that they "will be easier and more practical to discussed by non-scientific audiences".[\[113\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-113) Nextstrain divides the variants into five clades (19A, 19B, 20A, 20B, and 20C), while GISAID divides them into seven (L, O, V, S, G, GH, and GR).[\[114\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Alm2020Aug-114) The Pango tool groups variants into lineages, with many circulating lineages being classed under the B.1 lineage.[\[112\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Rambaut-2020-112)[\[115\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-115)
Several notable variants of SARS-CoV-2 emerged throughout 2020.[\[116\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Lauring_Hodcroft_2021_pp._529%E2%80%93531-116)[\[117\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Abdool_Karim_de_Oliveira_pp._1866%E2%80%931868-117) [Cluster 5](https://en.wikipedia.org/wiki/Cluster_5 "Cluster 5") emerged among [minks](https://en.wikipedia.org/wiki/Mink "Mink") and mink farmers in [Denmark](https://en.wikipedia.org/wiki/Denmark "Denmark").[\[118\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-118) After [strict quarantines](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Denmark "COVID-19 pandemic in Denmark") and the [slaughter of all the country's mink](https://en.wikipedia.org/wiki/2020_Danish_mink_cull "2020 Danish mink cull"), the cluster was assessed to no longer be circulating among humans in Denmark as of 1 February 2021.[\[119\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-119)
As of December 2021[\[update\]](https://en.wikipedia.org/w/index.php?title=COVID-19&action=edit), there are five dominant variants of SARS-CoV-2 spreading among global populations: the [Alpha variant](https://en.wikipedia.org/wiki/SARS-CoV-2_Alpha_variant "SARS-CoV-2 Alpha variant") (B.1.1.7, formerly called the UK variant), first found in London and Kent, the [Beta variant](https://en.wikipedia.org/wiki/SARS-CoV-2_Beta_variant "SARS-CoV-2 Beta variant") (B.1.351, formerly called the South Africa variant), the [Gamma variant](https://en.wikipedia.org/wiki/SARS-CoV-2_Gamma_variant "SARS-CoV-2 Gamma variant") (P.1, formerly called the Brazil variant), the [Delta variant](https://en.wikipedia.org/wiki/SARS-CoV-2_Delta_variant "SARS-CoV-2 Delta variant") (B.1.617.2, formerly called the India variant),[\[120\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-120) and the [Omicron variant](https://en.wikipedia.org/wiki/SARS-CoV-2_Omicron_variant "SARS-CoV-2 Omicron variant") (B.1.1.529), which had spread to 57 countries as of 7 December.[\[121\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-121)[\[122\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-122)
On 19 December 2023, the WHO declared that another distinctive variant, JN.1, had emerged as a "variant of interest". Though the WHO expected an increase in cases globally, particularly for countries entering winter, the overall global health risk was considered low.[\[123\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-123)[\[124\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-124)
## Pathophysiology
[](https://en.wikipedia.org/wiki/File:Fpubh-08-00383-g003.jpg)
COVID‑19 [pathogenesis](https://en.wikipedia.org/wiki/Pathogenesis "Pathogenesis")
The SARS-CoV-2 virus can infect a wide range of cells and systems of the body. COVID‑19 is most known for affecting the upper respiratory tract (sinuses, nose, and throat) and the lower respiratory tract (windpipe and lungs).[\[125\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid33132005-125) The lungs are the organs most affected by COVID‑19 because the virus accesses host cells via the [receptor](https://en.wikipedia.org/wiki/Receptor_\(biochemistry\) "Receptor (biochemistry)") for the enzyme [angiotensin-converting enzyme 2](https://en.wikipedia.org/wiki/Angiotensin-converting_enzyme_2 "Angiotensin-converting enzyme 2") (ACE2), which is most abundant on the surface of [type II alveolar cells](https://en.wikipedia.org/wiki/Type_II_cell "Type II cell") of the lungs.[\[126\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-126) The virus uses a special surface glycoprotein called a "[spike](https://en.wikipedia.org/wiki/Coronavirus_spike_protein "Coronavirus spike protein")" to connect to the ACE2 receptor and enter the host cell.[\[127\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Nature_Microbiology-127)
### Respiratory tract
Following viral entry, COVID‑19 infects the ciliated epithelium of the nasopharynx and upper airways.[\[128\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-128) Autopsies of people who died of COVID‑19 have found [diffuse alveolar damage](https://en.wikipedia.org/wiki/Diffuse_alveolar_damage "Diffuse alveolar damage"), and lymphocyte-containing inflammatory infiltrates within the lung.[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
From the [CT scans](https://en.wikipedia.org/wiki/CT_scan "CT scan") of COVID-19 infected lungs, white patches were observed containing fluid known as [ground-glass opacity](https://en.wikipedia.org/wiki/Ground-glass_opacity "Ground-glass opacity") (GGO) or simply ground glass.[\[130\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-130) This tended to correlate with the clear jelly liquid found in lung autopsies of people who died of COVID-19. One possibility addressed in medical research is that [hyuralonic acid](https://en.wikipedia.org/wiki/Hyaluronic_acid "Hyaluronic acid") (HA) could be the leading factor for this observation of the clear jelly liquid found in the lungs, in what could be hyuralonic storm, in conjunction with [cytokine storm](https://en.wikipedia.org/wiki/Cytokine_storm "Cytokine storm").[\[131\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-131)
### Nervous system
See also: [Clouding of consciousness](https://en.wikipedia.org/wiki/Clouding_of_consciousness "Clouding of consciousness")
One common symptom, loss of smell, results from [infection of the support cells of the olfactory epithelium](https://en.wikipedia.org/wiki/Impact_of_COVID-19_on_neurological,_psychological_and_other_mental_health_outcomes "Impact of COVID-19 on neurological, psychological and other mental health outcomes"), with subsequent damage to the [olfactory neurons](https://en.wikipedia.org/wiki/Olfactory_receptor_neuron "Olfactory receptor neuron").[\[132\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Meunier-2020-132) The involvement of both the central and peripheral nervous system in COVID‑19 has been reported in many medical publications.[\[133\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Guerrero2020-133) It is clear that many people with [COVID-19 exhibit neurological or mental health issues](https://en.wikipedia.org/wiki/Impact_of_COVID-19_on_neurological,_psychological_and_other_mental_health_outcomes "Impact of COVID-19 on neurological, psychological and other mental health outcomes"). The virus is not detected in the [central nervous system](https://en.wikipedia.org/wiki/Central_nervous_system "Central nervous system") (CNS) of the majority of people with COVID-19 who also have [neurological issues](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_neurological,_psychological_and_other_mental_health_outcomes "Impact of the COVID-19 pandemic on neurological, psychological and other mental health outcomes"). However, SARS-CoV-2 has been detected at low levels in the brains of those who have died from COVID‑19, but these results need to be confirmed.[\[134\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Pezzini2020-134) While virus has been detected in [cerebrospinal fluid](https://en.wikipedia.org/wiki/Cerebrospinal_fluid "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.[\[135\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-135)[\[136\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-136)[\[137\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-137) The virus may also enter the bloodstream from the lungs and cross the blood–brain barrier to gain access to the CNS, possibly within an infected white blood cell.[\[134\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Pezzini2020-134)
[](https://en.wikipedia.org/wiki/File:Ijms-21-05932-g003.webp)
[Tropism](https://en.wikipedia.org/wiki/Host_tropism "Host tropism") and [multiple organ injuries](https://en.wikipedia.org/wiki/Multiple_organ_dysfunction_syndrome "Multiple organ dysfunction syndrome") in SARS-CoV-2 infection
Research conducted when Alpha was the dominant variant has suggested COVID-19 may cause brain damage.[\[138\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-138) Later research showed that all variants studied (including Omicron) killed brain cells, but the exact cells killed varied by variant.[\[139\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-139) It is unknown if such damage is temporary or permanent.[\[140\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-140)[\[141\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-141) Observed individuals infected with COVID-19 (most with mild cases) experienced an additional 0.2% to 2% of brain tissue lost in regions of the brain connected to the sense of smell compared with uninfected individuals, and the overall effect on the brain was equivalent on average to at least one extra year of normal ageing; infected individuals also scored lower on several cognitive tests. All effects were more pronounced among older ages.[\[142\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-142)
### Gastrointestinal tract
The virus also affects gastrointestinal organs as ACE2 is abundantly expressed in the [glandular](https://en.wikipedia.org/wiki/Gland "Gland") cells of [gastric](https://en.wikipedia.org/wiki/Stomach "Stomach"), [duodenal](https://en.wikipedia.org/wiki/Duodenum "Duodenum") and [rectal](https://en.wikipedia.org/wiki/Rectum "Rectum") [epithelium](https://en.wikipedia.org/wiki/Epithelium "Epithelium")[\[143\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Gu-2020-143) as well as [endothelial](https://en.wikipedia.org/wiki/Endothelium "Endothelium") cells and [enterocytes](https://en.wikipedia.org/wiki/Enterocyte "Enterocyte") of the [small intestine](https://en.wikipedia.org/wiki/Small_intestine "Small intestine").[\[144\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid32343593-144)
### Cardiovascular system
The virus can cause [acute myocardial injury](https://en.wikipedia.org/wiki/Myocardial_infarction "Myocardial infarction") and chronic damage to the [cardiovascular system](https://en.wikipedia.org/wiki/Circulatory_system "Circulatory system").[\[145\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-145)[\[146\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Zheng-2020-146) An acute cardiac injury was found in 12% of infected people admitted to the hospital in Wuhan, China,[\[147\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Huang24Jan2020-147) and is more frequent in severe disease.[\[148\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-148) 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.[\[146\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Zheng-2020-146) ACE2 receptors are highly expressed in the heart and are involved in heart function.[\[146\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Zheng-2020-146)[\[149\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-149)
A high incidence of [thrombosis](https://en.wikipedia.org/wiki/Thrombosis "Thrombosis") and [venous thromboembolism](https://en.wikipedia.org/wiki/Venous_thromboembolism "Venous thromboembolism") occurs in people transferred to [intensive care units](https://en.wikipedia.org/wiki/Intensive_care_unit "Intensive care unit") with COVID‑19 infections, and may be related to poor prognosis.[\[150\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-150) Blood vessel dysfunction and clot formation (as suggested by high [D-dimer](https://en.wikipedia.org/wiki/D-dimer "D-dimer") levels caused by blood clots) may have a significant role in mortality, incidents of clots leading to [pulmonary embolisms](https://en.wikipedia.org/wiki/Pulmonary_embolism "Pulmonary embolism"), and [ischaemic events](https://en.wikipedia.org/wiki/Stroke "Stroke") (strokes) within the brain found as complications leading to death in people infected with COVID‑19.[\[151\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Science-151) Infection may initiate a chain of [vasoconstrictive responses](https://en.wikipedia.org/wiki/Vasoconstriction "Vasoconstriction") within the body, including pulmonary vasoconstriction – a possible mechanism in which oxygenation decreases during pneumonia.[\[151\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Science-151) Furthermore, damage of [arterioles](https://en.wikipedia.org/wiki/Arterioles "Arterioles") and [capillaries](https://en.wikipedia.org/wiki/Capillaries "Capillaries") was found in brain tissue samples of people who died from COVID‑19.[\[152\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-152)[\[153\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-153)
COVID‑19 may also cause substantial structural changes to [blood cells](https://en.wikipedia.org/wiki/Blood_cell "Blood cell"), sometimes persisting for months after hospital discharge.[\[154\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-154) [A low level of blood lymphocytess](https://en.wikipedia.org/wiki/Lymphopenia "Lymphopenia") may result from the virus acting through ACE2-related entry into lymphocytes.[\[155\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-155)
### Kidneys
Another common cause of death is complications related to the [kidneys](https://en.wikipedia.org/wiki/Kidney "Kidney").[\[151\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Science-151) Early reports show that up to 30% of people hospitalised with COVID-19 both in China and in New York have experienced some injury to their kidneys, including some persons with no previous kidney problems.[\[156\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-156)
### Immunopathology
[](https://en.wikipedia.org/wiki/File:Fimmu-11-579250-g003.jpg)
Key components of the [adaptive immune response](https://en.wikipedia.org/wiki/Adaptive_immune_system "Adaptive immune system") to SARS-CoV-2
Although SARS-CoV-2 has a tropism for ACE2-expressing epithelial cells of the respiratory tract, people with severe COVID‑19 have symptoms of systemic hyperinflammation. Clinical laboratory findings of elevated [IL‑2](https://en.wikipedia.org/wiki/Interleukin_2 "Interleukin 2"), [IL‑6](https://en.wikipedia.org/wiki/Interleukin_6 "Interleukin 6"), [IL‑7](https://en.wikipedia.org/wiki/Interleukin_7 "Interleukin 7"), as well as the following suggest an underlying immunopathology:[\[147\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Huang24Jan2020-147)
- [Granulocyte-macrophage colony-stimulating factor](https://en.wikipedia.org/wiki/Granulocyte-macrophage_colony-stimulating_factor "Granulocyte-macrophage colony-stimulating factor") (GM‑CSF)
- [Interferon gamma-induced protein 10](https://en.wikipedia.org/wiki/CXCL10 "CXCL10") (IP‑10)
- [Monocyte chemoattractant protein 1](https://en.wikipedia.org/wiki/Monocyte_chemoattractant_protein-1 "Monocyte chemoattractant protein-1") (MCP1)
- [Macrophage inflammatory protein 1‑alpha](https://en.wikipedia.org/wiki/CCL3 "CCL3") (MIP‑1‑alpha)
- [Tumour necrosis factor](https://en.wikipedia.org/wiki/Tumour_necrosis_factor "Tumour necrosis factor") (TNF‑α) indicative of [cytokine release syndrome](https://en.wikipedia.org/wiki/Cytokine_release_syndrome "Cytokine release syndrome") (CRS)
[Interferon alpha](https://en.wikipedia.org/wiki/Interferon-alpha "Interferon-alpha") plays a complex, Janus-faced role in the pathogenesis of COVID-19. Although it promotes the elimination of virus-infected cells, it also upregulates the expression of ACE-2, thereby facilitating the SARS-Cov2 virus to enter cells and to replicate.[\[157\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-157)[\[158\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-158) A competition of negative feedback loops (via protective effects of interferon alpha) and positive feedback loops (via upregulation of ACE-2) is assumed to determine the fate of people with COVID-19.[\[159\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-159)\[*[needs update](https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items "Wikipedia:Manual of Style/Dates and numbers")*\]
Additionally, people with COVID‑19 and [acute respiratory distress syndrome](https://en.wikipedia.org/wiki/Acute_respiratory_distress_syndrome "Acute respiratory distress syndrome") (ARDS) have classical [serum](https://en.wikipedia.org/wiki/Serum_\(blood\) "Serum (blood)") [biomarkers](https://en.wikipedia.org/wiki/Biomarker_\(medicine\) "Biomarker (medicine)") of CRS, including elevated [C-reactive protein](https://en.wikipedia.org/wiki/C-reactive_protein "C-reactive protein") (CRP), [lactate dehydrogenase](https://en.wikipedia.org/wiki/Lactate_dehydrogenase "Lactate dehydrogenase") (LDH), [D-dimer](https://en.wikipedia.org/wiki/D-dimer "D-dimer"), and [ferritin](https://en.wikipedia.org/wiki/Ferritin "Ferritin").[\[160\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-160)
Systemic inflammation results in [vasodilation](https://en.wikipedia.org/wiki/Vasodilation "Vasodilation"), allowing inflammatory lymphocytic and monocytic infiltration of the lung and the heart. In particular, pathogenic GM-CSF-secreting [T cells](https://en.wikipedia.org/wiki/T_cell "T cell") were shown to correlate with the recruitment of inflammatory IL-6-secreting [monocytes](https://en.wikipedia.org/wiki/Monocyte "Monocyte") and severe lung pathology in people with COVID‑19.[\[161\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-161) Lymphocytic infiltrates have also been reported at autopsy.[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
### Viral and host factors
#### Virus proteins
[](https://en.wikipedia.org/wiki/File:Fpubh-08-00383-g004.jpg)
The association between SARS-CoV-2 and the [Renin-Angiotensin-Aldosterone System](https://en.wikipedia.org/wiki/Renin%E2%80%93angiotensin_system "Renin–angiotensin system") (RAAS)
Multiple viral and host factors affect the pathogenesis of the virus. The [S-protein](https://en.wikipedia.org/wiki/S_protein "S protein"), otherwise known as the spike protein, is the viral component that attaches to the host receptor via the [ACE2](https://en.wikipedia.org/wiki/Angiotensin-converting_enzyme_2 "Angiotensin-converting enzyme 2") receptors. It includes two subunits: S1 and S2.
- S1 determines the virus-host range and cellular tropism via the receptor-binding domain.
- S2 mediates the membrane fusion of the virus to its potential cell host via the H1 and HR2, which are [heptad repeat](https://en.wikipedia.org/wiki/Heptad_repeat "Heptad repeat") regions.
Studies have shown that S1 domain induced [IgG](https://en.wikipedia.org/wiki/IgG "IgG") and [IgA](https://en.wikipedia.org/wiki/IgA "IgA") antibody levels at a much higher capacity. It is the focus spike proteins expression that are involved in many effective COVID‑19 vaccines.[\[162\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid33340022-162)
The M protein is the viral protein responsible for the transmembrane transport of nutrients. It is the cause of the bud release and the formation of the viral envelope.[\[163\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Boopathi-2020-163) The N and E protein are accessory proteins that interfere with the host's immune response.[\[163\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Boopathi-2020-163)
#### Host factors
Human [angiotensin converting enzyme 2](https://en.wikipedia.org/wiki/Angiotensin_converting_enzyme_2 "Angiotensin converting enzyme 2") (hACE2) is the host factor that SARS-CoV-2 virus targets causing COVID‑19. Theoretically, the usage of [angiotensin receptor blockers](https://en.wikipedia.org/wiki/Angiotensin_II_receptor_blocker "Angiotensin II receptor blocker") (ARB) and [ACE inhibitors](https://en.wikipedia.org/wiki/ACE_inhibitor "ACE inhibitor") upregulating ACE2 expression might increase [morbidity](https://en.wikipedia.org/wiki/Morbidity "Morbidity") with COVID‑19, though animal data suggest some potential protective effect of ARB; however no clinical studies have proven susceptibility or outcomes. Until further data is available, guidelines and recommendations for people with hypertension remain.[\[164\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-164)
The effect of the virus on ACE2 cell surfaces leads to leukocytic infiltration, increased blood vessel permeability, alveolar wall permeability, as well as decreased secretion of lung surfactants. These effects cause the majority of the respiratory symptoms. However, the aggravation of local inflammation causes a cytokine storm eventually leading to a [systemic inflammatory response syndrome](https://en.wikipedia.org/wiki/Systemic_inflammatory_response_syndrome "Systemic inflammatory response syndrome").[\[165\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-165)
Among healthy adults not exposed to SARS-CoV-2, about 35% have [CD4\+ T cells](https://en.wikipedia.org/wiki/CD4%2B_T_cell "CD4+ T cell") that recognise the SARS-CoV-2 [S protein](https://en.wikipedia.org/wiki/Peplomer "Peplomer") (particularly the S2 subunit) and about 50% react to other proteins of the virus, suggesting [cross-reactivity](https://en.wikipedia.org/wiki/Cross-reactivity "Cross-reactivity") from previous [common colds](https://en.wikipedia.org/wiki/Common_cold "Common cold") caused by other coronaviruses.[\[166\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-166)
It is unknown whether different persons use similar antibody genes in response to COVID‑19.[\[167\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-167)
### Host cytokine response
[](https://en.wikipedia.org/wiki/File:Ijms-21-05932-g004.webp)
Mild versus severe [immune response](https://en.wikipedia.org/wiki/Immune_system "Immune system") during [virus infection](https://en.wikipedia.org/wiki/Viral_disease "Viral disease")
The severity of the inflammation can be attributed to the severity of what is known as the [cytokine storm](https://en.wikipedia.org/wiki/Cytokine_storm "Cytokine storm").[\[168\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid32474885-168) Levels of [interleukin 1B](https://en.wikipedia.org/wiki/Interleukin_1_beta "Interleukin 1 beta"), [interferon-gamma](https://en.wikipedia.org/wiki/Interferon_gamma "Interferon gamma"), interferon-inducible protein 10, and monocyte chemoattractant protein 1 were all associated with COVID‑19 disease severity. Treatment has been proposed to combat the cytokine storm as it remains to be one of the leading causes of [morbidity](https://en.wikipedia.org/wiki/Morbidity "Morbidity") and mortality in COVID‑19 disease.[\[169\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-169)
A cytokine storm is due to an acute hyperinflammatory response that is responsible for clinical illness in an array of diseases but in COVID‑19, it is related to worse prognosis and increased fatality. The storm causes acute respiratory distress syndrome, blood clotting events such as strokes, [myocardial infarction](https://en.wikipedia.org/wiki/Myocardial_infarction "Myocardial infarction"), [encephalitis](https://en.wikipedia.org/wiki/Encephalitis "Encephalitis"), [acute kidney injury](https://en.wikipedia.org/wiki/Acute_kidney_injury "Acute kidney injury"), and [vasculitis](https://en.wikipedia.org/wiki/Vasculitis "Vasculitis"). The production of [IL-1](https://en.wikipedia.org/wiki/Interleukin_1 "Interleukin 1"), [IL-2](https://en.wikipedia.org/wiki/Interleukin_2 "Interleukin 2"), [IL-6](https://en.wikipedia.org/wiki/Interleukin_6 "Interleukin 6"), [TNF-alpha](https://en.wikipedia.org/wiki/Tumor_necrosis_factor "Tumor necrosis factor"), and [interferon-gamma](https://en.wikipedia.org/wiki/Interferon_gamma "Interferon gamma"), all crucial components of normal immune responses, inadvertently become the causes of a cytokine storm. The cells of the [central nervous system](https://en.wikipedia.org/wiki/Central_nervous_system "Central nervous system"), the [microglia](https://en.wikipedia.org/wiki/Microglia "Microglia"), [neurons](https://en.wikipedia.org/wiki/Neuron "Neuron"), and [astrocytes](https://en.wikipedia.org/wiki/Astrocyte "Astrocyte"), are also involved in the release of [pro-inflammatory cytokines](https://en.wikipedia.org/wiki/Pro-inflammatory_cytokine "Pro-inflammatory cytokine") affecting the nervous system, and effects of cytokine storms toward the CNS are not uncommon.[\[170\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-170)
### Pregnancy response
There are many unknowns for pregnant women during the COVID-19 pandemic. Given that they are prone to have complications and severe disease infection with other types of coronaviruses, they have been identified as a vulnerable group and advised to take supplementary preventive measures.[\[171\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wastnedge_2021-171)
Physiological responses to pregnancy can include:
- Immunological: The immunological response to COVID-19, like other viruses, depends on a working immune system. It adapts during pregnancy to allow the development of the foetus whose genetic load is only partially shared with their mother, leading to a different immunological reaction to infections during the course of pregnancy.[\[171\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wastnedge_2021-171)
- Respiratory: Many factors can make pregnant women more vulnerable to hard respiratory infections. One of them is the total reduction of the lungs' capacity and inability to clear secretions.[\[171\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wastnedge_2021-171)
- Coagulation: During pregnancy, there are higher levels of circulating coagulation factors, and the pathogenesis of SARS-CoV-2 infection can be implicated. The thromboembolic events with associated mortality are a risk for pregnant women.[\[171\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wastnedge_2021-171)
However, from the evidence base, it is difficult to conclude whether pregnant women are at increased risk of grave consequences of this virus.[\[171\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wastnedge_2021-171)
In addition to the above, other clinical studies have proved that SARS-CoV-2 can affect the period of pregnancy in different ways. On the one hand, there is little evidence of its impact up to 12 weeks gestation. On the other hand, COVID-19 infection may cause increased rates of unfavourable outcomes in the course of the pregnancy. Some examples of these could be foetal growth restriction, preterm birth, and perinatal mortality, which refers to the foetal death past 22 or 28 completed weeks of pregnancy as well as the death among live-born children up to seven completed days of life.[\[171\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wastnedge_2021-171) For preterm birth, a 2023 review indicates that there appears to be a correlation with COVID-19.[\[172\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-172)
Unvaccinated women in later stages of pregnancy with COVID-19 are more likely than other people to need very intensive care. Babies born to mothers with COVID-19 are more likely to have breathing problems. Pregnant women are strongly encouraged to get [vaccinated](https://en.wikipedia.org/wiki/COVID-19_vaccine "COVID-19 vaccine").[\[173\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-173)
## Diagnosis
COVID‑19 can provisionally be diagnosed on the basis of symptoms and confirmed using [reverse transcription polymerase chain reaction](https://en.wikipedia.org/wiki/Reverse_transcription_polymerase_chain_reaction "Reverse transcription polymerase chain reaction") (RT-PCR) or other [nucleic acid testing](https://en.wikipedia.org/wiki/Nucleic_acid_test "Nucleic acid test") of infected secretions.[\[174\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid32621814-174)[\[175\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-jTxKm-175) Along with laboratory testing, chest CT scans may be helpful to diagnose COVID‑19 in individuals with a high clinical suspicion of infection.[\[176\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Salehi-2020-176) Detection of a past infection is possible with [serological tests](https://en.wikipedia.org/wiki/Serology "Serology"), which detect [antibodies](https://en.wikipedia.org/wiki/Antibody "Antibody") produced by the body in response to the infection.[\[174\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid32621814-174)
### Viral testing
Main article: [COVID-19 testing](https://en.wikipedia.org/wiki/COVID-19_testing "COVID-19 testing")
[](https://en.wikipedia.org/wiki/File:Infektionsschutzzentrum_im_Rautenstrauch-Joest-Museum,_K%C3%B6ln-6313_\(cropped\).jpg)
Demonstration of a [nasopharyngeal swab](https://en.wikipedia.org/wiki/Nasopharyngeal_swab "Nasopharyngeal swab") for [COVID‑19 testing](https://en.wikipedia.org/wiki/COVID%E2%80%9119_testing "COVID‑19 testing")
The standard methods of testing for presence of SARS-CoV-2 are [nucleic acid tests](https://en.wikipedia.org/wiki/Nucleic_acid_test "Nucleic acid test"),[\[174\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid32621814-174)[\[177\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-20200130cdc-177) which detects the presence of viral RNA fragments.[\[178\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO_InterimGuidance-178) As these tests detect RNA but not infectious virus, its "ability to determine duration of infectivity of patients is limited".[\[179\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-2k0iS-179) The test is typically done on respiratory samples obtained by a [nasopharyngeal swab](https://en.wikipedia.org/wiki/Nasopharyngeal_swab "Nasopharyngeal swab"); however, a nasal swab or sputum sample may also be used.[\[180\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC2020Testing-180)[\[181\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-20200129cdc-181) Results are generally available within hours.[\[174\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid32621814-174) The WHO has published several testing protocols for the disease.[\[182\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-182)
Several laboratories and companies have developed serological tests, which detect antibodies produced by the body in response to infection. Some have been evaluated by [Public Health England](https://en.wikipedia.org/wiki/Public_Health_England "Public Health England") and approved for use in the UK.[\[183\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-independent9515466-183)
The [University of Oxford](https://en.wikipedia.org/wiki/University_of_Oxford "University of Oxford")'s CEBM has pointed to mounting evidence[\[184\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-yFMEP-184)[\[185\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-2exX5-185) that "a good proportion of 'new' mild cases and people re-testing positives after quarantine or discharge from hospital are not infectious, but are simply clearing harmless virus particles which their immune system has efficiently dealt with" and have called for "an international effort to standardize and periodically calibrate testing"[\[186\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-PQGAv-186) In September 2020, the UK government issued "guidance for procedures to be implemented in laboratories to provide assurance of positive SARS-CoV-2 RNA results during periods of low prevalence, when there is a reduction in the predictive value of positive test results".[\[187\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-9Kblp-187)
### Imaging
[](https://en.wikipedia.org/wiki/File:COVID19CTPneumonia.jpg)
A [CT](https://en.wikipedia.org/wiki/Computed_tomography "Computed tomography") scan of a person with COVID-19 shows lesions (bright regions) in the lungs
[](https://en.wikipedia.org/wiki/File:COVID19CT1.webp)
CT scan of rapid progression stage of COVID-19
[](https://en.wikipedia.org/wiki/File:COVID-19_Pneumonie_-_82m_Roe_Thorax_ap_-_001.jpg)
Chest X-ray showing COVID‑19 pneumonia
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.[\[176\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Salehi-2020-176)[\[188\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-acr.org-188) Bilateral multilobar [ground-glass opacities](https://en.wikipedia.org/wiki/Ground-glass_opacity "Ground-glass opacity") with a peripheral, asymmetric, and posterior distribution are common in early infection.[\[176\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Salehi-2020-176)[\[189\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-189) Subpleural dominance, [crazy paving](https://en.wikipedia.org/wiki/Crazy_paving_\(medicine\) "Crazy paving (medicine)") (lobular septal thickening with variable alveolar filling), and [consolidation](https://en.wikipedia.org/wiki/Pulmonary_consolidation "Pulmonary consolidation") may appear as the disease progresses.[\[176\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Salehi-2020-176)[\[190\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-190) Characteristic imaging features on chest [radiographs](https://en.wikipedia.org/wiki/Radiograph "Radiograph") and [computed tomography](https://en.wikipedia.org/wiki/Computed_tomography "Computed tomography") (CT) of people who are symptomatic include asymmetric peripheral ground-glass opacities without [pleural effusions](https://en.wikipedia.org/wiki/Pleural_effusion "Pleural effusion").[\[191\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AJR-191)
Many groups have created [COVID‑19 datasets](https://en.wikipedia.org/wiki/COVID%E2%80%9119_datasets "COVID‑19 datasets") that include imagery such as the [Italian Radiological Society](https://en.wikipedia.org/wiki/Italian_Society_of_Medical_and_Interventional_Radiology "Italian Society of Medical and Interventional Radiology") which has compiled an international online database of imaging findings for confirmed cases.[\[192\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cx70C-192) Due to overlap with other infections such as [adenovirus](https://en.wikipedia.org/wiki/Adenovirus "Adenovirus"), imaging without confirmation by rRT-PCR is of limited [specificity](https://en.wikipedia.org/wiki/Specificity_\(statistics\) "Specificity (statistics)") in identifying COVID‑19.[\[191\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AJR-191) A large study in China compared chest CT results to PCR and demonstrated that though imaging is less specific for the infection, it is faster and more [sensitive](https://en.wikipedia.org/wiki/Sensitivity_\(statistics\) "Sensitivity (statistics)").[\[175\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-jTxKm-175)
### Coding
In late 2019, the WHO assigned emergency [ICD-10](https://en.wikipedia.org/wiki/ICD-10 "ICD-10") disease codes 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.[\[193\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-ICD10_2019_U07p2-193)
### Pathology
The main pathological findings at autopsy are:
- [Macroscopy](https://en.wikipedia.org/wiki/Macroscopic_scale "Macroscopic scale"): [pericarditis](https://en.wikipedia.org/wiki/Pericarditis "Pericarditis"), [lung consolidation](https://en.wikipedia.org/wiki/Lung_consolidation "Lung consolidation") and [pulmonary oedema](https://en.wikipedia.org/wiki/Pulmonary_edema "Pulmonary edema")[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
- Lung findings:
- Minor serous [exudation](https://en.wikipedia.org/wiki/Exudate "Exudate"), minor [fibrin](https://en.wikipedia.org/wiki/Fibrin "Fibrin") exudation[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
- Pulmonary oedema, [pneumocyte](https://en.wikipedia.org/wiki/Pneumocyte "Pneumocyte") [hyperplasia](https://en.wikipedia.org/wiki/Hyperplasia "Hyperplasia"), large atypical [pneumocytes](https://en.wikipedia.org/wiki/Pneumocyte "Pneumocyte"), interstitial [inflammation](https://en.wikipedia.org/wiki/Inflammation "Inflammation") with [lymphocytic](https://en.wikipedia.org/wiki/Lymphocytic "Lymphocytic") [infiltration](https://en.wikipedia.org/wiki/Infiltration_\(medical\) "Infiltration (medical)") and [multinucleated giant cell](https://en.wikipedia.org/wiki/Giant_cell "Giant cell") formation[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
- [Diffuse alveolar damage](https://en.wikipedia.org/wiki/Diffuse_alveolar_damage "Diffuse alveolar damage") (DAD) with diffuse [alveolar](https://en.wikipedia.org/wiki/Pulmonary_alveolus "Pulmonary alveolus") [exudates](https://en.wikipedia.org/wiki/Exudates "Exudates"). DAD is the cause of [acute respiratory distress syndrome](https://en.wikipedia.org/wiki/Acute_respiratory_distress_syndrome "Acute respiratory distress syndrome") (ARDS) and severe [hypoxaemia](https://en.wikipedia.org/wiki/Hypoxemia "Hypoxemia").[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
- [Organisation](https://en.wikipedia.org/wiki/Healing "Healing") of [exudates](https://en.wikipedia.org/wiki/Exudate "Exudate") in [alveolar cavities](https://en.wikipedia.org/wiki/Pulmonary_alveolus "Pulmonary alveolus") and [pulmonary interstitial fibrosis](https://en.wikipedia.org/wiki/Pulmonary_fibrosis "Pulmonary fibrosis")[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
- [Plasmocytosis](https://en.wikipedia.org/wiki/Plasma_cell "Plasma cell") in [bronchoalveolar lavage](https://en.wikipedia.org/wiki/Bronchoalveolar_lavage "Bronchoalveolar lavage") (BAL)[\[194\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-194)
- Blood and vessels: [disseminated intravascular coagulation](https://en.wikipedia.org/wiki/Disseminated_intravascular_coagulation "Disseminated intravascular coagulation") (DIC);[\[195\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-195) [leukoerythroblastic](https://en.wikipedia.org/wiki/Leukoerythroblastic "Leukoerythroblastic") reaction,[\[196\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-196) [endotheliitis](https://en.wikipedia.org/wiki/Endotheliitis "Endotheliitis"),[\[197\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-SatturwarFowkes2021-197) [hemophagocytosis](https://en.wikipedia.org/wiki/Hemophagocytosis "Hemophagocytosis")[\[197\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-SatturwarFowkes2021-197)
- Heart: [cardiac muscle cell](https://en.wikipedia.org/wiki/Cardiac_muscle_cell "Cardiac muscle cell") necrosis[\[197\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-SatturwarFowkes2021-197)
- Liver: microvesicular [steatosis](https://en.wikipedia.org/wiki/Steatosis "Steatosis")[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
- Nose: [shedding of olfactory epithelium](https://en.wikipedia.org/wiki/Impact_of_COVID-19_on_neurological,_psychological_and_other_mental_health_outcomes "Impact of COVID-19 on neurological, psychological and other mental health outcomes")[\[132\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Meunier-2020-132)
- Brain: [infarction](https://en.wikipedia.org/wiki/Cerebral_infarction "Cerebral infarction")[\[197\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-SatturwarFowkes2021-197)
- Kidneys: acute tubular damage.[\[197\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-SatturwarFowkes2021-197)
- Spleen: [white pulp](https://en.wikipedia.org/wiki/White_pulp "White pulp") depletion.[\[197\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-SatturwarFowkes2021-197)
## Prevention
Further information: [COVID-19 vaccine](https://en.wikipedia.org/wiki/COVID-19_vaccine "COVID-19 vaccine"), [Workplace hazard controls for COVID-19](https://en.wikipedia.org/wiki/Workplace_hazard_controls_for_COVID-19 "Workplace hazard controls for COVID-19"), [Pandemic prevention](https://en.wikipedia.org/wiki/Pandemic_prevention "Pandemic prevention"), [Non-pharmaceutical intervention](https://en.wikipedia.org/wiki/Non-pharmaceutical_intervention_\(epidemiology\) "Non-pharmaceutical intervention (epidemiology)"), [Preparations prior to COVID-19](https://en.wikipedia.org/wiki/Pandemic_predictions_and_preparations_prior_to_the_COVID-19_pandemic "Pandemic predictions and preparations prior to the COVID-19 pandemic"), [COVID-19 surveillance](https://en.wikipedia.org/wiki/COVID-19_surveillance "COVID-19 surveillance"), and [COVID-19 apps](https://en.wikipedia.org/wiki/COVID-19_apps "COVID-19 apps")
[](https://en.wikipedia.org/wiki/File:20200609_Effect_of_pandemic_containment_measures.gif)
Without pandemic containment measures – such as social distancing, vaccination, and face masks – pathogens can spread exponentially.[\[198\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Science_20200515-198) This graphic shows how early adoption of containment measures tends to protect wider swaths of the population.
Preventive measures to reduce the chances of infection include getting vaccinated, staying at home, wearing a mask in public, avoiding crowded places, keeping distance from others, ventilating indoor spaces, managing potential exposure durations,[\[199\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-199) 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.[\[200\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC042020-200)[\[201\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-201)
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](https://en.wikipedia.org/wiki/COVID-19#Face_masks_and_respiratory_hygiene) 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.[\[202\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC2020IfSick-202)[\[203\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-203)
The first [COVID‑19 vaccine](https://en.wikipedia.org/wiki/COVID%E2%80%9119_vaccine "COVID‑19 vaccine") was granted regulatory approval on 2 December 2020 by the UK medicines regulator [MHRA](https://en.wikipedia.org/wiki/Medicines_and_Healthcare_products_Regulatory_Agency "Medicines and Healthcare products Regulatory Agency").[\[204\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-ukgov12-2-204) It was evaluated for [emergency use authorisation](https://en.wikipedia.org/wiki/Emergency_use_authorisation "Emergency use authorisation") (EUA) status by the US [FDA](https://en.wikipedia.org/wiki/Food_and_Drugs_Administration "Food and Drugs Administration"), and in several other countries.[\[205\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-mueller-205) Initially, the US [National Institutes of Health](https://en.wikipedia.org/wiki/National_Institutes_of_Health "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 the setting of a clinical trial.[\[206\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NIHGuidelines2020-206)[\[76\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Sanders202022-76) Without a vaccine, other prophylactic measures, or effective treatments, a key part of managing COVID‑19 is trying to decrease and delay the epidemic peak, known as "flattening the [curve](https://en.wikipedia.org/wiki/Epidemic_curve "Epidemic curve")".[\[207\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Lancet2020Flatten-207) This is done by slowing the infection rate to decrease the risk of health services being overwhelmed, allowing for better treatment of active cases, and delaying additional cases until effective treatments or a vaccine become available.[\[207\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Lancet2020Flatten-207)[\[208\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wiles-208)
### Vaccine
Main article: [COVID-19 vaccine](https://en.wikipedia.org/wiki/COVID-19_vaccine "COVID-19 vaccine")
[](https://en.wikipedia.org/wiki/File:Fphar-11-00937-g004-L.jpg)
Different vaccine candidate types in development for SARS-CoV-2
[](https://en.wikipedia.org/wiki/File:2021-_COVID-19_death_rates_by_vaccination_status_-_US.svg)
Death rates for unvaccinated Americans substantially exceeded those who were vaccinated, with bivalent boosters further reducing the death rate.[\[209\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVIDmortality_2021_2023-209)
Major vaccines include the [Pfizer–BioNTech mRNA vaccine](https://en.wikipedia.org/wiki/Pfizer%E2%80%93BioNTech_COVID-19_vaccine "Pfizer–BioNTech COVID-19 vaccine"), [Moderna mRNA vaccine](https://en.wikipedia.org/wiki/Moderna_COVID-19_vaccine "Moderna COVID-19 vaccine"), and the [Novavax protein subunit vaccine](https://en.wikipedia.org/wiki/Novavax_COVID-19_vaccine "Novavax COVID-19 vaccine").[\[210\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_VaccineKnowledgeCOVID-210) With the emergence of new [SARS-CoV-2 variants](https://en.wikipedia.org/wiki/Variants_of_SARS-CoV-2 "Variants of SARS-CoV-2"), the original vaccines—particularly [Pfizer](https://en.wikipedia.org/wiki/Pfizer "Pfizer")–[BioNTech](https://en.wikipedia.org/wiki/BioNTech "BioNTech") and [Moderna](https://en.wikipedia.org/wiki/Moderna "Moderna") vaccines—have been updated. These "variant-adapted" vaccines are offered as [booster doses](https://en.wikipedia.org/wiki/Booster_dose "Booster dose").[\[210\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_VaccineKnowledgeCOVID-210) The immunity from the vaccines also wanes over time, requiring people to get boosters to maintain protection.[\[211\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_Rogers_2022-211)
Common side effects of COVID‑19 vaccines include soreness, fatigue, headache, [myalgia](https://en.wikipedia.org/wiki/Myalgia "Myalgia") (muscle pain), and [arthralgia](https://en.wikipedia.org/wiki/Arthralgia "Arthralgia") (joint pain), which resolve without medical treatment within a few days.[\[212\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_COVID-19_vaccine_WHO-212) COVID‑19 vaccination is safe for people who are pregnant or are breastfeeding.[\[213\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_breastf-213)
The COVID‑19 vaccines are widely credited for their role in reducing the spread of COVID‑19 and reducing the severity and death caused by COVID‑19.[\[211\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_Rogers_2022-211)[\[214\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-214) Many countries implemented phased distribution plans that prioritized those at highest risk of complications, such as the elderly, and those at high risk of exposure, such as [healthcare workers](https://en.wikipedia.org/wiki/Health_professional "Health professional").[\[215\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_Beaumont-215)[\[216\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_Wang1-216) By December 2020, more than 10 billion vaccine doses had been preordered,[\[217\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_mullard-217) with about half of the doses purchased by [high-income countries](https://en.wikipedia.org/wiki/World_Bank_high-income_economy "World Bank high-income economy") comprising 14% of the world's population.[\[218\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_So-218) As of August 2024[\[update\]](https://en.wikipedia.org/w/index.php?title=COVID-19&action=edit), over 13 billion doses of COVID‑19 vaccines have been administered worldwide.[\[219\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_Richie_2021-219)
### Face masks and respiratory hygiene
Main article: [Face masks during the COVID-19 pandemic](https://en.wikipedia.org/wiki/Face_masks_during_the_COVID-19_pandemic "Face masks during the COVID-19 pandemic")
[](https://en.wikipedia.org/wiki/File:2009Julija-210.jpg)
Masks with an exhalation valve. The valves are a weak point that can transmit the viruses outwards.
In community and healthcare settings, the use of face masks is intended as [source control](https://en.wikipedia.org/wiki/Source_control_\(respiratory_disease\) "Source control (respiratory disease)") to limit [transmission](https://en.wikipedia.org/wiki/Transmission_of_COVID-19 "Transmission of COVID-19") of the virus and for personal protection to prevent infection.[\[220\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_AR2021-220) Properly worn masks both limit the [respiratory droplets](https://en.wikipedia.org/wiki/Respiratory_droplet "Respiratory droplet") and [aerosols](https://en.wikipedia.org/wiki/Airborne_transmission "Airborne transmission") spread by infected individuals and help protect healthy individuals from infection.[\[221\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_Matuschek-221)[\[222\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_interplay-222)
Reviews of various kinds of scientific studies have concluded that masking is effective in protecting the individual against COVID-19.[\[221\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_Matuschek-221)[\[223\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_Talic-223)[\[224\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_cdc-sci-224) Various [case-control](https://en.wikipedia.org/wiki/Case%E2%80%93control_study "Case–control study") and population-based studies have also shown that increased levels of masking in a community reduces the spread of SARS-CoV-2,[\[223\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_Talic-223)[\[224\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_cdc-sci-224) though there is a paucity of evidence from [randomized controlled trials](https://en.wikipedia.org/wiki/Randomized_controlled_trial "Randomized controlled trial") (RCTs).[\[225\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_cochrane-225)[\[226\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_royalsoc-226) Masks vary in how well they work. Fitted [N95s](https://en.wikipedia.org/wiki/N95_respirator "N95 respirator") outperform surgical masks,[\[227\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_Ju-227)[\[228\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_norespirator-228) while cloth masks provide marginal protection.[\[229\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_Ataei-229)[\[230\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_cloth_v_surgical-230) During the public health emergency, governments widely recommended and mandated mask-wearing, and prominent national and intergovernmental health agencies and their leaders recommended the use of masks to reduce transmission, including the [WHO](https://en.wikipedia.org/wiki/WHO "WHO"), [American](https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention "Centers for Disease Control and Prevention"), [European](https://en.wikipedia.org/wiki/ECDC "ECDC"), and [Chinese](https://en.wikipedia.org/wiki/Chinese_Center_for_Disease_Control_and_Prevention "Chinese Center for Disease Control and Prevention") Centers for Disease Control and Prevention.
### Indoor ventilation and avoiding crowded indoor spaces
The CDC states that avoiding crowded indoor spaces reduces the risk of COVID-19 infection.[\[231\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC-2020b-231) When indoors, increasing the rate of air change, decreasing recirculation of air and increasing the use of outdoor air can reduce transmission.[\[231\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC-2020b-231)[\[232\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-ecdc_transmission2-232) The WHO recommends [ventilation](https://en.wikipedia.org/wiki/Ventilation_\(architecture\) "Ventilation (architecture)") and [air filtration](https://en.wikipedia.org/wiki/Air_filtration "Air filtration") in public spaces to help clear out infectious aerosols.[\[233\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDCasof07092020-233)[\[234\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-KoFZO-234)[\[235\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Lancetdroplet05272020-235)
Exhaled respiratory particles can build-up within enclosed spaces with inadequate [ventilation](https://en.wikipedia.org/wiki/Ventilation_\(architecture\) "Ventilation (architecture)"). The risk of COVID‑19 infection increases especially in spaces where people engage in physical exertion or raise their voice (e.g., exercising, shouting, singing) as this increases exhalation of respiratory droplets. Prolonged exposure to these conditions, typically more than 15 minutes, leads to higher risk of infection.[\[231\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC-2020b-231)
[Displacement ventilation](https://en.wikipedia.org/wiki/Displacement_ventilation "Displacement ventilation") with large natural inlets can move stale air directly to the exhaust in [laminar flow](https://en.wikipedia.org/wiki/Laminar_flow "Laminar flow") while significantly reducing the concentration of droplets and particles. [Passive ventilation](https://en.wikipedia.org/wiki/Passive_ventilation "Passive ventilation") reduces energy consumption and maintenance costs but may lack [controllability](https://en.wikipedia.org/wiki/Demand_controlled_ventilation "Demand controlled ventilation") and [heat recovery](https://en.wikipedia.org/wiki/Heat_recovery_ventilation "Heat recovery ventilation"). Displacement ventilation can also be achieved mechanically with higher energy and maintenance costs. The use of large ducts and openings helps to prevent mixing in closed environments. Recirculation and mixing should be avoided because recirculation prevents dilution of harmful particles and redistributes possibly contaminated air, and mixing increases the concentration and range of infectious particles and keeps larger particles in the air.[\[236\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-236)
### Hand-washing and hygiene
Main article: [Hand washing](https://en.wikipedia.org/wiki/Hand_washing "Hand washing")
[](https://en.wikipedia.org/wiki/File:In_Rwanda_build_where_everyone_can_wash_hand_in_prevention_of_covid-19.jpg)
Students in [Rwanda](https://en.wikipedia.org/wiki/Rwanda "Rwanda") hand washing and wearing face masks during the [COVID‑19 pandemic in the country](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Rwanda "COVID-19 pandemic in Rwanda")
Thorough hand hygiene after any cough or sneeze is required.[\[237\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-nhs.uk-2020-237) The WHO 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.[\[238\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO-2020b-238) When soap and water are not available, the CDC recommends using an alcohol-based [hand sanitiser](https://en.wikipedia.org/wiki/Hand_sanitiser "Hand sanitiser") with at least 60% alcohol.[\[239\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-239) 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](https://en.wikipedia.org/wiki/Ethanol "Ethanol") or [isopropanol](https://en.wikipedia.org/wiki/Isopropanol "Isopropanol"). [Hydrogen peroxide](https://en.wikipedia.org/wiki/Hydrogen_peroxide "Hydrogen peroxide") is used to help eliminate [bacterial spores](https://en.wikipedia.org/wiki/Bacterial_spore "Bacterial spore") in the alcohol; it is "not an active substance for hand [antisepsis](https://en.wikipedia.org/wiki/Antisepsis "Antisepsis")". [Glycerol](https://en.wikipedia.org/wiki/Glycerol "Glycerol") is added as a [humectant](https://en.wikipedia.org/wiki/Humectant "Humectant").[\[240\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-240)
### Social distancing
Main article: [Social distancing measures related to the COVID-19 pandemic](https://en.wikipedia.org/wiki/Social_distancing_measures_related_to_the_COVID-19_pandemic "Social distancing measures related to the COVID-19 pandemic")
Social distancing (also known as physical distancing) includes [infection control](https://en.wikipedia.org/wiki/Infection_control "Infection control") actions intended to slow the spread of the disease by minimising close contact between individuals. Methods include quarantines; travel restrictions; and the closing of schools, workplaces, stadiums, theatres, or shopping centres. Individuals may apply social distancing methods by staying at home, limiting travel, avoiding crowded areas, using no-contact greetings, and physically distancing themselves from others.[\[241\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-241)
In 2020, outbreaks occurred in prisons due to crowding and an inability to enforce adequate social distancing.[\[242\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Hawks2020-242)[\[243\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-243) In the United States, the prisoner population is ageing 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.[\[242\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Hawks2020-242)
### Surface cleaning
After being expelled from the body, coronaviruses can survive on surfaces for hours to days. If a person touches the dirty surface, they may deposit the virus at the eyes, nose, or mouth where it can enter the body and cause infection.[\[244\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDCTrans-244) Evidence indicates that contact with infected surfaces is not the main driver of COVID‑19,[\[245\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-245)[\[246\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-246)[\[247\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-cdc.gov-247) leading to recommendations for optimised disinfection procedures to avoid issues such as the increase of [antimicrobial resistance](https://en.wikipedia.org/wiki/Antimicrobial_resistance "Antimicrobial resistance") through the use of inappropriate cleaning products and processes.[\[248\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-disinfection-foodindus-248)[\[249\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-249) [Deep cleaning](https://en.wikipedia.org/wiki/Deep_clean_\(COVID-19\) "Deep clean (COVID-19)") and other surface sanitation has been criticised as [hygiene theatre](https://en.wikipedia.org/wiki/Hygiene_theater "Hygiene theater"), giving a false sense of security against something primarily spread through the air.[\[250\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-250)[\[251\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-251)
The amount of time that the virus can survive depends significantly on the type of surface, the temperature, and the humidity.[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252) Coronaviruses die very quickly when exposed to the [UV light](https://en.wikipedia.org/wiki/UV_light "UV light") in [sunlight](https://en.wikipedia.org/wiki/Sunlight "Sunlight").[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252) Like other enveloped viruses, SARS-CoV-2 survives longest when the temperature is at [room temperature](https://en.wikipedia.org/wiki/Room_temperature "Room temperature") or lower, and when the [relative humidity](https://en.wikipedia.org/wiki/Relative_humidity "Relative humidity") is low (\<50%).[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252)
On many surfaces, including glass, some types of plastic, stainless steel, and skin, the virus can remain infective for several days indoors at room temperature, or even about a week under ideal conditions.[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252)[\[253\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-253) On some surfaces, including cotton fabric and copper, the virus usually dies after a few hours.[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252) The virus dies faster on porous surfaces than on non-porous surfaces due to capillary action within pores and faster aerosol droplet evaporation.[\[254\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-254)[\[247\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-cdc.gov-247)[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252) However, of the many surfaces tested, two with the longest survival times are N95 respirator masks and surgical masks, both of which are considered porous surfaces.[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252)
The CDC says that in most situations, cleaning surfaces with soap or detergent, not disinfecting, is enough to reduce risk of transmission.[\[247\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-cdc.gov-247)[\[255\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-255) The CDC recommends that if a COVID‑19 case is suspected or confirmed at a facility such as an office or day care, all areas such as offices, bathrooms, common areas, shared electronic equipment like tablets, touch screens, keyboards, remote controls, and ATMs used by the ill persons should be disinfected.[\[256\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-sxygw-256) Surfaces may be decontaminated with the following:
- 62–71% [ethanol](https://en.wikipedia.org/wiki/Ethanol "Ethanol")
- 50–100% [isopropanol](https://en.wikipedia.org/wiki/Isopropanol "Isopropanol")
- 0\.1% [sodium hypochlorite](https://en.wikipedia.org/wiki/Sodium_hypochlorite "Sodium hypochlorite")
- 0\.5% [hydrogen peroxide](https://en.wikipedia.org/wiki/Hydrogen_peroxide "Hydrogen peroxide")
- 0\.2–7.5% [povidone-iodine](https://en.wikipedia.org/wiki/Povidone-iodine "Povidone-iodine")
- 50–200 ppm [hypochlorous acid](https://en.wikipedia.org/wiki/Hypochlorous_acid "Hypochlorous acid")
Other solutions, such as [benzalkonium chloride](https://en.wikipedia.org/wiki/Benzalkonium_chloride "Benzalkonium chloride") and [chlorhexidine gluconate](https://en.wikipedia.org/wiki/Chlorhexidine_gluconate "Chlorhexidine gluconate"), are less effective. [Ultraviolet germicidal irradiation](https://en.wikipedia.org/wiki/Ultraviolet_germicidal_irradiation "Ultraviolet germicidal irradiation") may also be used,[\[233\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDCasof07092020-233) although popular devices require 5–10 min exposure and may deteriorate some materials over time.[\[257\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-257)
### Self-isolation
[Self-isolation](https://en.wikipedia.org/wiki/Self-isolation "Self-isolation") at home has been recommended for those diagnosed with COVID‑19 and those who suspect they have been infected. Health agencies have issued detailed instructions for proper self-isolation.[\[258\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid33012884-258) Many governments have mandated or recommended self-quarantine for entire populations. The strongest self-quarantine instructions have been issued to those in high-risk groups.[\[259\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-lZR3i-259) Those who may have been exposed to someone with COVID‑19 and those who have recently travelled to a country or region with the widespread transmission have been advised to self-quarantine for 14 days from the time of last possible exposure.[\[260\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-260)
### International travel-related control measures
A 2021 Cochrane rapid review found that based upon low-certainty evidence, international travel-related control measures such as restricting cross-border travel may help to contain the spread of COVID‑19.[\[261\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Burns-2021-261) Additionally, symptom/exposure-based screening measures at borders may miss many positive cases.[\[261\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Burns-2021-261) While test-based border screening measures may be more effective, it could also miss many positive cases if only conducted upon arrival without follow-up. The review concluded that a minimum 10-day quarantine may be beneficial in preventing the spread of COVID‑19 and may be more effective if combined with an additional control measure like border screening.[\[261\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Burns-2021-261)
## Treatment
Main article: [Treatment and management of COVID-19](https://en.wikipedia.org/wiki/Treatment_and_management_of_COVID-19 "Treatment and management of COVID-19")
The [treatment and management of COVID-19](https://en.wikipedia.org/wiki/Treatment_and_management_of_COVID-19 "Treatment and management of COVID-19") combines both [supportive care](https://en.wikipedia.org/wiki/Supportive_care "Supportive care"), which includes treatment to [relieve symptoms](https://en.wikipedia.org/wiki/Symptomatic_treatment "Symptomatic treatment"), [fluid therapy](https://en.wikipedia.org/wiki/Fluid_replacement "Fluid replacement"), [oxygen support](https://en.wikipedia.org/wiki/Oxygen_support "Oxygen support") as needed,[\[262\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_NatureDale_Fisher_&_David_Heymann-262)[\[263\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_KuiFang2020-263)[\[264\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_Wang_Du_Zhu_Cao_2020_p.-264) and a growing list of approved medications. Highly effective vaccines have reduced mortality related to SARS-CoV-2; for those awaiting vaccination, as well as for the estimated millions of immunocompromised persons who are unlikely to respond robustly to vaccination, treatment remains important.[\[265\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-265) Some people may experience persistent symptoms or disability after recovery from the infection, known as [long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID"), but there is still limited information on the best management and rehabilitation for this condition.[\[266\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_NIHGuidelines2020-266)
Most cases of COVID-19 are mild. In these, supportive care includes medication such as [paracetamol](https://en.wikipedia.org/wiki/Paracetamol "Paracetamol") or [NSAIDs](https://en.wikipedia.org/wiki/NSAID "NSAID") to relieve symptoms (fever, body aches, cough), proper intake of fluids, rest, and [nasal breathing](https://en.wikipedia.org/wiki/Obligate_nasal_breathing "Obligate nasal breathing").[\[267\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-267)[\[268\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_AutoDW-63-268)[\[269\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-269)[\[270\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-270) Good personal hygiene and a [healthy diet](https://en.wikipedia.org/wiki/Healthy_diet "Healthy diet") are also recommended.[\[271\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-271) As of April 2020 the U.S. [Centers for Disease Control and Prevention](https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention "Centers for Disease Control and Prevention") (CDC) recommended that those who suspect they are carrying the virus isolate themselves at home and wear a face mask.[\[272\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_CDC2020IfSick-272) As of November 2020 use of the [glucocorticoid](https://en.wikipedia.org/wiki/Glucocorticoid "Glucocorticoid") [dexamethasone](https://en.wikipedia.org/wiki/Dexamethasone "Dexamethasone") had been strongly recommended in those severe cases treated in hospital with low oxygen levels, to reduce the risk of death.[\[273\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_:3-273)[\[274\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_:0-274)[\[275\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_:1-275) [Noninvasive ventilation](https://en.wikipedia.org/wiki/Noninvasive_ventilation "Noninvasive ventilation") and, ultimately, admission to an [intensive care unit](https://en.wikipedia.org/wiki/Intensive_care_unit "Intensive care unit") for [mechanical ventilation](https://en.wikipedia.org/wiki/Mechanical_ventilation "Mechanical ventilation") may be required to support breathing.[\[266\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_NIHGuidelines2020-266) [Extracorporeal membrane oxygenation](https://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygenation "Extracorporeal membrane oxygenation") (ECMO) has been used to address respiratory failure, but its benefits are still under consideration.[\[276\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_Guan_Ni_Hu_Liang_p.-276)[\[277\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_Henry_2020_p.-277) Some of the cases of severe disease course are caused by systemic hyper-inflammation, the so-called *[cytokine storm](https://en.wikipedia.org/wiki/Cytokine_storm "Cytokine storm")*.[\[278\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-278)
Although several medications have been approved in different countries as of April 2022, not all countries have these medications. Patients with mild to moderate symptoms who are in the risk groups can take [nirmatrelvir/ritonavir](https://en.wikipedia.org/wiki/Nirmatrelvir/ritonavir "Nirmatrelvir/ritonavir") (marketed as Paxlovid) or [remdesivir](https://en.wikipedia.org/wiki/Remdesivir "Remdesivir"), either of which reduces the risk of serious illness or hospitalization.[\[279\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-279)[\[280\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-280) In the US, the [Biden Administration COVID-19 action plan](https://en.wikipedia.org/wiki/Biden_Administration_COVID-19_action_plan "Biden Administration COVID-19 action plan") includes the Test to Treat initiative, where people can go to a pharmacy, take a COVID test, and immediately receive free Paxlovid if they test positive.[\[281\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-281) In November 2021, the UK approved the use of [molnupiravir](https://en.wikipedia.org/wiki/Molnupiravir "Molnupiravir") as a COVID treatment for vulnerable patients recently diagnosed with the disease.[\[282\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-282)
Several [experimental treatments](https://en.wikipedia.org/wiki/Clinical_research "Clinical research") are being actively studied in [clinical trials](https://en.wikipedia.org/wiki/Clinical_trial "Clinical trial").[\[283\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_BMJ-283) Others were thought to be promising early in the pandemic, such as [hydroxychloroquine](https://en.wikipedia.org/wiki/Hydroxychloroquine "Hydroxychloroquine") and [lopinavir/ritonavir](https://en.wikipedia.org/wiki/Lopinavir/ritonavir "Lopinavir/ritonavir"), but later research found them to be ineffective or even harmful,[\[283\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_BMJ-283)[\[284\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_Kim_Read_Fauci_p=2149-284)[\[285\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_NIHGuidelinesTherapeuticManagement-285) like [fluvoxamine](https://en.wikipedia.org/wiki/Fluvoxamine "Fluvoxamine"), a cheap and widely available [antidepressant](https://en.wikipedia.org/wiki/Antidepressant "Antidepressant");[\[286\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-286) As of December 2020, there was not enough high-quality evidence to recommend so-called early treatment.[\[284\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_Kim_Read_Fauci_p=2149-284)[\[285\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_NIHGuidelinesTherapeuticManagement-285) In December 2020, two [monoclonal antibody](https://en.wikipedia.org/wiki/Monoclonal_antibody "Monoclonal antibody")\-based therapies were available in the United States, for early use in cases thought to be at high risk of progression to severe disease.[\[285\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_NIHGuidelinesTherapeuticManagement-285) The antiviral [remdesivir](https://en.wikipedia.org/wiki/Remdesivir "Remdesivir") has been available in the U.S., Canada, Australia, and several other countries, with varying restrictions; it is not recommended for people needing mechanical ventilation and has been discouraged altogether by the [World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization "World Health Organization") (WHO),[\[287\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_Hsu_p=m4457-287) due to limited evidence of its efficacy.[\[283\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_BMJ-283)
## Prognosis and risk factors
See also: [COVID-19 pandemic death rates by country](https://en.wikipedia.org/wiki/COVID-19_pandemic_death_rates_by_country "COVID-19 pandemic death rates by country")
[](https://en.wikipedia.org/wiki/File:Covid-19_SP_-_UTI_V._Nova_Cachoeirinha.jpg)
Medical professionals treating a COVID-19 patient in critical condition in an [intensive care unit](https://en.wikipedia.org/wiki/Intensive_care_unit "Intensive care unit") in May 2020.
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](https://en.wikipedia.org/wiki/Common_cold "Common cold"). In 3–4% of cases (7.4% for those over age 65) symptoms are severe enough to cause hospitalisation.[\[288\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid33087398-288) 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.[\[107\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHOReport24Feb2020-107) The Italian [Istituto Superiore di Sanità](https://en.wikipedia.org/wiki/Istituto_Superiore_di_Sanit%C3%A0 "Istituto Superiore di Sanità") reported that the median time between the onset of symptoms and death was twelve days, with seven being hospitalised. However, people transferred to an ICU had a median time of ten days between hospitalisation and death.[\[289\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-ISSCharacteristics-289) Abnormal sodium levels during hospitalisation with COVID-19 are associated with poor prognoses: high sodium with a greater risk of death, and low sodium with an increased chance of needing ventilator support.[\[290\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-290)[\[291\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-291) Prolonged [prothrombin](https://en.wikipedia.org/wiki/Prothrombin "Prothrombin") time and elevated [C-reactive protein](https://en.wikipedia.org/wiki/C-reactive_protein "C-reactive protein") levels on admission to the hospital are associated with severe course of COVID‑19 and with a transfer to ICU.[\[292\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-292)[\[293\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-293)
Some early studies suggest 10% to 20% of people with COVID‑19 will experience [symptoms lasting longer than a month](https://en.wikipedia.org/wiki/Long_COVID "Long COVID").[\[294\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NIHRreportSep20-294)[\[295\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-HvIJa-295) A majority of those who were admitted to hospital with severe disease report long-term problems including fatigue and shortness of breath.[\[296\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-UniWashingtonSep20-296) On 30 October 2020, WHO chief [Tedros Adhanom](https://en.wikipedia.org/wiki/Tedros_Adhanom "Tedros Adhanom") warned that "to a significant number of people, the COVID virus poses a range of serious long-term effects". He has described the vast spectrum of COVID‑19 symptoms that fluctuate over time as "really concerning". They range from fatigue, a cough and shortness of breath, to inflammation and injury of major organs – including the lungs and heart, and also neurological and psychologic effects. Symptoms often overlap and can affect any system in the body. Infected people have reported cyclical bouts of fatigue, headaches, months of complete exhaustion, mood swings, and other symptoms. Tedros therefore concluded that a strategy of achieving [herd immunity](https://en.wikipedia.org/wiki/Herd_immunity "Herd immunity") by infection, rather than vaccination, is "morally unconscionable and unfeasible".[\[297\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-OaTsI-297)
In terms of hospital readmissions about 9% of 106,000 individuals had to return for hospital treatment within two months of discharge. The average to readmit was eight days since first hospital visit. There are several risk factors that have been identified as being a cause of multiple admissions to a hospital facility. Among these are advanced age (above 65 years of age) and presence of a chronic condition such as diabetes, COPD, heart failure or chronic kidney disease.[\[298\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-rArHO-298)[\[299\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CtbMg-299)
According to [scientific reviews](https://en.wikipedia.org/wiki/Scientific_review "Scientific review") smokers are more likely to require intensive care or die compared to non-smokers.[\[300\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-300)[\[301\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-engin-review-301) Acting on the same ACE2 pulmonary receptors affected by smoking, air pollution has been correlated with the disease.[\[301\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-engin-review-301) Short-term[\[302\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-302) and chronic[\[303\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-303) exposure to air pollution seems to enhance morbidity and mortality from COVID‑19.[\[304\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-304)[\[305\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-305)[\[306\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-306) Pre-existing heart and lung diseases[\[307\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-307) and also [obesity](https://en.wikipedia.org/wiki/Obesity "Obesity"), especially in conjunction with [fatty liver disease](https://en.wikipedia.org/wiki/Fatty_liver_disease "Fatty liver disease"), contributes to an increased health risk of COVID‑19.[\[301\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-engin-review-301)[\[308\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-308)[\[309\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-309)[\[310\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-310)
It is also assumed that those that are immunocompromised are at higher risk of getting severely sick from SARS-CoV-2.[\[311\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-311) One research study that looked into the COVID‑19 infections in hospitalised kidney transplant recipients found a mortality rate of 11%.[\[312\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-312)
Men with untreated [hypogonadism](https://en.wikipedia.org/wiki/Hypogonadism "Hypogonadism") were 2.4 times more likely than men with eugonadism to be hospitalised if they contracted COVID-19; Hypogonad men treated with [testosterone](https://en.wikipedia.org/wiki/Testosterone "Testosterone") were less likely to be hospitalised for COVID-19 than men who were not treated for hypogonadism.[\[313\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-jama-313)
### Genetic risk factors
[Genetics](https://en.wikipedia.org/wiki/Genetics "Genetics") plays an important role in the ability to fight off Covid.[\[314\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid33888907-314) For instance, those that do not produce detectable [type I interferons](https://en.wikipedia.org/wiki/Type_I_interferon "Type I interferon") or produce [auto-antibodies](https://en.wikipedia.org/wiki/Autoantibody "Autoantibody") against these may get much sicker from COVID‑19.[\[315\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-315)[\[316\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-316) [Genetic screening](https://en.wikipedia.org/wiki/Genetic_screening "Genetic screening") is able to detect [interferon](https://en.wikipedia.org/wiki/Interferon "Interferon") effector genes.[\[317\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-317) Some genetic variants are risk factors in specific populations. For instance, an [allele](https://en.wikipedia.org/wiki/Allele "Allele") of the [DOCK2](https://en.wikipedia.org/wiki/DOCK2 "DOCK2") gene (dedicator of cytokinesis 2 gene) is a common risk factor in Asian populations but much less common in Europe. The mutation leads to lower expression of DOCK2 especially in younger people with severe COVID-19 infections.[\[318\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-318) In fact, many other genes and genetic variants have been found that determine the outcome of SARS-CoV-2 infections.[\[319\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-319)
#### Blood group
This section is an excerpt from [Relationship between blood group and COVID-19](https://en.wikipedia.org/wiki/Relationship_between_blood_group_and_COVID-19 "Relationship between blood group and COVID-19").\[[edit](https://en.wikipedia.org/w/index.php?title=Relationship_between_blood_group_and_COVID-19&action=edit)\]
A series of studies have examined a potential [relationship between blood group and COVID-19](https://en.wikipedia.org/wiki/Relationship_between_blood_group_and_COVID-19 "Relationship between blood group and COVID-19"). Initial research conducted by scientists in [Wuhan](https://en.wikipedia.org/wiki/Wuhan "Wuhan"), [China](https://en.wikipedia.org/wiki/China "China"), on thousands of infected patients suggested that individuals with [blood group](https://en.wikipedia.org/wiki/Blood_type "Blood type") A were more likely to experience severe symptoms of COVID-19 infection compared to those with blood group O.[\[320\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-320)[\[321\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-321) Other blood types fell between these two in terms of relative risk.
A second study, published in the *[New England Journal of Medicine](https://en.wikipedia.org/wiki/New_England_Journal_of_Medicine "New England Journal of Medicine")*, did not establish a [causal relationship](https://en.wikipedia.org/wiki/Causal_relationship "Causal relationship") between blood type and the severity of COVID-19, but it did support the earlier findings from Chinese researchers.[\[322\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Relationship_between_blood_group_and_COVID-19_hamshahrionline.ir-322) However, later studies conducted in other countries did not confirm a significant or meaningful link between blood type and disease severity, calling into question the universality of the initial findings.
### Children
See also: [Impact of the COVID-19 pandemic on children](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_children "Impact of the COVID-19 pandemic on children")
While very young children have experienced lower rates of infection, older children have a rate of infection that is similar to the population as a whole.[\[323\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-323)[\[324\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-324) Children are likely to have milder symptoms and are at lower risk of severe disease than adults.[\[325\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Reardon-325) The CDC reports that in the US roughly a third of hospitalised children were admitted to the ICU,[\[326\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-326) while a European multinational study of hospitalised children from June 2020, found that about 8% of children admitted to a hospital needed intensive care.[\[327\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-327) Four of the 582 children (0.7%) in the European study died, but the actual mortality rate may be "substantially lower" since milder cases that did not seek medical help were not included in the study.[\[328\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-328)[\[329\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC_2020children-329)
### Long-term effects
Further information: [Long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID")
Around 10% to 30% of non-hospitalised people with COVID-19 go on to develop [long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID"). For those that do need hospitalisation, the incidence of long-term effects is over 50%.[\[15\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-davis-15) Long COVID is an often severe multisystem disease with a large set of symptoms. Common symptoms are [fatigue](https://en.wikipedia.org/wiki/Fatigue "Fatigue"), [post-exertional malaise](https://en.wikipedia.org/wiki/Post-exertional_malaise "Post-exertional malaise"), [cognitive issues](https://en.wikipedia.org/wiki/Cognitive_impairment "Cognitive impairment"), [shortness of breath](https://en.wikipedia.org/wiki/Shortness_of_breath "Shortness of breath") and pain. There are likely various, possibly coinciding, causes.[\[15\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-davis-15) Organ damage from the acute infection can explain a part of the symptoms, but long COVID is also observed in people where organ damage seems to be absent.[\[330\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid35594336-330)
By a variety of mechanisms, the lungs are the organs most affected in COVID‑19.[\[331\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Torres-331) In people requiring hospital admission, up to 98% of CT scans performed show lung abnormalities after 28 days of illness even if they had clinically improved.[\[332\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-332) People with advanced age, severe disease, prolonged ICU stays, or who smoke are more likely to have long-lasting effects, including pulmonary fibrosis.[\[333\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Rai-333) Overall, approximately one-third of those investigated after four weeks will have findings of [pulmonary fibrosis](https://en.wikipedia.org/wiki/Pulmonary_fibrosis "Pulmonary fibrosis") or reduced lung function as measured by [DLCO](https://en.wikipedia.org/wiki/DLCO "DLCO"), even in asymptomatic people, but with the suggestion of continuing improvement with the passing of more time.[\[331\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Torres-331) After severe disease, lung function can take anywhere from three months to a year or more to return to previous levels.[\[334\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-334)
The risks of [cognitive deficit](https://en.wikipedia.org/wiki/Cognitive_deficit "Cognitive deficit"), [dementia](https://en.wikipedia.org/wiki/Dementia "Dementia"), psychotic disorders, and [epilepsy](https://en.wikipedia.org/wiki/Epilepsy "Epilepsy") or seizures persists at an increased level two years after infection.[\[335\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-335)
### Immunity
See also: [COVID-19 vaccine](https://en.wikipedia.org/wiki/COVID-19_vaccine "COVID-19 vaccine")
[](https://en.wikipedia.org/wiki/File:Diagnostics-10-00453-g001.webp)
Human [antibody response](https://en.wikipedia.org/wiki/Antibody_response "Antibody response") to SARS-CoV-2 infection
The [immune response](https://en.wikipedia.org/wiki/Immune_response "Immune response") by humans to SARS-CoV-2 virus occurs as a combination of the [cell-mediated immunity](https://en.wikipedia.org/wiki/Cell-mediated_immunity "Cell-mediated immunity") and antibody production,[\[336\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-336) just as with most other infections.[\[337\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-337) B cells interact with T cells and begin dividing before selection into the plasma cell, partly on the basis of their affinity for antigen.[\[338\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-338) Since SARS-CoV-2 has been in the human population only since December 2019, it remains unknown if the [immunity](https://en.wikipedia.org/wiki/Immunity_\(medical\) "Immunity (medical)") is long-lasting in people who recover from the disease.[\[339\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CohenJI2020Dec-339) The presence of neutralising antibodies in blood strongly correlates with protection from infection, but the level of neutralising antibody declines with time. Those with asymptomatic or mild disease had undetectable levels of neutralising antibody two months after infection. In another study, the level of neutralising antibodies fell four-fold one to four months after the onset of symptoms. However, the lack of antibodies in the blood does not mean antibodies will not be rapidly produced upon reexposure to SARS-CoV-2. Memory B cells specific for the spike and nucleocapsid proteins of SARS-CoV-2 last for at least six months after the appearance of symptoms.[\[339\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CohenJI2020Dec-339)
As of August 2021, reinfection with COVID‑19 was possible but uncommon. The first case of reinfection was documented in August 2020.[\[340\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wang-2021-340) A systematic review found 17 cases of confirmed reinfection in medical literature as of May 2021.[\[340\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wang-2021-340) With the Omicron variant, as of 2022, reinfections have become common, albeit it is unclear how common.[\[341\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-abc-reinfections-341) [COVID-19 reinfections](https://en.wikipedia.org/wiki/SARS-CoV-2#Reinfection "SARS-CoV-2") are thought to likely be less severe than primary infections, especially if one was previously infected by the same variant.[\[341\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-abc-reinfections-341)\[*[additional citation(s) needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
## Mortality
Main articles: [COVID-19 pandemic](https://en.wikipedia.org/wiki/COVID-19_pandemic "COVID-19 pandemic") and [COVID-19 pandemic death rates by country](https://en.wikipedia.org/wiki/COVID-19_pandemic_death_rates_by_country "COVID-19 pandemic death rates by country")
Several measures are commonly used to quantify mortality.[\[342\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-342) 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.[\[343\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:0-343)
The [mortality rate](https://en.wikipedia.org/wiki/Mortality_rate "Mortality rate") reflects the number of deaths within a specific demographic group divided by the population of that demographic group. Consequently, the mortality rate reflects the prevalence as well as the severity of the disease within a given population. Mortality rates are highly correlated to age, with relatively low rates for young people and relatively high rates among the elderly.[\[344\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-JAMAPedsCOVID19-344)[\[345\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Lu_Zhang_Du_Zhang_p.-345)[\[346\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pediatrics_tong-346) In fact, one relevant factor of mortality rates is the age structure of the countries' populations. For example, the case fatality rate for COVID‑19 is lower in India than in the US since India's younger population represents a larger percentage than in the US.[\[347\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Dehingia-2021-347)
### Case fatality rate
The [case fatality rate](https://en.wikipedia.org/wiki/Case_fatality_rate "Case fatality rate") (CFR) 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 1\.02% (6,881,955/676,609,955) as of 10 March 2023.[\[348\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-JHU_ticker-348) The number varies by region.[\[349\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-349)[\[343\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:0-343)
- [](https://en.wikipedia.org/wiki/File:Cumulative_confirmed_COVID-19_cases.svg "Total confirmed cases over time")
Total confirmed cases over time
- [![Total confirmed cases of COVID‑19 per million people\[350\]](https://upload.wikimedia.org/wikipedia/commons/thumb/7/75/World_map_of_total_confirmed_COVID-19_cases_per_million_people.svg/330px-World_map_of_total_confirmed_COVID-19_cases_per_million_people.svg.png)](https://en.wikipedia.org/wiki/File:World_map_of_total_confirmed_COVID-19_cases_per_million_people.svg "Total confirmed cases of COVID‑19 per million people[350]")
Total confirmed cases of COVID‑19 per million people[\[350\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-350)
- [](https://en.wikipedia.org/wiki/File:Daily_and_total_confirmed_COVID-19_deaths,_World.svg "Total confirmed deaths over time")
Total confirmed deaths over time
- [![Total confirmed deaths due to COVID‑19 per million people\[351\]](https://upload.wikimedia.org/wikipedia/commons/thumb/3/3a/World_map_of_total_confirmed_COVID-19_deaths_per_million_people_by_country.svg/330px-World_map_of_total_confirmed_COVID-19_deaths_per_million_people_by_country.svg.png)](https://en.wikipedia.org/wiki/File:World_map_of_total_confirmed_COVID-19_deaths_per_million_people_by_country.svg "Total confirmed deaths due to COVID‑19 per million people[351]")
Total confirmed deaths due to COVID‑19 per million people[\[351\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-351)
### Infection fatality rate
A key metric in gauging the severity of COVID‑19 is the [infection fatality rate](https://en.wikipedia.org/wiki/Infection_fatality_rate "Infection fatality rate") (IFR), also referred to as the *infection fatality ratio* or *infection fatality risk*.[\[352\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-352)[\[353\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-353)[\[354\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-354) This metric is calculated by dividing the total number of deaths from the disease by the total number of infected individuals; hence, in contrast to the [CFR](https://en.wikipedia.org/wiki/Case_fatality_rate "Case fatality rate"), the IFR incorporates asymptomatic and undiagnosed infections as well as reported cases.[\[355\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-urlGeneralized_trapezoidal_ogive_curves_for_fatality_rate_modeling-355)
#### Estimates
[](https://en.wikipedia.org/wiki/File:Graph_of_Covid-19_Infection_Fatality_Ratio_by_age.png)
The red line shows the estimate of infection fatality rate (IFR), in percentage terms, as a function of age. The shaded region depicts the 95% confidence interval for that estimate. Markers denotes specific observations used in the meta-analysis.[\[356\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-EJE_levinetal-356)
[](https://en.wikipedia.org/wiki/File:Log_Graph_of_Covid-19_Infection_Fatality_Ratio_by_age.png)
The same relationship plotted on a log scale
A December 2020 systematic review and meta-analysis estimated that population IFR during the first wave of the pandemic was about 0.5% to 1% in many locations (including France, Netherlands, New Zealand, and Portugal), 1% to 2% in other locations (Australia, England, Lithuania, and Spain), and exceeded 2% in Italy.[\[356\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-EJE_levinetal-356) That study also found that most of these differences in IFR reflected corresponding differences in the age composition of the population and age-specific infection rates; in particular, the metaregression estimate of IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85.[\[356\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-EJE_levinetal-356) These results were also highlighted in a December 2020 report issued by the WHO.[\[357\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-357)
| Age group | IFR |
|---|---|
| 0–34 | 0\.004% |
| 35–44 | 0\.068% |
| 45–54 | 0\.23% |
| 55–64 | 0\.75% |
| 65–74 | 2\.5% |
| 75–84 | 8\.5% |
| 85 + | 28\.3% |
An analysis of those IFR rates indicates that COVID‑19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate of COVID-19 is two orders of magnitude greater than the annualised risk of a fatal automobile accident and far more dangerous than seasonal [influenza](https://en.wikipedia.org/wiki/Influenza "Influenza").[\[356\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-EJE_levinetal-356)
#### Earlier estimates of IFR
At an early stage of the pandemic, the World Health Organization reported estimates of IFR between 0.3% and 1%.[\[358\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-358)[\[359\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-359) On 2 July, The WHO's chief scientist reported that the average IFR estimate presented at a two-day WHO expert forum was about 0.6%.[\[360\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NYT-20200704dm-360)[\[361\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-361) In August, the WHO found that studies incorporating data from broad serology testing in Europe showed IFR estimates converging at approximately 0.5–1%.[\[362\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-362) Firm lower limits of IFRs have been established in a number of locations such as New York City and Bergamo in Italy since the IFR cannot be less than the population fatality rate. (After sufficient time however, people can get reinfected).[\[363\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-363) As of 10 July, in New York City, with a population of 8.4 million, 23,377 individuals (18,758 confirmed and 4,619 probable) have died with COVID‑19 (0.3% of the population).[\[364\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-364) Antibody testing in New York City suggested an IFR of ≈0.9%,[\[365\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-365) and ≈1.4%.[\[366\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-366) In [Bergamo province](https://en.wikipedia.org/wiki/Province_of_Bergamo "Province of Bergamo"), 0.6% of the population has died.[\[367\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-367) In September 2020, the U.S. Centers for Disease Control and Prevention (CDC) reported preliminary estimates of age-specific IFRs for public health planning purposes.[\[368\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:1-368)
### Sex differences
Main article: [Gendered impact of the COVID-19 pandemic](https://en.wikipedia.org/wiki/Gendered_impact_of_the_COVID-19_pandemic "Gendered impact of the COVID-19 pandemic")
| Percentage of infected people who are hospitalised | | | | | | | | | |
|---|---|---|---|---|---|---|---|---|---|
| 0–19 | 20–29 | 30–39 | 40–49 | 50–59 | 60–69 | 70–79 | 80+ | Total | |
| Female | 0\.1 (0.07–0.2) | 0\.5 (0.3–0.8) | 0\.9 (0.5–1.5) | 1\.3 (0.7–2.1) | 2\.6 (1.5–4.2) | 5\.1 (2.9–8.3) | 7\.8 (4.4–12.8) | 19\.3 (10.9–31.6) | 2\.6 (1.5–4.3) |
| Male | 0\.2 (0.08–0.2) | 0\.6 (0.3–0.9) | 1\.2 (0.7–1.9) | 1\.6 (0.9–2.6) | 3\.2 (1.8–5.2) | 6\.7 (3.7–10.9) | 11\.0 (6.2–17.9) | 37\.6 (21.1–61.3) | 3\.3 (1.8–5.3) |
| Total | 0\.1 (0.08–0.2) | 0\.5 (0.3–0.8) | 1\.1 (0.6–1.7) | 1\.4 (0.8–2.3) | 2\.9 (1.6–4.7) | 5\.8 (3.3–9.5) | 9\.3 (5.2–15.1) | 26\.2 (14.8–42.7) | 2\.9 (1.7–4.8) |
| Percentage of hospitalised people who go to Intensive Care Unit | | | | | | | | | |
| 0–19 | 20–29 | 30–39 | 40–49 | 50–59 | 60–69 | 70–79 | 80+ | Total | |
| Female | 16\.7 (14.3–19.3) | 8\.7 (7.5–9.9) | 11\.9 (10.9–13.0) | 16\.6 (15.6–17.7) | 20\.7 (19.8–21.6) | 23\.1 (22.2–24.0) | 18\.7 (18.0–19.5) | 4\.2 (4.0–4.5) | 14\.3 (13.9–14.7) |
| Male | 26\.9 (23.1–31.1) | 14\.0 (12.2–16.0) | 19\.2 (17.6–20.9) | 26\.9 (25.4–28.4) | 33\.4 (32.0–34.8) | 37\.3 (36.0–38.6) | 30\.2 (29.1–31.3) | 6\.8 (6.5–7.2) | 23\.1 (22.6–23.6) |
| Total | 22\.2 (19.1–25.7) | 11\.6 (10.1–13.2) | 15\.9 (14.5–17.3) | 22\.2 (21.0–23.5) | 27\.6 (26.5–28.7) | 30\.8 (29.8–31.8) | 24\.9 (24.1–25.8) | 5\.6 (5.3–5.9) | 19\.0 (18.7–19.44) |
| Percent of hospitalised people who die | | | | | | | | | |
| 0–19 | 20–29 | 30–39 | 40–49 | 50–59 | 60–69 | 70–79 | 80+ | Total | |
| Female | 0\.5 (0.2–1.0) | 0\.9 (0.5–1.3) | 1\.5 (1.2–1.9) | 2\.6 (2.3–3.0) | 5\.2 (4.8–5.6) | 10\.1 (9.5–10.6) | 16\.7 (16.0–17.4) | 25\.2 (24.4–26.0) | 14\.4 (14.0–14.8) |
| Male | 0\.7 (0.3–1.5) | 1\.3 (0.8–1.9) | 2\.2 (1.7–2.7) | 3\.8 (3.3–4.4) | 7\.6 (7.0–8.2) | 14\.8 (14.1–15.6) | 24\.6 (23.7–25.6) | 37\.1 (36.1–38.2) | 21\.2 (20.8–21.7) |
| Total | 0\.6 (0.2–1.3) | 1\.1 (0.7–1.6) | 1\.9 (1.5–2.3) | 3\.3 (2.9–3.8) | 6\.5 (6.0–7.0) | 12\.6 (12.0–13.2) | 21\.0 (20.3–21.7) | 31\.6 (30.9–32.4) | 18\.1 (17.8–18.4) |
| Percent of infected people who die – infection fatality rate (IFR) | | | | | | | | | |
| 0–19 | 20–29 | 30–39 | 40–49 | 50–59 | 60–69 | 70–79 | 80+ | Total | |
| Female | 0\.001 (\<0.001–0.002) | 0\.004 (0.002–0.007) | 0\.01 (0.007–0.02) | 0\.03 (0.02–0.06) | 0\.1 (0.08–0.2) | 0\.5 (0.3–0.8) | 1\.3 (0.7–2.1) | 4\.9 (2.7–8.0) | 0\.4 (0.2–0.6) |
| Male | 0\.001 (\<0.001–0.003) | 0\.007 (0.003–0.01) | 0\.03 (0.02–0.05) | 0\.06 (0.03–0.1) | 0\.2 (0.1–0.4) | 1\.0 (0.6–1.6) | 2\.7 (1.5–1.4) | 14\.0 (7.9–22.7) | 0\.7 (0.4–1.1) |
| Total | 0\.001 (\<0.001–0.002) | 0\.005 (0.003–0.01) | 0\.02 (0.01–0.03) | 0\.05 (0.03–0.08) | 0\.2 (0.1–0.3) | 0\.7 (0.4–1.2) | 1\.9 (1.1–3.2) | 8\.3 (4.7–13.5) | 0\.5 (0.3–0.9) |
| Numbers in parentheses are 95% [credible intervals](https://en.wikipedia.org/wiki/Credible_interval "Credible interval") for the estimates. | | | | | | | | | |
COVID‑19 [case fatality rates](https://en.wikipedia.org/wiki/Case_fatality_rate "Case fatality rate") are higher among men than women in most countries. However, in a few countries like India, Nepal, Vietnam, and Slovenia the fatality cases are higher in women than men.[\[347\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Dehingia-2021-347) Globally, men are more likely to be admitted to the [ICU](https://en.wikipedia.org/wiki/Intensive_care_unit "Intensive care unit") and more likely to die.[\[370\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-370)[\[371\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-371) One meta-analysis found that globally, men were more likely to get COVID‑19 than women; there were approximately 55 men and 45 women per 100 infections ([CI](https://en.wikipedia.org/wiki/Confidence_interval "Confidence interval"): 51.43–56.58).[\[372\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-372)
The [Chinese Center for Disease Control and Prevention](https://en.wikipedia.org/wiki/Chinese_Center_for_Disease_Control_and_Prevention "Chinese Center for Disease Control and Prevention") reported the death rate was 2.8% for men and 1.7% for women.[\[373\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Epidemiology17Feb2020-373) Later reviews in June 2020 indicated that there is no significant difference in susceptibility or in CFR between genders.[\[374\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-374)[\[375\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-375) One review acknowledges the different mortality rates in Chinese men, suggesting that it may be attributable to lifestyle choices such as smoking and drinking alcohol rather than genetic factors.[\[376\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-376) Smoking, which in some countries like China is mainly a male activity, is a habit that contributes to increasing significantly the case fatality rates among men.[\[347\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Dehingia-2021-347) Sex-based immunological differences, lesser 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.[\[377\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-nyt-italy-377) In Europe as of February 2020, 57% of the infected people were men and 72% of those died with COVID‑19 were men.[\[378\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-378) As of April 2020, the US government is not tracking sex-related data of COVID‑19 infections.[\[379\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-nytimesus-379) Research has shown that viral illnesses like Ebola, HIV, influenza and SARS affect men and women differently.[\[379\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-nytimesus-379)
### Ethnic differences
In the US, a greater proportion of deaths due to COVID‑19 have occurred among African Americans and other minority groups.[\[380\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AVD-380) Structural factors that prevent them from practising social distancing include their concentration in crowded substandard housing and in "essential" occupations such as retail grocery workers, public transit employees, health-care workers and custodial staff. Greater prevalence of lacking [health insurance](https://en.wikipedia.org/wiki/Health_insurance "Health insurance") and care of underlying conditions such as [diabetes](https://en.wikipedia.org/wiki/Diabetes "Diabetes"),[\[381\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Shauly-Aharonov-2021-381) hypertension, and [heart disease](https://en.wikipedia.org/wiki/Heart_disease "Heart disease") also increase their risk of death.[\[382\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-382) Similar issues affect [Native American](https://en.wikipedia.org/wiki/Indigenous_peoples_of_the_Americas "Indigenous peoples of the Americas") and [Latino](https://en.wikipedia.org/wiki/Latino_\(demonym\) "Latino (demonym)") communities.[\[380\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AVD-380) On the one hand, in the Dominican Republic there is a clear example of both gender and ethnic inequality. In this Latin American territory, there is great inequality and precariousness that especially affects Dominican women, with greater emphasis on those of Haitian descent.[\[383\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Batthyany-2020-383) According to a US health policy non-profit, 34% of American Indian and Alaska Native People (AIAN) non-elderly adults are at risk of serious illness compared to 21% of white non-elderly adults.[\[384\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:2-384) The source attributes it to disproportionately high rates of many health conditions that may put them at higher risk as well as living conditions like lack of access to clean water.[\[384\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:2-384)
Leaders have called for efforts to research and address the disparities.[\[385\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-385) In the UK, a greater proportion of deaths due to COVID‑19 have occurred in those of a [Black](https://en.wikipedia.org/wiki/Black_British_people "Black British people"), [Asian](https://en.wikipedia.org/wiki/British_Asian "British Asian"), and other ethnic minority background.[\[386\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-386)[\[387\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-387)[\[388\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-388) More severe impacts upon patients including the relative incidence of the necessity of hospitalisation requirements, and vulnerability to the disease has been associated via DNA analysis to be expressed in genetic variants at chromosomal region 3, features that are associated with European [Neanderthal](https://en.wikipedia.org/wiki/Neanderthal "Neanderthal") heritage. That structure imposes greater risks that those affected will develop a more severe form of the disease.[\[389\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Neanderthal-389) The findings are from Professor Svante Pääbo and researchers he leads at the [Max Planck Institute for Evolutionary Anthropology](https://en.wikipedia.org/wiki/Max_Planck_Institute_for_Evolutionary_Anthropology "Max Planck Institute for Evolutionary Anthropology") and the [Karolinska Institutet](https://en.wikipedia.org/wiki/Karolinska_Institutet "Karolinska Institutet").[\[389\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Neanderthal-389) This admixture of modern human and Neanderthal genes is estimated to have occurred roughly between 50,000 and 60,000 years ago in Southern Europe.[\[389\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Neanderthal-389)
### Comorbidities
[Biological](https://en.wikipedia.org/wiki/Biology "Biology") factors (immune response) and the general behaviour (habits) can strongly determine the consequences of COVID‑19.[\[347\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Dehingia-2021-347) Most of those who die of COVID‑19 have [pre-existing (underlying) conditions](https://en.wikipedia.org/wiki/Pre-existing_condition "Pre-existing condition"), including hypertension, [diabetes mellitus](https://en.wikipedia.org/wiki/Diabetes_mellitus "Diabetes mellitus"),[\[381\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Shauly-Aharonov-2021-381) and [cardiovascular disease](https://en.wikipedia.org/wiki/Cardiovascular_disease "Cardiovascular disease").[\[390\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO-2020a-390) According to March data from the United States, 89% of those hospitalised had preexisting conditions.[\[391\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-391) The Italian Istituto Superiore di Sanità reported that out of 8.8% of deaths where [medical charts](https://en.wikipedia.org/wiki/Medical_record "Medical record") were available, 96.1% of people had at least one [comorbidity](https://en.wikipedia.org/wiki/Comorbidity "Comorbidity") with the average person having 3.4 diseases.[\[289\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-ISSCharacteristics-289) According to this report the most common comorbidities are hypertension (66% of deaths), [type 2 diabetes](https://en.wikipedia.org/wiki/Type_2_diabetes "Type 2 diabetes") (29.8% of deaths), [ischaemic heart disease](https://en.wikipedia.org/wiki/Ischemic_heart_disease "Ischemic heart disease") (27.6% of deaths), [atrial fibrillation](https://en.wikipedia.org/wiki/Atrial_fibrillation "Atrial fibrillation") (23.1% of deaths) and [chronic renal failure](https://en.wikipedia.org/wiki/Chronic_renal_failure "Chronic renal failure") (20.2% of deaths).
Most critical respiratory comorbidities according to the US Centers for Disease Control and Prevention (CDC), are: moderate or severe [asthma](https://en.wikipedia.org/wiki/Asthma "Asthma"), pre-existing [COPD](https://en.wikipedia.org/wiki/Chronic_obstructive_pulmonary_disease "Chronic obstructive pulmonary disease"), [pulmonary fibrosis](https://en.wikipedia.org/wiki/Pulmonary_fibrosis "Pulmonary fibrosis"), and [cystic fibrosis](https://en.wikipedia.org/wiki/Cystic_fibrosis "Cystic fibrosis").[\[392\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:3-392) Evidence stemming from [meta-analysis](https://en.wikipedia.org/wiki/Meta-analysis "Meta-analysis") of several smaller research papers also suggests that smoking can be associated with worse outcomes.[\[393\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-393)[\[394\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-394) When someone with existing respiratory problems is infected with COVID‑19, they might be at greater risk for severe symptoms.[\[392\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:3-392) COVID‑19 also poses a greater risk to people who [misuse opioids](https://en.wikipedia.org/wiki/Opioid_use_disorder "Opioid use disorder") and [amphetamines](https://en.wikipedia.org/wiki/Stimulant_use_disorder "Stimulant use disorder"), insofar as their drug use may have caused lung damage.[\[395\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-395)
In August 2020, the CDC issued a caution that [tuberculosis](https://en.wikipedia.org/wiki/Tuberculosis "Tuberculosis") (TB) infections could increase the risk of severe illness or death. The WHO recommended that people with respiratory symptoms be screened for both diseases, as testing positive for COVID‑19 could not rule out co-infections. Some projections have estimated that reduced TB detection due to the pandemic could result in 6.3 million additional TB cases and 1.4 million TB-related deaths by 2025.[\[396\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-396)
## History
Main articles: [Timeline of the COVID-19 pandemic](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic "Timeline of the COVID-19 pandemic") and [Investigations into the origin of COVID-19](https://en.wikipedia.org/wiki/Investigations_into_the_origin_of_COVID-19 "Investigations into the origin of COVID-19")
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|  | This section needs to be **updated**. The reason given is: **excessive detail about the very early pandemic while missing an overview of the later pandemic**. Please help update this article to reflect recent events or newly available information. *(July 2023)* |
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| Part of [a series](https://en.wikipedia.org/wiki/Category:COVID-19_pandemic "Category:COVID-19 pandemic") on the |
| [COVID-19 pandemic](https://en.wikipedia.org/wiki/COVID-19_pandemic "COVID-19 pandemic") |
| [](https://en.wikipedia.org/wiki/File:Coronavirus._SARS-CoV-2.png "Scientifically accurate atomic model of the external structure of SARS-CoV-2. Each \"ball\" is an atom.") Scientifically accurate atomic model of the external structure of SARS-CoV-2. Each "ball" is an atom. |
| [COVID-19]() (disease) [SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2") (virus) [Cases](https://en.wikipedia.org/wiki/COVID-19_pandemic_cases "COVID-19 pandemic cases") [Deaths](https://en.wikipedia.org/wiki/COVID-19_pandemic_deaths "COVID-19 pandemic deaths") |
| [Timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic "Timeline of the COVID-19 pandemic") [2019](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_2019 "Timeline of the COVID-19 pandemic in 2019") 2020 [January](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_January_2020 "Timeline of the COVID-19 pandemic in January 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_January_2020 "Responses to the COVID-19 pandemic in January 2020") [February](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_February_2020 "Timeline of the COVID-19 pandemic in February 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_February_2020 "Responses to the COVID-19 pandemic in February 2020") [March](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_March_2020 "Timeline of the COVID-19 pandemic in March 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_March_2020 "Responses to the COVID-19 pandemic in March 2020") [April](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_April_2020 "Timeline of the COVID-19 pandemic in April 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_April_2020 "Responses to the COVID-19 pandemic in April 2020") [May](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_May_2020 "Timeline of the COVID-19 pandemic in May 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_May_2020 "Responses to the COVID-19 pandemic in May 2020") [June](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_June_2020 "Timeline of the COVID-19 pandemic in June 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_June_2020 "Responses to the COVID-19 pandemic in June 2020") [July](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_July_2020 "Timeline of the COVID-19 pandemic in July 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_July_2020 "Responses to the COVID-19 pandemic in July 2020") [August](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_August_2020 "Timeline of the COVID-19 pandemic in August 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_August_2020 "Responses to the COVID-19 pandemic in August 2020") [September](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_September_2020 "Timeline of the COVID-19 pandemic in September 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_September_2020 "Responses to the COVID-19 pandemic in September 2020") [October](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_October_2020 "Timeline of the COVID-19 pandemic in October 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_October_2020 "Responses to the COVID-19 pandemic in October 2020") [November](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_November_2020 "Timeline of the COVID-19 pandemic in November 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_November_2020 "Responses to the COVID-19 pandemic in November 2020") [December](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_December_2020 "Timeline of the COVID-19 pandemic in December 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_December_2020 "Responses to the COVID-19 pandemic in December 2020") 2021 [January](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_January_2021 "Timeline of the COVID-19 pandemic in January 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_January_2021 "Responses to the COVID-19 pandemic in January 2021") [February](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_February_2021 "Timeline of the COVID-19 pandemic in February 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_February_2021 "Responses to the COVID-19 pandemic in February 2021") [March](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_March_2021 "Timeline of the COVID-19 pandemic in March 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_March_2021 "Responses to the COVID-19 pandemic in March 2021") [April](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_April_2021 "Timeline of the COVID-19 pandemic in April 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_April_2021 "Responses to the COVID-19 pandemic in April 2021") [May](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_May_2021 "Timeline of the COVID-19 pandemic in May 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_May_2021 "Responses to the COVID-19 pandemic in May 2021") [June](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_June_2021 "Timeline of the COVID-19 pandemic in June 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_June_2021 "Responses to the COVID-19 pandemic in June 2021") [July](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_July_2021 "Timeline of the COVID-19 pandemic in July 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_July_2021 "Responses to the COVID-19 pandemic in July 2021") [August](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_August_2021 "Timeline of the COVID-19 pandemic in August 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_August_2021 "Responses to the COVID-19 pandemic in August 2021") [September](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_September_2021 "Timeline of the COVID-19 pandemic in September 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_September_2021 "Responses to the COVID-19 pandemic in September 2021") [October](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_October_2021 "Timeline of the COVID-19 pandemic in October 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_October_2021 "Responses to the COVID-19 pandemic in October 2021") [November](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_November_2021 "Timeline of the COVID-19 pandemic in November 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_November_2021 "Responses to the COVID-19 pandemic in November 2021") [December](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_December_2021 "Timeline of the COVID-19 pandemic in December 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_December_2021 "Responses to the COVID-19 pandemic in December 2021") 2022 [January](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_January_2022 "Timeline of the COVID-19 pandemic in January 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_January_2022 "Responses to the COVID-19 pandemic in January 2022") [February](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_February_2022 "Timeline of the COVID-19 pandemic in February 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_February_2022 "Responses to the COVID-19 pandemic in February 2022") [March](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_March_2022 "Timeline of the COVID-19 pandemic in March 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_March_2022 "Responses to the COVID-19 pandemic in March 2022") [April](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_April_2022 "Timeline of the COVID-19 pandemic in April 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_April_2022 "Responses to the COVID-19 pandemic in April 2022") [May](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_May_2022 "Timeline of the COVID-19 pandemic in May 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_May_2022 "Responses to the COVID-19 pandemic in May 2022") [June](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_June_2022 "Timeline of the COVID-19 pandemic in June 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_June_2022 "Responses to the COVID-19 pandemic in June 2022") [July](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_July_2022 "Timeline of the COVID-19 pandemic in July 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_July_2022 "Responses to the COVID-19 pandemic in July 2022") [August](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_August_2022 "Timeline of the COVID-19 pandemic in August 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_August_2022 "Responses to the COVID-19 pandemic in August 2022") [September](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_September_2022 "Timeline of the COVID-19 pandemic in September 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_September_2022 "Responses to the COVID-19 pandemic in September 2022") [October](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_October_2022 "Timeline of the COVID-19 pandemic in October 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_October_2022 "Responses to the COVID-19 pandemic in October 2022") [November](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_November_2022 "Timeline of the COVID-19 pandemic in November 2022") [December](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_December_2022 "Timeline of the COVID-19 pandemic in December 2022") [2023](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_2023 "Timeline of the COVID-19 pandemic in 2023") |
| [Locations](https://en.wikipedia.org/wiki/COVID-19_pandemic_by_country_and_territory "COVID-19 pandemic by country and territory") [By country and territory](https://en.wikipedia.org/wiki/COVID-19_pandemic_by_country_and_territory "COVID-19 pandemic by country and territory") [Africa](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Africa "COVID-19 pandemic in Africa") [Antarctica](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Antarctica "COVID-19 pandemic in Antarctica") [Asia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Asia "COVID-19 pandemic in Asia") [Europe](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Europe "COVID-19 pandemic in Europe") [North America](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_North_America "COVID-19 pandemic in North America") [Oceania](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Oceania "COVID-19 pandemic in Oceania") [South America](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_South_America "COVID-19 pandemic in South America") By conveyance [Cruise ships](https://en.wikipedia.org/wiki/COVID-19_pandemic_on_cruise_ships "COVID-19 pandemic on cruise ships") [Naval ships](https://en.wikipedia.org/wiki/COVID-19_pandemic_on_naval_ships "COVID-19 pandemic on naval ships") |
| International response [Endemic phase](https://en.wikipedia.org/wiki/Endemic_phase_of_COVID-19 "Endemic phase of COVID-19") [Evacuations](https://en.wikipedia.org/wiki/Evacuations_related_to_the_COVID-19_pandemic "Evacuations related to the COVID-19 pandemic") [Face masks](https://en.wikipedia.org/wiki/Face_masks_during_the_COVID-19_pandemic "Face masks during the COVID-19 pandemic") [International aid](https://en.wikipedia.org/wiki/International_aid_related_to_the_COVID-19_pandemic "International aid related to the COVID-19 pandemic") [Origin](https://en.wikipedia.org/wiki/Origin_of_SARS-CoV-2 "Origin of SARS-CoV-2") [Lockdowns](https://en.wikipedia.org/wiki/COVID-19_lockdowns "COVID-19 lockdowns") [by country](https://en.wikipedia.org/wiki/COVID-19_lockdowns_by_country "COVID-19 lockdowns by country") [Misinformation](https://en.wikipedia.org/wiki/COVID-19_misinformation "COVID-19 misinformation") [by governments](https://en.wikipedia.org/wiki/COVID-19_misinformation_by_governments "COVID-19 misinformation by governments") [Fake treatments](https://en.wikipedia.org/wiki/List_of_unproven_methods_against_COVID-19 "List of unproven methods against COVID-19") [Social distancing](https://en.wikipedia.org/wiki/Social_distancing_measures_related_to_the_COVID-19_pandemic "Social distancing measures related to the COVID-19 pandemic") [Software](https://en.wikipedia.org/wiki/Use_and_development_of_software_for_COVID-19_pandemic_mitigation "Use and development of software for COVID-19 pandemic mitigation") [Travel](https://en.wikipedia.org/wiki/Travel_during_the_COVID-19_pandemic "Travel during the COVID-19 pandemic") [United Nations](https://en.wikipedia.org/wiki/United_Nations_response_to_the_COVID-19_pandemic "United Nations response to the COVID-19 pandemic") [World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization%27s_response_to_the_COVID-19_pandemic "World Health Organization's response to the COVID-19 pandemic") [WTO IP waiver](https://en.wikipedia.org/wiki/TRIPS_Agreement_waiver "TRIPS Agreement waiver") [Undercounting of deaths](https://en.wikipedia.org/wiki/Undercounting_of_COVID-19_pandemic_deaths_by_country "Undercounting of COVID-19 pandemic deaths by country") [COVID-19 apps](https://en.wikipedia.org/wiki/COVID-19_apps "COVID-19 apps") [Zero-COVID](https://en.wikipedia.org/wiki/Zero-COVID "Zero-COVID") [National responses](https://en.wikipedia.org/wiki/National_responses_to_the_COVID-19_pandemic "National responses to the COVID-19 pandemic") [Africa](https://en.wikipedia.org/wiki/National_responses_to_the_COVID-19_pandemic_in_Africa "National responses to the COVID-19 pandemic in Africa") [China](https://en.wikipedia.org/wiki/Chinese_government_response_to_COVID-19 "Chinese government response to COVID-19") [European Union](https://en.wikipedia.org/wiki/European_Union_response_to_the_COVID-19_pandemic "European Union response to the COVID-19 pandemic") [Germany](https://en.wikipedia.org/wiki/German_government_response_to_the_COVID-19_pandemic "German government response to the COVID-19 pandemic") [Ghana](https://en.wikipedia.org/wiki/Ghanaian_government_response_to_the_COVID-19_pandemic "Ghanaian government response to the COVID-19 pandemic") [India](https://en.wikipedia.org/wiki/Indian_government_response_to_the_COVID-19_pandemic "Indian government response to the COVID-19 pandemic") [Ireland](https://en.wikipedia.org/wiki/Irish_government_response_to_the_COVID-19_pandemic "Irish government response to the COVID-19 pandemic") [Netherlands](https://en.wikipedia.org/wiki/Dutch_government_response_to_the_COVID-19_pandemic "Dutch government response to the COVID-19 pandemic") [New Zealand](https://en.wikipedia.org/wiki/New_Zealand_government_response_to_the_COVID-19_pandemic "New Zealand government response to the COVID-19 pandemic") [Nigeria](https://en.wikipedia.org/wiki/Nigerian_government_response_to_the_COVID-19_pandemic "Nigerian government response to the COVID-19 pandemic") [Philippines](https://en.wikipedia.org/wiki/Philippine_government_response_to_the_COVID-19_pandemic "Philippine government response to the COVID-19 pandemic") [Russia](https://en.wikipedia.org/wiki/Russian_government_response_to_the_COVID-19_pandemic "Russian government response to the COVID-19 pandemic") [Sweden](https://en.wikipedia.org/wiki/Swedish_government_response_to_the_COVID-19_pandemic "Swedish government response to the COVID-19 pandemic") [UK](https://en.wikipedia.org/wiki/United_Kingdom_responses_to_the_COVID-19_pandemic "United Kingdom responses to the COVID-19 pandemic") [government](https://en.wikipedia.org/wiki/British_government_response_to_the_COVID-19_pandemic "British government response to the COVID-19 pandemic") [US](https://en.wikipedia.org/wiki/United_States_responses_to_the_COVID-19_pandemic "United States responses to the COVID-19 pandemic") [federal government](https://en.wikipedia.org/wiki/U.S._federal_government_response_to_the_COVID-19_pandemic "U.S. federal government response to the COVID-19 pandemic") [Vietnam](https://en.wikipedia.org/wiki/Vietnamese_government_response_to_the_COVID-19_pandemic "Vietnamese government response to the COVID-19 pandemic") |
| Medical response [Disease testing](https://en.wikipedia.org/wiki/COVID-19_testing "COVID-19 testing") [Breathalyzer](https://en.wikipedia.org/wiki/Coronavirus_breathalyzer "Coronavirus breathalyzer") [Development](https://en.wikipedia.org/wiki/Development_of_COVID-19_tests "Development of COVID-19 tests") [Drug development](https://en.wikipedia.org/wiki/COVID-19_drug_development "COVID-19 drug development") [Drug repurposing](https://en.wikipedia.org/wiki/COVID-19_drug_repurposing_research "COVID-19 drug repurposing research") [Public health mitigation](https://en.wikipedia.org/wiki/Public_health_mitigation_of_COVID-19 "Public health mitigation of COVID-19") [Vaccines](https://en.wikipedia.org/wiki/COVID-19_vaccine "COVID-19 vaccine") [History](https://en.wikipedia.org/wiki/History_of_COVID-19_vaccine_development "History of COVID-19 vaccine development") [Research](https://en.wikipedia.org/wiki/COVID-19_vaccine_clinical_research "COVID-19 vaccine clinical research") [VITT](https://en.wikipedia.org/wiki/Embolic_and_thrombotic_events_after_COVID-19_vaccination "Embolic and thrombotic events after COVID-19 vaccination") [Deployment](https://en.wikipedia.org/wiki/Deployment_of_COVID-19_vaccines "Deployment of COVID-19 vaccines") [Authorizations](https://en.wikipedia.org/wiki/List_of_COVID-19_vaccine_authorizations "List of COVID-19 vaccine authorizations") [Operation Warp Speed](https://en.wikipedia.org/wiki/Operation_Warp_Speed "Operation Warp Speed") [Misinformation and hesitancy](https://en.wikipedia.org/wiki/COVID-19_vaccine_misinformation_and_hesitancy "COVID-19 vaccine misinformation and hesitancy") [US](https://en.wikipedia.org/wiki/COVID-19_vaccine_hesitancy_in_the_United_States "COVID-19 vaccine hesitancy in the United States") [Vaccine card](https://en.wikipedia.org/wiki/COVID-19_vaccine_card "COVID-19 vaccine card") [Vaccine passports](https://en.wikipedia.org/wiki/Vaccine_passports_during_the_COVID-19_pandemic "Vaccine passports during the COVID-19 pandemic") Current vaccines [CoronaVac](https://en.wikipedia.org/wiki/CoronaVac "CoronaVac") [Covaxin](https://en.wikipedia.org/wiki/Covaxin "Covaxin") [Convidecia](https://en.wikipedia.org/wiki/Convidecia "Convidecia") [Janssen](https://en.wikipedia.org/wiki/Janssen_COVID-19_vaccine "Janssen COVID-19 vaccine") [Medigen](https://en.wikipedia.org/wiki/MVC_COVID-19_vaccine "MVC COVID-19 vaccine") [Moderna](https://en.wikipedia.org/wiki/Moderna_COVID-19_vaccine "Moderna COVID-19 vaccine") [Novavax](https://en.wikipedia.org/wiki/Novavax_COVID-19_vaccine "Novavax COVID-19 vaccine") [Oxford–AstraZeneca](https://en.wikipedia.org/wiki/Oxford%E2%80%93AstraZeneca_COVID-19_vaccine "Oxford–AstraZeneca COVID-19 vaccine") [Pfizer–BioNTech](https://en.wikipedia.org/wiki/Pfizer%E2%80%93BioNTech_COVID-19_vaccine "Pfizer–BioNTech COVID-19 vaccine") [Sinopharm BIBP](https://en.wikipedia.org/wiki/Sinopharm_BIBP_COVID-19_vaccine "Sinopharm BIBP COVID-19 vaccine") [Sputnik V](https://en.wikipedia.org/wiki/Sputnik_V_COVID-19_vaccine "Sputnik V COVID-19 vaccine") |
| [Variants](https://en.wikipedia.org/wiki/Variants_of_SARS-CoV-2 "Variants of SARS-CoV-2") [Variants of concern](https://en.wikipedia.org/wiki/SARS-CoV-2_variant_of_concern "SARS-CoV-2 variant of concern") [Alpha](https://en.wikipedia.org/wiki/SARS-CoV-2_Alpha_variant "SARS-CoV-2 Alpha variant") [Beta](https://en.wikipedia.org/wiki/SARS-CoV-2_Beta_variant "SARS-CoV-2 Beta variant") [Gamma](https://en.wikipedia.org/wiki/SARS-CoV-2_Gamma_variant "SARS-CoV-2 Gamma variant") [Delta](https://en.wikipedia.org/wiki/SARS-CoV-2_Delta_variant "SARS-CoV-2 Delta variant") [Omicron](https://en.wikipedia.org/wiki/SARS-CoV-2_Omicron_variant "SARS-CoV-2 Omicron variant") Other variants [Epsilon](https://en.wikipedia.org/wiki/SARS-CoV-2_Epsilon_variant "SARS-CoV-2 Epsilon variant") [Zeta](https://en.wikipedia.org/wiki/SARS-CoV-2_Zeta_variant "SARS-CoV-2 Zeta variant") [Eta](https://en.wikipedia.org/wiki/SARS-CoV-2_Eta_variant "SARS-CoV-2 Eta variant") [Theta](https://en.wikipedia.org/wiki/SARS-CoV-2_Theta_variant "SARS-CoV-2 Theta variant") [Iota](https://en.wikipedia.org/wiki/SARS-CoV-2_Iota_variant "SARS-CoV-2 Iota variant") [Kappa](https://en.wikipedia.org/wiki/SARS-CoV-2_Kappa_variant "SARS-CoV-2 Kappa variant") [Lambda](https://en.wikipedia.org/wiki/SARS-CoV-2_Lambda_variant "SARS-CoV-2 Lambda variant") [Mu](https://en.wikipedia.org/wiki/SARS-CoV-2_Mu_variant "SARS-CoV-2 Mu variant") [Cluster 5](https://en.wikipedia.org/wiki/Cluster_5 "Cluster 5") [Lineage B.1.617](https://en.wikipedia.org/wiki/SARS-CoV-2_lineage_B.1.617 "SARS-CoV-2 lineage B.1.617") |
| [Economic impact](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic "Economic impact of the COVID-19 pandemic") and [recession](https://en.wikipedia.org/wiki/COVID-19_recession "COVID-19 recession") [Arts and culture](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_arts_and_cultural_heritage "Impact of the COVID-19 pandemic on the arts and cultural heritage") [Aviation](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_aviation "Impact of the COVID-19 pandemic on aviation") [Cannabis](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_cannabis_industry "Impact of the COVID-19 pandemic on the cannabis industry") [Cinema](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_cinema "Impact of the COVID-19 pandemic on cinema") [films](https://en.wikipedia.org/wiki/List_of_films_impacted_by_the_COVID-19_pandemic "List of films impacted by the COVID-19 pandemic") [Disney](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_Walt_Disney_Company "Impact of the COVID-19 pandemic on the Walt Disney Company") [Fashion](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_fashion_industry "Impact of the COVID-19 pandemic on the fashion industry") [Financial markets](https://en.wikipedia.org/wiki/Financial_market_impact_of_the_COVID-19_pandemic "Financial market impact of the COVID-19 pandemic") [Food industry](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_food_industry "Impact of the COVID-19 pandemic on the food industry") [Food security](https://en.wikipedia.org/wiki/Food_security_during_the_COVID-19_pandemic "Food security during the COVID-19 pandemic") [Journalism](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_journalism "Impact of the COVID-19 pandemic on journalism") [Music](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_music_industry "Impact of the COVID-19 pandemic on the music industry") [Performing arts](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_performing_arts "Impact of the COVID-19 pandemic on the performing arts") [Retail](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_retail "Impact of the COVID-19 pandemic on retail") [Shipping](https://en.wikipedia.org/wiki/2021%E2%80%932022_global_supply_chain_crisis#Shipping "2021–2022 global supply chain crisis") [Television](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_television "Impact of the COVID-19 pandemic on television") [US](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_television_in_the_United_States "Impact of the COVID-19 pandemic on television in the United States") [sportscasting](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_American_sports_broadcasting "Impact of the COVID-19 pandemic on American sports broadcasting") [programs](https://en.wikipedia.org/wiki/List_of_American_television_series_impacted_by_the_COVID-19_pandemic "List of American television series impacted by the COVID-19 pandemic") [Tourism](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_tourism "Impact of the COVID-19 pandemic on tourism") [Video games](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_video_game_industry "Impact of the COVID-19 pandemic on the video game industry") By country [Canada](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_Canada "Economic impact of the COVID-19 pandemic in Canada") [India](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_India "Economic impact of the COVID-19 pandemic in India") [Ireland](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_the_Republic_of_Ireland "Economic impact of the COVID-19 pandemic in the Republic of Ireland") [Malaysia](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_Malaysia "Economic impact of the COVID-19 pandemic in Malaysia") [New Zealand](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_New_Zealand "Economic impact of the COVID-19 pandemic in New Zealand") [Russia](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_Russia "Economic impact of the COVID-19 pandemic in Russia") [UK](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_the_United_Kingdom "Economic impact of the COVID-19 pandemic in the United Kingdom") [US](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_the_United_States "Economic impact of the COVID-19 pandemic in the United States") [By sport](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_sports "Impact of the COVID-19 pandemic on sports") [Association football](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_association_football "Impact of the COVID-19 pandemic on association football") [Baseball](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_baseball "Impact of the COVID-19 pandemic on baseball") [Basketball](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_basketball "Impact of the COVID-19 pandemic on basketball") [Combat sports](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_combat_sports "Impact of the COVID-19 pandemic on combat sports") [Cricket](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_cricket "Impact of the COVID-19 pandemic on cricket") [Disc golf](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_disc_golf "Impact of the COVID-19 pandemic on disc golf") [Gaelic games](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_Gaelic_games "Impact of the COVID-19 pandemic on Gaelic games") [Gridiron football](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_gridiron_football "Impact of the COVID-19 pandemic on gridiron football") [Ice hockey](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_ice_hockey "Impact of the COVID-19 pandemic on ice hockey") [Motorsport](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_motorsport "Impact of the COVID-19 pandemic on motorsport") [Rugby league](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_rugby_league "Impact of the COVID-19 pandemic on rugby league") |
| [Impacts](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic "Impact of the COVID-19 pandemic") [Long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID") [Neurological and psychological symptoms](https://en.wikipedia.org/wiki/Impact_of_COVID-19_on_neurological,_psychological_and_other_mental_health_outcomes "Impact of COVID-19 on neurological, psychological and other mental health outcomes") [Post-exertional malaise](https://en.wikipedia.org/wiki/Post-exertional_malaise "Post-exertional malaise") [Society](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic "Social impact of the COVID-19 pandemic") [African diaspora](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_African_diaspora "Impact of the COVID-19 pandemic on the African diaspora") [Indian migrant workers](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_Indian_migrant_workers "Impact of the COVID-19 pandemic on Indian migrant workers") [Animals](https://en.wikipedia.org/wiki/COVID-19_pandemic_and_animals "COVID-19 pandemic and animals") [Alzheimer's disease patients](https://en.wikipedia.org/wiki/Alzheimer%27s_disease_and_COVID-19 "Alzheimer's disease and COVID-19") [Crime](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_crime "Impact of the COVID-19 pandemic on crime") [Death rates by country](https://en.wikipedia.org/wiki/COVID-19_pandemic_death_rates_by_country "COVID-19 pandemic death rates by country") [Disability](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_people_with_disabilities "Impact of the COVID-19 pandemic on people with disabilities") [Domestic violence](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_domestic_violence "Impact of the COVID-19 pandemic on domestic violence") [Emergency evacuations](https://en.wikipedia.org/wiki/Emergency_evacuation_procedures_during_the_COVID-19_pandemic "Emergency evacuation procedures during the COVID-19 pandemic") [Education](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_education "Impact of the COVID-19 pandemic on education") [Female](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_female_education "Impact of the COVID-19 pandemic on female education") [Environment](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_environment "Impact of the COVID-19 pandemic on the environment") [Hospitals](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_hospitals "Impact of the COVID-19 pandemic on hospitals") [Language](https://en.wikipedia.org/wiki/Glossary_of_the_COVID-19_pandemic "Glossary of the COVID-19 pandemic") [LGBTQ community](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_LGBTQ_community "Impact of the COVID-19 pandemic on the LGBTQ community") [Long-term care](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_long-term_care_facilities "Impact of the COVID-19 pandemic on long-term care facilities") [Media coverage](https://en.wikipedia.org/wiki/Media_coverage_of_the_COVID-19_pandemic "Media coverage of the COVID-19 pandemic") [Mental health](https://en.wikipedia.org/wiki/Mental_health_during_the_COVID-19_pandemic "Mental health during the COVID-19 pandemic") [Migration](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_migration "Impact of the COVID-19 pandemic on migration") [Military](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_military "Impact of the COVID-19 pandemic on the military") [Notable deaths](https://en.wikipedia.org/wiki/List_of_deaths_due_to_COVID-19 "List of deaths due to COVID-19") [Other health issues](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_other_health_issues "Impact of the COVID-19 pandemic on other health issues") [Popular culture](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_popular_culture "COVID-19 pandemic in popular culture") [Protests](https://en.wikipedia.org/wiki/Protests_against_responses_to_the_COVID-19_pandemic "Protests against responses to the COVID-19 pandemic") [Pregnancy](https://en.wikipedia.org/wiki/COVID-19_in_pregnancy "COVID-19 in pregnancy") [Prisons](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_prisons "Impact of the COVID-19 pandemic on prisons") [Religion](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_religion "Impact of the COVID-19 pandemic on religion") [Catholic Church](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_Catholic_Church "Impact of the COVID-19 pandemic on the Catholic Church") [Hajj](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_Hajj "Impact of the COVID-19 pandemic on Hajj") [Science and technology](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_science_and_technology "Impact of the COVID-19 pandemic on science and technology") [Social media](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_social_media "Impact of the COVID-19 pandemic on social media") [Strikes](https://en.wikipedia.org/wiki/Strikes_during_the_COVID-19_pandemic "Strikes during the COVID-19 pandemic") [Suicides](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_suicide_rates "Impact of the COVID-19 pandemic on suicide rates") [Telehealth](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_telehealth_industry "Impact of the COVID-19 pandemic on the telehealth industry") [Xenophobia and racism](https://en.wikipedia.org/wiki/Xenophobia_and_racism_related_to_the_COVID-19_pandemic "Xenophobia and racism related to the COVID-19 pandemic") [Politics](https://en.wikipedia.org/wiki/Political_impact_of_the_COVID-19_pandemic "Political impact of the COVID-19 pandemic") [Diplomacy](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_international_relations "Impact of the COVID-19 pandemic on international relations") [Infected leaders](https://en.wikipedia.org/wiki/List_of_political_officials_who_have_tested_positive_for_COVID-19 "List of political officials who have tested positive for COVID-19") [Ireland](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic_in_the_Republic_of_Ireland "Social impact of the COVID-19 pandemic in the Republic of Ireland") [Malaysia](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic_in_Malaysia "Social impact of the COVID-19 pandemic in Malaysia") [New Zealand](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic_in_New_Zealand "Social impact of the COVID-19 pandemic in New Zealand") [Russia](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic_in_Russia "Social impact of the COVID-19 pandemic in Russia") [UK](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic_in_the_United_Kingdom "Social impact of the COVID-19 pandemic in the United Kingdom") [US](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic_in_the_United_States "Social impact of the COVID-19 pandemic in the United States") |
| [](https://en.wikipedia.org/wiki/File:SARS-CoV-2_\(Wikimedia_colors\).svg) [COVID-19 portal](https://en.wikipedia.org/wiki/Portal:COVID-19 "Portal:COVID-19") |
| [v](https://en.wikipedia.org/wiki/Template:COVID-19_pandemic_sidebar "Template:COVID-19 pandemic sidebar") [t](https://en.wikipedia.org/wiki/Template_talk:COVID-19_pandemic_sidebar "Template talk:COVID-19 pandemic sidebar") [e](https://en.wikipedia.org/wiki/Special:EditPage/Template:COVID-19_pandemic_sidebar "Special:EditPage/Template:COVID-19 pandemic sidebar") |
The virus is thought to be of natural animal origin, most likely through [spillover infection](https://en.wikipedia.org/wiki/Spillover_infection "Spillover infection").[\[102\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NM-20200317-102)[\[397\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-PMC7969828-397)[\[398\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-398) A joint-study conducted in early 2021 by the People's Republic of China and the World Health Organization indicated that the virus descended from a coronavirus that infects wild bats, and likely spread to humans through an intermediary wildlife host.[\[399\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-399) There are several theories about where the [index case](https://en.wikipedia.org/wiki/Index_case "Index case") originated and [investigations into the origin of the pandemic](https://en.wikipedia.org/wiki/Investigations_into_the_origin_of_COVID-19 "Investigations into the origin of COVID-19") are ongoing.[\[400\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-patientZero-400) According to articles published in July 2022 in *[Science](https://en.wikipedia.org/wiki/Science_\(journal\) "Science (journal)")*, virus transmission into humans occurred through two spillover events in November 2019 and was likely due to live wildlife trade on the [Huanan wet market](https://en.wikipedia.org/wiki/Huanan_Seafood_Wholesale_Market "Huanan Seafood Wholesale Market") in the city of [Wuhan](https://en.wikipedia.org/wiki/Wuhan "Wuhan") (Hubei, China).[\[401\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-401)[\[402\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-402)[\[403\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-403) Doubts about the conclusions have mostly centered on the precise site of spillover.[\[404\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-404) Earlier [phylogenetics](https://en.wikipedia.org/wiki/Phylogenetics "Phylogenetics") estimated that SARS-CoV-2 arose in October or November 2019.[\[102\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NM-20200317-102)[\[405\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-evolutionary-405)[\[406\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-dorp_evo-406) A phylogenetic algorithm analysis suggested that the virus may have been circulating in [Guangdong](https://en.wikipedia.org/wiki/Guangdong "Guangdong") before Wuhan.[\[407\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-407)
Most scientists believe the virus spilled into human populations through natural [zoonosis](https://en.wikipedia.org/wiki/Zoonosis "Zoonosis"), similar to the [SARS-CoV-1](https://en.wikipedia.org/wiki/SARS-CoV-1 "SARS-CoV-1") and [MERS-CoV](https://en.wikipedia.org/wiki/MERS-CoV "MERS-CoV") outbreaks, and consistent with other pandemics in human history.[\[20\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pekar-20)[\[21\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-jiang_wang-21) According to the [Intergovernmental Panel on Climate Change](https://en.wikipedia.org/wiki/Intergovernmental_Panel_on_Climate_Change "Intergovernmental Panel on Climate Change") several social and environmental factors including [climate change](https://en.wikipedia.org/wiki/Climate_change "Climate change"), [natural ecosystem destruction](https://en.wikipedia.org/wiki/Environmental_degradation "Environmental degradation") and [wildlife trade](https://en.wikipedia.org/wiki/Wildlife_trade_and_zoonoses "Wildlife trade and zoonoses") increased the likelihood of such zoonotic spillover.[\[22\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-IPCC-2022a-22)[\[23\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-IPCC-2022b-23) One study made with the support of the [European Union](https://en.wikipedia.org/wiki/European_Union "European Union") found climate change increased the likelihood of the pandemic by influencing distribution of bat species.[\[24\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-University-of-Cambridge-2021-24)[\[25\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-European-Commission-25)
Available evidence suggests that the SARS-CoV-2 virus was originally harboured by bats, and spread to humans multiple times from infected wild animals at the [Huanan Seafood Market](https://en.wikipedia.org/wiki/Huanan_Seafood_Market "Huanan Seafood Market") in [Wuhan](https://en.wikipedia.org/wiki/Wuhan "Wuhan") in December 2019.[\[20\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pekar-20)[\[21\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-jiang_wang-21) A minority of scientists and some members of the [U.S intelligence community](https://en.wikipedia.org/wiki/United_States_Intelligence_Community "United States Intelligence Community") believe the virus may have been [unintentionally leaked](https://en.wikipedia.org/wiki/COVID-19_lab_leak_theory "COVID-19 lab leak theory") from a laboratory such as the [Wuhan Institute of Virology](https://en.wikipedia.org/wiki/Wuhan_Institute_of_Virology "Wuhan Institute of Virology").[\[408\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NYT_DoE_Feb2023-408)[\[409\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Hill_Feb_2023_DoE-409) The US intelligence community has mixed views on the issue,[\[410\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CNN_Feb2023_LeBlanc-410)[\[411\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Guardian_Feb2023-411) but overall agrees with the scientific consensus that the virus was not developed as a [biological weapon](https://en.wikipedia.org/wiki/Biological_agent "Biological agent") and is unlikely to have been [genetically engineered](https://en.wikipedia.org/wiki/Genetic_engineering "Genetic engineering").[\[412\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-412)[\[413\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-413)[\[414\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-414)[\[415\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-415) There is no evidence SARS-CoV-2 existed in any laboratory prior to the pandemic.[\[416\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-critical-416)[\[417\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Gorski-417)[\[418\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-HolmesConversationDead-418)
The first confirmed human infections were in Wuhan. A study of the first 41 cases of confirmed COVID‑19, published in January 2020 in *The Lancet*, reported the earliest date of onset of symptoms as 1 December 2019.[\[419\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WuMarch2020-419)[\[420\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wang24Jan2020-420)[\[421\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AutoDW-67-421) Official publications from the WHO reported the earliest onset of symptoms as 8 December 2019.[\[422\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-422) Human-to-human transmission was confirmed by the WHO and Chinese authorities by 20 January 2020.[\[423\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-423)[\[424\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-424) According to official Chinese sources, these were mostly linked to the [Huanan Seafood Wholesale Market](https://en.wikipedia.org/wiki/Huanan_Seafood_Wholesale_Market "Huanan Seafood Wholesale Market"), which also sold live animals.[\[425\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-characteristicsZH-425) In May 2020, [George Gao](https://en.wikipedia.org/wiki/George_F._Gao "George F. Gao"), the director of the CDC, said animal samples collected from the seafood market had tested negative for the virus, indicating that the market was the site of an early [superspreading event](https://en.wikipedia.org/wiki/Superspreader "Superspreader"), but that it was not the site of the initial outbreak.[\[426\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-426) Traces of the virus have been found in wastewater samples that were collected in [Milan](https://en.wikipedia.org/wiki/Milan "Milan") and [Turin](https://en.wikipedia.org/wiki/Turin "Turin"), Italy, on 18 December 2019.[\[427\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-427)
By December 2019, the spread of infection was almost entirely driven by human-to-human transmission.[\[373\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Epidemiology17Feb2020-373)[\[428\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-428) The number of COVID-19 cases in Hubei gradually increased, reaching 60 by 20 December,[\[429\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-429) and at least 266 by 31 December.[\[430\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-430) On 24 December, [Wuhan Central Hospital](https://en.wikipedia.org/wiki/Wuhan_Central_Hospital "Wuhan Central Hospital") sent a [bronchoalveolar lavage fluid](https://en.wikipedia.org/wiki/Bronchoalveolar_lavage_fluid "Bronchoalveolar lavage fluid") (BAL) sample from an unresolved clinical case to sequencing company Vision Medicals. On 27 and 28 December, Vision Medicals informed the Wuhan Central Hospital and the Chinese CDC of the results of the test, showing a new coronavirus.[\[431\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-431) A pneumonia cluster of unknown cause was observed on 26 December and treated by the doctor [Zhang Jixian](https://en.wikipedia.org/wiki/Zhang_Jixian "Zhang Jixian") in Hubei Provincial Hospital, who informed the Wuhan Jianghan CDC on 27 December.[\[432\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-432) On 30 December, a test report addressed to Wuhan Central Hospital, from company CapitalBio Medlab, stated an erroneous positive result for [SARS](https://en.wikipedia.org/wiki/SARS "SARS"), causing a group of doctors at Wuhan Central Hospital to alert their colleagues and relevant hospital authorities of the result. The Wuhan Municipal Health Commission issued a notice to various medical institutions on "the treatment of pneumonia of unknown cause" that same evening.[\[433\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-433) Eight of these doctors, including [Li Wenliang](https://en.wikipedia.org/wiki/Li_Wenliang "Li Wenliang") (punished on 3 January),[\[434\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-434) were later admonished by the police for spreading false rumours and another, [Ai Fen](https://en.wikipedia.org/wiki/Ai_Fen "Ai Fen"), was reprimanded by her superiors for raising the alarm.[\[435\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-435)
The Wuhan Municipal Health Commission made the first public announcement of a pneumonia outbreak of unknown cause on 31 December, confirming 27 cases[\[436\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AutoDW-69-436)[\[437\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-437)[\[438\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AutoDW-68-438) – enough to trigger an investigation.[\[439\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-bbc50984025-439)
During the early stages of the outbreak, the number of cases doubled approximately every seven and a half days.[\[440\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Qun29Jan2020-440) In early and mid-January 2020, the virus spread to other [Chinese provinces](https://en.wikipedia.org/wiki/Provinces_of_China "Provinces of China"), helped by the [Chinese New Year migration](https://en.wikipedia.org/wiki/Chunyun "Chunyun") and Wuhan being a transport hub and major rail interchange.[\[107\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHOReport24Feb2020-107) On 20 January, China reported nearly 140 new cases in one day, including two people in Beijing and one in [Shenzhen](https://en.wikipedia.org/wiki/Shenzhen "Shenzhen").[\[441\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-france2420200120-441) Later official data shows 6,174 people had already developed symptoms by then,[\[373\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Epidemiology17Feb2020-373) and more may have been infected.[\[442\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-flattery-442) A report in *The Lancet* on 24 January indicated human transmission, strongly recommended personal protective equipment for health workers, and said testing for the virus was essential due to its "pandemic potential".[\[147\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Huang24Jan2020-147)[\[443\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Horton_18_March-443) On 30 January, the WHO declared COVID-19 a [Public Health Emergency of International Concern](https://en.wikipedia.org/wiki/Public_Health_Emergency_of_International_Concern "Public Health Emergency of International Concern").[\[442\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-flattery-442) By this time, the outbreak spread by a factor of 100 to 200 times.[\[444\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-444)
Italy had its first confirmed cases on 31 January 2020, two tourists from China.[\[445\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Corriere_20Jan-445) Italy overtook China as the country with the most deaths on 19 March 2020.[\[446\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-sky11960412-446) By 26 March the United States had overtaken China and Italy with the highest number of confirmed cases in the world.[\[447\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NYT-20200326-447) Research on coronavirus genomes indicates the majority of COVID-19 cases in [New York](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_New_York_\(state\) "COVID-19 pandemic in New York (state)") came from European travellers, rather than directly from China or any other Asian country.[\[448\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-20200408nytimes-448) Retesting of prior samples found a person in France who had the virus on 27 December 2019,[\[449\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-France-retest-449)[\[450\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Deslandes-2020-450) and a person in the United States who died from the disease on 6 February 2020.[\[451\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-PBS-2wks-451)
RT-PCR testing of untreated wastewater samples from Brazil and Italy have suggested detection of SARS-CoV-2 as early as November and December 2019, respectively, but the methods of such sewage studies have not been optimised, many have not been peer-reviewed, details are often missing, and there is a risk of false positives due to contamination or if only one gene target is detected.[\[452\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-452) A September 2020 review journal article said, "The possibility that the COVID‑19 infection had already spread to Europe at the end of last year is now indicated by abundant, even if partially circumstantial, evidence", including pneumonia case numbers and radiology in France and Italy in November and December.[\[453\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-platto-453)
As of 1 October 2021[\[update\]](https://en.wikipedia.org/w/index.php?title=COVID-19&action=edit), *[Reuters](https://en.wikipedia.org/wiki/Reuters "Reuters")* reported that it had estimated the worldwide total number of deaths due to COVID‑19 to have exceeded five million.[\[454\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-454)
The Public Health Emergency of International Concern for COVID-19 ended on 5 May 2023. By this time, everyday life in most countries had returned to how it was before the pandemic.[\[455\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-455)[\[456\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-456)
## Misinformation
Main article: [COVID-19 misinformation](https://en.wikipedia.org/wiki/COVID-19_misinformation "COVID-19 misinformation")
After the initial outbreak of COVID‑19, [misinformation](https://en.wikipedia.org/wiki/Misinformation "Misinformation") and [disinformation](https://en.wikipedia.org/wiki/Disinformation "Disinformation") regarding the origin, scale, prevention, treatment, and other aspects of the disease rapidly spread online.[\[457\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-bbc_misinfo-457)[\[458\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-GUAR-458)[\[459\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-RunningList-459)
In September 2020, the US Centers for Disease Control and Prevention (CDC) published preliminary estimates of the risk of death by age groups in the United States, but those estimates were widely misreported and misunderstood.[\[368\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:1-368)[\[460\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-460)
## Other species
See also: [Impact of the COVID-19 pandemic on animals](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_animals "Impact of the COVID-19 pandemic on animals")
Humans appear to be capable of spreading the virus to some other animals,[\[461\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Gryseels_2021_MammalReview-461)[\[462\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-TanLam2022_NatComm-462) a type of disease transmission referred to as [zooanthroponosis](https://en.wikipedia.org/wiki/Anthroponotic_disease "Anthroponotic disease").[\[463\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Pappas_MDPI_2022-463)[\[464\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-MunirAshraf_2020-464)
Some pets, especially cats and [ferrets](https://en.wikipedia.org/wiki/Ferret "Ferret"), can catch this virus from infected humans.[\[465\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Kampf-2020-465)[\[466\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-466) Symptoms in cats include [respiratory](https://en.wikipedia.org/wiki/Respiratory_symptom "Respiratory symptom") (such as a cough) and digestive symptoms.[\[465\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Kampf-2020-465) Cats can spread the virus to other cats, and may be able to spread the virus to humans, but cat-to-human transmission of SARS-CoV-2 has not been proven.[\[465\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Kampf-2020-465)[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467) Compared to cats, dogs are less susceptible to this infection.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467) Behaviours which increase the risk of transmission include kissing, licking, and petting the animal.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467)
The virus does not appear to be able to infect [pigs](https://en.wikipedia.org/wiki/Pig "Pig"), [ducks](https://en.wikipedia.org/wiki/Domestic_duck "Domestic duck"), or chickens at all.[\[465\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Kampf-2020-465) [Mice](https://en.wikipedia.org/wiki/Mouse "Mouse"), rats, and rabbits, if they can be infected at all, are unlikely to be involved in spreading the virus.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467)
Tigers and lions in zoos have become infected as a result of contact with infected humans.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467) As expected, monkeys and [great ape](https://en.wikipedia.org/wiki/Great_ape "Great ape") species such as [orangutans](https://en.wikipedia.org/wiki/Orangutan "Orangutan") can also be infected with the COVID‑19 virus.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467)
[Minks](https://en.wikipedia.org/wiki/Mink "Mink"), which are in the [same family](https://en.wikipedia.org/wiki/Weasel_family "Weasel family") as ferrets, have been infected.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467) Minks may be asymptomatic, and can also spread the virus to humans.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467) Multiple countries have identified infected animals in [mink farms](https://en.wikipedia.org/wiki/Mink_farm "Mink farm").[\[468\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Gorman-2021-468) [Denmark](https://en.wikipedia.org/wiki/Denmark "Denmark"), a major producer of mink pelts, ordered the slaughter of all minks over fears of viral mutations,[\[468\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Gorman-2021-468) following an outbreak referred to as [Cluster 5](https://en.wikipedia.org/wiki/Cluster_5 "Cluster 5"). A vaccine for mink and other animals is being researched.[\[468\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Gorman-2021-468)
## Research
Further information: [COVID-19 drug development](https://en.wikipedia.org/wiki/COVID-19_drug_development "COVID-19 drug development")
International research on vaccines and medicines in COVID‑19 is underway by government organisations, academic groups, and industry researchers.[\[469\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-dhama-469)[\[470\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-zhang2020-470) The CDC has classified it to require a [BSL3](https://en.wikipedia.org/wiki/BSL3 "BSL3") grade laboratory.[\[471\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-inlbg-471) There has been a great deal of COVID‑19 research, involving accelerated research processes and publishing shortcuts to meet the global demand.[\[472\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Aristovnik_et_al._2020-472)
As of December 2020[\[update\]](https://en.wikipedia.org/w/index.php?title=COVID-19&action=edit), hundreds of [clinical trials](https://en.wikipedia.org/wiki/Clinical_trial "Clinical trial") have been undertaken, with research happening on every continent except [Antarctica](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Antarctica "COVID-19 pandemic in Antarctica").[\[473\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-473) As of November 2020[\[update\]](https://en.wikipedia.org/w/index.php?title=COVID-19&action=edit), more than 200 possible treatments have been studied in humans.[\[474\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-474)
### Transmission and prevention research
Further information: [COVID-19 vaccine](https://en.wikipedia.org/wiki/COVID-19_vaccine "COVID-19 vaccine")
[Modelling](https://en.wikipedia.org/wiki/Modeling_and_simulation "Modeling and simulation") research has been conducted with several objectives, including predictions of the dynamics of transmission,[\[475\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-475) diagnosis and prognosis of infection,[\[476\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-476) estimation of the impact of interventions,[\[477\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-477)[\[478\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-478) or allocation of resources.[\[479\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-479) Modelling studies are mostly based on [compartmental models in epidemiology](https://en.wikipedia.org/wiki/Compartmental_models_in_epidemiology "Compartmental models in epidemiology"),[\[480\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-480) estimating the number of infected people over time under given conditions. Several other types of models have been developed and used during the COVID‑19 pandemic including [computational fluid dynamics](https://en.wikipedia.org/wiki/Computational_fluid_dynamics "Computational fluid dynamics") models to study the flow physics of COVID‑19,[\[481\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-481) retrofits of crowd movement models to study occupant exposure,[\[482\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-482) mobility-data based models to investigate transmission,[\[483\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-483) or the use of [macroeconomic](https://en.wikipedia.org/wiki/Macroeconomic "Macroeconomic") models to assess the economic impact of the pandemic.[\[484\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-484)
### Treatment-related research
Main article: [COVID-19 drug repurposing research](https://en.wikipedia.org/wiki/COVID-19_drug_repurposing_research "COVID-19 drug repurposing research")
[](https://en.wikipedia.org/wiki/File:Fmolb-07-585899-g001.jpg)
Seven possible drug targets in viral replication process and drugs
Repurposed [antiviral drugs](https://en.wikipedia.org/wiki/Antiviral_drug "Antiviral drug") make up most of the research into COVID‑19 treatments.[\[485\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-milken-485)[\[486\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-koch-486) Other candidates in trials include [vasodilators](https://en.wikipedia.org/wiki/Vasodilator "Vasodilator"), [corticosteroids](https://en.wikipedia.org/wiki/Corticosteroid "Corticosteroid"), immune therapies, [lipoic acid](https://en.wikipedia.org/wiki/Lipoic_acid "Lipoic acid"), [bevacizumab](https://en.wikipedia.org/wiki/Bevacizumab "Bevacizumab"), and [recombinant](https://en.wikipedia.org/wiki/Recombinant_DNA "Recombinant DNA") angiotensin-converting enzyme 2.[\[486\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-koch-486)
In March 2020, the World Health Organization (WHO) initiated the [Solidarity trial](https://en.wikipedia.org/wiki/Solidarity_trial "Solidarity trial") to assess the treatment effects of some promising drugs:[\[487\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-kai-487)[\[488\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-488)
- An [experimental drug](https://en.wikipedia.org/wiki/Experimental_drug "Experimental drug") called [remdesivir](https://en.wikipedia.org/wiki/Remdesivir "Remdesivir")
- [Anti-malarial](https://en.wikipedia.org/wiki/Antimalarial_medication "Antimalarial medication") drugs [chloroquine](https://en.wikipedia.org/wiki/Chloroquine "Chloroquine") and [hydroxychloroquine](https://en.wikipedia.org/wiki/Hydroxychloroquine "Hydroxychloroquine")
- Two [anti-HIV drugs](https://en.wikipedia.org/wiki/Anti-HIV_medications "Anti-HIV medications"), [lopinavir/ritonavir](https://en.wikipedia.org/wiki/Lopinavir/ritonavir "Lopinavir/ritonavir") and [interferon-beta](https://en.wikipedia.org/wiki/Interferon-beta "Interferon-beta")
More than 300 active clinical trials are underway as of April 2020.[\[76\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Sanders202022-76)
Research on the antimalarial drugs hydroxychloroquine and chloroquine showed that they were ineffective at best,[\[489\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-20200526nytimes-489)[\[490\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-490) and that they may reduce the antiviral activity of remdesivir.[\[491\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-491) By May 2020[\[update\]](https://en.wikipedia.org/w/index.php?title=COVID-19&action=edit), France, Italy, and Belgium had banned the use of hydroxychloroquine as a COVID‑19 treatment.[\[492\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-492)
In June, initial results from the randomised [RECOVERY Trial](https://en.wikipedia.org/wiki/RECOVERY_Trial "RECOVERY Trial") in the United Kingdom showed that dexamethasone reduced mortality by one third for people who are critically ill on ventilators and one fifth for those receiving supplemental oxygen.[\[493\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-493) Because this is a well-tested and widely available treatment, it was welcomed by the WHO, which is in the process of updating treatment guidelines to include dexamethasone and other steroids.[\[494\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-494)[\[495\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-495) Based on those preliminary results, dexamethasone treatment has been recommended by the NIH for peoples with COVID‑19 who are mechanically ventilated or who require supplemental oxygen but not in people with COVID‑19 who do not require supplemental oxygen.[\[496\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-496)
In September 2020, the WHO released updated guidance on using corticosteroids for COVID‑19.[\[497\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO_guidance-497)[\[498\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-498) The WHO recommends systemic corticosteroids rather than no systemic corticosteroids for the treatment of people with severe and critical COVID‑19 (strong recommendation, based on moderate certainty evidence).[\[497\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO_guidance-497) The WHO suggests not to use corticosteroids in the treatment of people with non-severe COVID‑19 (conditional recommendation, based on low certainty evidence).[\[497\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO_guidance-497) The updated guidance was based on a meta-analysis of clinical trials of people critically ill with COVID‑19.[\[499\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-499)[\[500\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-500)
In September 2020, the [European Medicines Agency](https://en.wikipedia.org/wiki/European_Medicines_Agency "European Medicines Agency") (EMA) endorsed the use of dexamethasone in adults and adolescents from 12 years of age and weighing at least 40 kilograms (88 lb) who require supplemental oxygen therapy.[\[501\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-EMA_PR-501)[\[502\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-502) Dexamethasone can be taken [by mouth](https://en.wikipedia.org/wiki/Oral_administration "Oral administration") or given as an injection or [infusion (drip) into a vein](https://en.wikipedia.org/wiki/Intravenous "Intravenous").[\[501\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-EMA_PR-501)
In November 2020, the US [Food and Drug Administration](https://en.wikipedia.org/wiki/Food_and_Drug_Administration "Food and Drug Administration") (FDA) issued an emergency use authorisation for the investigational monoclonal antibody therapy [bamlanivimab](https://en.wikipedia.org/wiki/Bamlanivimab "Bamlanivimab") for the treatment of mild-to-moderate COVID‑19.[\[503\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-FDA_bamlanivimab_EUA-503) Bamlanivimab is authorised for people with positive results of direct SARS-CoV-2 viral testing who are twelve years of age and older weighing at least 40 kilograms (88 lb), and who are at high risk for progressing to severe COVID‑19 or hospitalisation.[\[503\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-FDA_bamlanivimab_EUA-503) This includes those who are 65 years of age or older, or who have chronic medical conditions.[\[503\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-FDA_bamlanivimab_EUA-503)
In February 2021, the FDA issued an emergency use authorisation (EUA) for bamlanivimab and [etesevimab](https://en.wikipedia.org/wiki/Etesevimab "Etesevimab") administered together for the treatment of mild to moderate COVID‑19 in people twelve years of age or older weighing at least 40 kilograms (88 lb) who test positive for SARS‑CoV‑2 and who are at high risk for progressing to severe COVID‑19. The authorised use includes treatment for those who are 65 years of age or older or who have certain chronic medical conditions.[\[504\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-FDA_PR_20210209-504)
In April 2021, the FDA revoked the emergency use authorisation (EUA) that allowed for the investigational monoclonal antibody therapy bamlanivimab, when administered alone, to be used for the treatment of mild-to-moderate COVID‑19 in adults and certain paediatric patients.[\[505\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-FDA_PR_20210416-505)
#### Cytokine storm
[](https://en.wikipedia.org/wiki/File:Fimmu-11-01648-g003.jpg)
Various therapeutic strategies for targeting cytokine storm
A [cytokine storm](https://en.wikipedia.org/wiki/Cytokine_storm "Cytokine storm") can be a complication in the later stages of severe COVID‑19. A cytokine storm is a potentially deadly immune reaction where a large amount of pro-inflammatory cytokines and [chemokines](https://en.wikipedia.org/wiki/Chemokine "Chemokine") are released too quickly. A cytokine storm can lead to ARDS and multiple organ failure.[\[506\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-506) Data collected from Jin Yin-tan Hospital in Wuhan, China indicates that people who had more severe responses to COVID‑19 had greater amounts of pro-inflammatory cytokines and chemokines in their system than people who had milder responses. These high levels of pro-inflammatory cytokines and chemokines indicate presence of a cytokine storm.[\[507\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-507)
[Tocilizumab](https://en.wikipedia.org/wiki/Tocilizumab "Tocilizumab") has been included in treatment guidelines by China's [National Health Commission](https://en.wikipedia.org/wiki/National_Health_Commission "National Health Commission") after a small study was completed.[\[508\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-tocil-1-508)[\[509\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-tocil-2-509) It is undergoing a [Phase II](https://en.wikipedia.org/wiki/Phase_IIb "Phase IIb") non-randomised trial at the national level in Italy after showing positive results in people with severe disease.[\[510\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-510)[\[511\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-511) Combined with a serum [ferritin](https://en.wikipedia.org/wiki/Ferrite_\(magnet\) "Ferrite (magnet)") blood test to identify a cytokine storm (also called cytokine storm syndrome, not to be confused with [cytokine release syndrome](https://en.wikipedia.org/wiki/Cytokine_release_syndrome "Cytokine release syndrome")), it is meant to counter such developments, which are thought to be the cause of death in some affected people.[\[512\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-tocil-5,6,8-512) The [interleukin-6 receptor](https://en.wikipedia.org/wiki/Interleukin-6_receptor "Interleukin-6 receptor") (IL-6R) [antagonist](https://en.wikipedia.org/wiki/Receptor_antagonist "Receptor antagonist") was approved by the FDA to undergo a Phase III clinical trial assessing its effectiveness on COVID‑19 based on retrospective case studies for the treatment of steroid-refractory cytokine release syndrome induced by a different cause, [CAR T cell](https://en.wikipedia.org/wiki/Chimeric_antigen_receptor_T_cell "Chimeric antigen receptor T cell") [therapy](https://en.wikipedia.org/wiki/Gene_therapy "Gene therapy"), in 2017.[\[513\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CancerNetworkTocilizumabTrial-513) 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](https://en.wikipedia.org/wiki/Blood%E2%80%93brain_barrier "Blood–brain barrier"), and exacerbating [neurotoxicity](https://en.wikipedia.org/wiki/Neurotoxicity "Neurotoxicity") while having no effect on the incidence of CRS.[\[514\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-514)
[Lenzilumab](https://en.wikipedia.org/wiki/Lenzilumab "Lenzilumab"), an anti-GM-CSF [monoclonal antibody](https://en.wikipedia.org/wiki/Monoclonal_antibody "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.[\[515\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-515)
#### Passive antibodies
[](https://en.wikipedia.org/wiki/File:Ppat.1008735.g002.png)
Overview of the application and use of [convalescent plasma](https://en.wikipedia.org/wiki/Convalescent_plasma "Convalescent plasma") therapy
Transferring purified and concentrated [antibodies](https://en.wikipedia.org/wiki/Immunoglobulin_therapy "Immunoglobulin therapy") produced by the immune systems of those who have recovered from COVID‑19 to people who need them is being investigated as a non-vaccine method of [passive immunisation](https://en.wikipedia.org/wiki/Passive_immunity "Passive immunity").[\[516\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid-32167489-516)[\[517\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Iannizzi-2023-517) [Viral neutralisation](https://en.wikipedia.org/wiki/Neutralisation_\(immunology\) "Neutralisation (immunology)") is the anticipated [mechanism of action](https://en.wikipedia.org/wiki/Mechanism_of_action "Mechanism of action") by which passive antibody therapy can mediate defence against SARS-CoV-2. The spike protein of SARS-CoV-2 is the primary target for neutralising antibodies.[\[518\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Ho-2020-518) As of 8 August 2020, eight neutralising antibodies targeting the spike protein of SARS-CoV-2 have entered clinical studies.[\[519\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-519) It has been proposed that selection of broad-neutralising antibodies against SARS-CoV-2 and SARS-CoV might be useful for treating not only COVID‑19 but also future SARS-related CoV infections.[\[518\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Ho-2020-518) Other mechanisms, however, such as [antibody-dependant cellular cytotoxicity](https://en.wikipedia.org/wiki/Antibody-dependent_cellular_cytotoxicity "Antibody-dependent cellular cytotoxicity") or [phagocytosis](https://en.wikipedia.org/wiki/Phagocytosis "Phagocytosis"), may be possible.[\[516\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid-32167489-516) Other forms of passive antibody therapy, for example, using manufactured monoclonal antibodies, are in development.[\[516\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid-32167489-516)
The use of passive antibodies to treat people with active COVID‑19 is also being studied. This involves the production of [convalescent serum](https://en.wikipedia.org/wiki/Convalescent_serum "Convalescent serum"), which consists of the liquid portion of the blood from people who recovered from the infection and contains antibodies specific to this virus, which is then administered to active patients.[\[516\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid-32167489-516) This strategy was tried for SARS with inconclusive results.[\[516\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid-32167489-516) An updated Cochrane review in May 2023 found high certainty evidence that, for the treatment of people with moderate to severe COVID‑19, convalescent plasma did not reduce mortality or bring about symptom improvement.[\[517\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Iannizzi-2023-517) There continues to be uncertainty about the safety of convalescent plasma administration to people with COVID‑19 and differing outcomes measured in different studies limits their use in determining efficacy.[\[517\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Iannizzi-2023-517)
### Bioethics
Since the outbreak of the COVID‑19 pandemic, scholars have explored the [bioethics](https://en.wikipedia.org/wiki/Bioethics "Bioethics"), [normative economics](https://en.wikipedia.org/wiki/Normative_economics "Normative economics"), and [political theories](https://en.wikipedia.org/wiki/Political_philosophy "Political philosophy") of [healthcare policies](https://en.wikipedia.org/wiki/Healthcare_policy "Healthcare policy") related to the public health crisis.[\[520\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-520) Academics have pointed to the moral distress of healthcare workers, ethics of distributing scarce healthcare resources such as ventilators,[\[521\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-521) and the global justice of vaccine diplomacies.[\[522\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-522)[\[523\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-523) The socio-economic inequalities between genders,[\[524\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-524) races,[\[525\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-525) groups with disabilities,[\[526\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-526) communities,[\[527\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-527) regions, countries,[\[528\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-528) and continents have also drawn attention in academia and the general public.[\[529\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-529)[\[530\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-530)
## See also
- [](https://en.wikipedia.org/wiki/File:SARS-CoV-2_\(Wikimedia_colors\).svg)[COVID-19 portal](https://en.wikipedia.org/wiki/Portal:COVID-19 "Portal:COVID-19")
- [Medicine portal](https://en.wikipedia.org/wiki/Portal:Medicine "Portal:Medicine")
- [](https://en.wikipedia.org/wiki/File:Sida-aids.png)[Viruses portal](https://en.wikipedia.org/wiki/Portal:Viruses "Portal:Viruses")
- [Coronavirus diseases](https://en.wikipedia.org/wiki/Coronavirus_diseases "Coronavirus diseases"), a group of closely related syndromes
- [Disease X](https://en.wikipedia.org/wiki/Disease_X "Disease X"), a WHO term
- [Law of declining virulence](https://en.wikipedia.org/wiki/Law_of_declining_virulence "Law of declining virulence") – Disproved hypothesis of epidemiologist Theobald Smith
- [Theory of virulence](https://en.wikipedia.org/wiki/Theory_of_virulence "Theory of virulence") – Theory by biologist Paul W. Ewald
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## Further reading
- ["Progress report on the coronavirus pandemic"](https://doi.org/10.1038%2FD41586-020-02414-1). *[Nature](https://en.wikipedia.org/wiki/Nature_\(journal\) "Nature (journal)")*. **584** (7821): 325. 1 August 2020. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1038/D41586-020-02414-1](https://doi.org/10.1038%2FD41586-020-02414-1). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [1476-4687](https://search.worldcat.org/issn/1476-4687). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [32814893](https://pubmed.ncbi.nlm.nih.gov/32814893). [Wikidata](https://en.wikipedia.org/wiki/WDQ_\(identifier\) "WDQ (identifier)") [Q98568681](https://www.wikidata.org/wiki/Q98568681 "d:Q98568681").
- [COVID-19 infection prevention and control measures for primary care, including general practitioner practices, dental clinics and pharmacy settings: first update](https://www.ecdc.europa.eu/en/publications-data/covid-19-infection-prevention-and-control-primary-care). *[European Centre for Disease Prevention and Control](https://en.wikipedia.org/wiki/European_Centre_for_Disease_Prevention_and_Control "European Centre for Disease Prevention and Control") (ECDC)* (Report). October 2020.
## External links
[](https://en.wikipedia.org/wiki/File:Scholia_logo.svg)
[Scholia](https://www.wikidata.org/wiki/Wikidata:Scholia "d:Wikidata:Scholia") has a profile for [**COVID-19 (Q84263196)**](https://iw.toolforge.org/scholia/Q84263196 "toolforge:scholia/Q84263196").
### Health agencies
- [Coronavirus disease (COVID‑19)](https://www.who.int/emergencies/diseases/novel-coronavirus-2019) [Facts](https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters) by the World Health Organization (WHO)
- [Coronavirus (COVID‑19)](https://www.nhs.uk/conditions/coronavirus-covid-19/) by the UK [National Health Service](https://en.wikipedia.org/wiki/National_Health_Service "National Health Service") (NHS)
- [Coronavirus 2019 (COVID-19)](https://www.cdc.gov/coronavirus/2019-ncov/index.html) by the US [Centers for Disease Control and Prevention](https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention "Centers for Disease Control and Prevention") (CDC)
### Directories
- [Coronavirus Resource Center](https://centerforinquiry.org/coronavirus/) at the [Center for Inquiry](https://en.wikipedia.org/wiki/Center_for_Inquiry "Center for Inquiry")
- [COVID‑19 Information on FireMountain.net](https://www.firemountain.net/covid19.html) [Archived](https://web.archive.org/web/20220113160833/http://firemountain.net/covid19.html) 13 January 2022 at the [Wayback Machine](https://en.wikipedia.org/wiki/Wayback_Machine "Wayback Machine")
- [COVID‑19 Resource Directory on OpenMD](https://openmd.com/directory/covid-19)
### Medical journals
- [BMJ's Coronavirus (covid‑19) Hub](https://www.bmj.com/coronavirus) by the [BMJ](https://en.wikipedia.org/wiki/BMJ_\(company\) "BMJ (company)")
- [Coronavirus (Covid‑19)](https://www.nejm.org/coronavirus) by *[The New England Journal of Medicine](https://en.wikipedia.org/wiki/The_New_England_Journal_of_Medicine "The New England Journal of Medicine")*
- [Coronavirus (COVID‑19) Research Highlights](https://www.springernature.com/gp/researchers/campaigns/coronavirus) by [Springer Nature](https://en.wikipedia.org/wiki/Springer_Nature "Springer Nature")
- [Coronavirus Disease 2019 (COVID‑19)](https://jamanetwork.com/journals/jama/pages/coronavirus-alert) by *[JAMA](https://en.wikipedia.org/wiki/JAMA_\(journal\) "JAMA (journal)")*
- [COVID‑19 Resource Centre](https://www.thelancet.com/coronavirus) by *[The Lancet](https://en.wikipedia.org/wiki/The_Lancet "The Lancet")*
- [Covid‑19: Novel Coronavirus](https://novel-coronavirus.onlinelibrary.wiley.com/); [Archived](https://web.archive.org/web/20200924195411/https://novel-coronavirus.onlinelibrary.wiley.com/) 24 September 2020 at the [Wayback Machine](https://en.wikipedia.org/wiki/Wayback_Machine "Wayback Machine") by [Wiley Publishing](https://en.wikipedia.org/wiki/Wiley_\(publisher\) "Wiley (publisher)")
- [Novel Coronavirus Information Center](https://www.elsevier.com/connect/coronavirus-information-center) by [Elsevier](https://en.wikipedia.org/wiki/Elsevier "Elsevier")
### Treatment guidelines
- ["Bouncing Back from COVID-19: Your Guide to Restoring Movement"](https://web.archive.org/web/20200629012405/https://www.hopkinsmedicine.org/physical_medicine_rehabilitation/coronavirus-rehabilitation/_files/impact-of-covid-patient-recovery.pdf) (PDF). Johns Hopkins Medicine. Archived from [the original](https://www.hopkinsmedicine.org/physical_medicine_rehabilitation/coronavirus-rehabilitation/_files/impact-of-covid-patient-recovery.pdf) (PDF) on 29 June 2020.
- ["Coronavirus Disease 2019 (COVID-19) Treatment Guidelines"](https://files.covid19treatmentguidelines.nih.gov/guidelines/covid19treatmentguidelines.pdf) (PDF). National Institutes of Health.
- ["Guidelines on the Treatment and Management of Patients with COVID-19"](https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/). Infectious Diseases Society of America.
- ["JHMI Clinical Recommendations for Available Pharmacologic Therapies for COVID-19"](https://www.hopkinsguides.com/hopkins/ub?cmd=repview&type=479-1279&name=40_538747_PDF) (PDF). Johns Hopkins Medicine.
- [National Guidance for post-COVID syndrome assessment clinics](https://www.england.nhs.uk/coronavirus/publication/national-guidance-for-post-covid-syndrome-assessment-clinics/) (Report). NHS England. 28 July 2022.
- [Therapeutics and COVID-19: living guideline, 14 January 2022](https://www.who.int/publications/i/item/therapeutics-and-covid-19-living-guideline) (Report). World Health Organization. 2022. [hdl](https://en.wikipedia.org/wiki/Hdl_\(identifier\) "Hdl (identifier)"):[10665/351006](https://hdl.handle.net/10665%2F351006). WHO/2019-nCoV/therapeutics/2022.1.
| | |
|---|---|
| Classification | [D](https://www.wikidata.org/wiki/Q84263196 "d:Q84263196") **[ICD](https://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems "International Statistical Classification of Diseases and Related Health Problems")\-[10](https://en.wikipedia.org/wiki/ICD-10 "ICD-10")**: [U07.1](https://icd.who.int/browse10/2019/en#/U07.1), [U07.2](https://icd.who.int/browse10/2019/en#/U07.2) **[MeSH](https://en.wikipedia.org/wiki/Medical_Subject_Headings "Medical Subject Headings")**: [D000086382](https://meshb.nlm.nih.gov/record/ui?ui=D000086382) **[SNOMED CT](https://en.wikipedia.org/wiki/SNOMED_CT "SNOMED CT")**: [840539006](https://browser.ihtsdotools.org/?perspective=full&conceptId1=840539006&languages=en) |
| [v](https://en.wikipedia.org/wiki/Template:SARS "Template:SARS") [t](https://en.wikipedia.org/wiki/Template_talk:SARS "Template talk:SARS") [e](https://en.wikipedia.org/wiki/Special:EditPage/Template:SARS "Special:EditPage/Template:SARS")[Severe acute respiratory syndrome (SARS)](https://en.wikipedia.org/wiki/SARS "SARS") | |
|---|---|
| [SARS-CoV-1](https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_1 "Severe acute respiratory syndrome coronavirus 1") [SARSr-CoV](https://en.wikipedia.org/wiki/SARS-related_coronavirus "SARS-related coronavirus") | |
| General topics | [2002–2004 SARS outbreak](https://en.wikipedia.org/wiki/2002%E2%80%932004_SARS_outbreak "2002–2004 SARS outbreak") [Outbreak among healthcare workers](https://en.wikipedia.org/wiki/2002%E2%80%932004_SARS_outbreak_among_healthcare_workers "2002–2004 SARS outbreak among healthcare workers") [List of medical professionals who died](https://en.wikipedia.org/wiki/List_of_medical_professionals_who_died_during_the_SARS_outbreak "List of medical professionals who died during the SARS outbreak") [Air China Flight 112](https://en.wikipedia.org/wiki/Air_China_Flight_112 "Air China Flight 112") [SARS conspiracy theory](https://en.wikipedia.org/wiki/SARS_conspiracy_theory "SARS conspiracy theory") |
| People | [Zhong Nanshan](https://en.wikipedia.org/wiki/Zhong_Nanshan "Zhong Nanshan") [Ab Osterhaus](https://en.wikipedia.org/wiki/Ab_Osterhaus "Ab Osterhaus") [Joanna Tse](https://en.wikipedia.org/wiki/Joanna_Tse "Joanna Tse") [Carlo Urbani](https://en.wikipedia.org/wiki/Carlo_Urbani "Carlo Urbani") [Jiang Yanyong](https://en.wikipedia.org/wiki/Jiang_Yanyong "Jiang Yanyong") |
| In popular culture | *[Plague City: SARS in Toronto](https://en.wikipedia.org/wiki/Plague_City:_SARS_in_Toronto "Plague City: SARS in Toronto")* [Molson Canadian Rocks for Toronto](https://en.wikipedia.org/wiki/Molson_Canadian_Rocks_for_Toronto "Molson Canadian Rocks for Toronto") [1:99 Concert](https://en.wikipedia.org/wiki/1:99_Concert "1:99 Concert") *[Contagion](https://en.wikipedia.org/wiki/Contagion_\(2011_film\) "Contagion (2011 film)")* *[SARS Wars](https://en.wikipedia.org/wiki/SARS_Wars "SARS Wars")* |
| Related articles | [Coronavirus](https://en.wikipedia.org/wiki/Coronavirus "Coronavirus") [Global alert](https://en.wikipedia.org/wiki/Global_alert "Global alert") [Health in China](https://en.wikipedia.org/wiki/Health_in_China "Health in China") [MERS](https://en.wikipedia.org/wiki/MERS "MERS") [MERS-CoV](https://en.wikipedia.org/wiki/Middle_East_respiratory_syndrome-related_coronavirus "Middle East respiratory syndrome-related coronavirus") [COVID-19]() [SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2") [pandemic](https://en.wikipedia.org/wiki/COVID-19_pandemic "COVID-19 pandemic") |
| [v](https://en.wikipedia.org/wiki/Template:COVID-19_pandemic "Template:COVID-19 pandemic") [t](https://en.wikipedia.org/wiki/Template_talk:COVID-19_pandemic "Template talk:COVID-19 pandemic") [e](https://en.wikipedia.org/wiki/Special:EditPage/Template:COVID-19_pandemic "Special:EditPage/Template:COVID-19 pandemic")[COVID-19 pandemic](https://en.wikipedia.org/wiki/COVID-19_pandemic "COVID-19 pandemic") | |
|---|---|
| **[COVID-19]()** (disease) **[SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2")** (virus) | |
| [Timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic "Timeline of the COVID-19 pandemic") | |
| | |
| [Pre-pandemic](https://en.wikipedia.org/wiki/Pandemic_predictions_and_preparations_prior_to_the_COVID-19_pandemic "Pandemic predictions and preparations prior to the COVID-19 pandemic") | [Severe acute respiratory syndrome](https://en.wikipedia.org/wiki/SARS "SARS") (SARS) [Middle East respiratory syndrome](https://en.wikipedia.org/wiki/MERS "MERS") (MERS) [Crimson Contagion](https://en.wikipedia.org/wiki/Crimson_Contagion "Crimson Contagion") [Disease X](https://en.wikipedia.org/wiki/Disease_X "Disease X") [Exercise Cygnus](https://en.wikipedia.org/wiki/Exercise_Cygnus "Exercise Cygnus") [2019](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_2019 "Timeline of the COVID-19 pandemic in 2019") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_2019 "Responses to the COVID-19 pandemic in 2019") |
| 2020 | [January](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_January_2020 "Timeline of the COVID-19 pandemic in January 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_January_2020 "Responses to the COVID-19 pandemic in January 2020") [February](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_February_2020 "Timeline of the COVID-19 pandemic in February 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_February_2020 "Responses to the COVID-19 pandemic in February 2020") [March](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_March_2020 "Timeline of the COVID-19 pandemic in March 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_March_2020 "Responses to the COVID-19 pandemic in March 2020") [April](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_April_2020 "Timeline of the COVID-19 pandemic in April 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_April_2020 "Responses to the COVID-19 pandemic in April 2020") [May](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_May_2020 "Timeline of the COVID-19 pandemic in May 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_May_2020 "Responses to the COVID-19 pandemic in May 2020") [June](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_June_2020 "Timeline of the COVID-19 pandemic in June 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_June_2020 "Responses to the COVID-19 pandemic in June 2020") [July](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_July_2020 "Timeline of the COVID-19 pandemic in July 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_July_2020 "Responses to the COVID-19 pandemic in July 2020") [August](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_August_2020 "Timeline of the COVID-19 pandemic in August 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_August_2020 "Responses to the COVID-19 pandemic in August 2020") [September](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_September_2020 "Timeline of the COVID-19 pandemic in September 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_September_2020 "Responses to the COVID-19 pandemic in September 2020") [October](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_October_2020 "Timeline of the COVID-19 pandemic in October 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_October_2020 "Responses to the COVID-19 pandemic in October 2020") [November](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_November_2020 "Timeline of the COVID-19 pandemic in November 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_November_2020 "Responses to the COVID-19 pandemic in November 2020") [December](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_December_2020 "Timeline of the COVID-19 pandemic in December 2020") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_December_2020 "Responses to the COVID-19 pandemic in December 2020") |
| 2021 | [January](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_January_2021 "Timeline of the COVID-19 pandemic in January 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_January_2021 "Responses to the COVID-19 pandemic in January 2021") [February](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_February_2021 "Timeline of the COVID-19 pandemic in February 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_February_2021 "Responses to the COVID-19 pandemic in February 2021") [March](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_March_2021 "Timeline of the COVID-19 pandemic in March 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_March_2021 "Responses to the COVID-19 pandemic in March 2021") [April](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_April_2021 "Timeline of the COVID-19 pandemic in April 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_April_2021 "Responses to the COVID-19 pandemic in April 2021") [May](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_May_2021 "Timeline of the COVID-19 pandemic in May 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_May_2021 "Responses to the COVID-19 pandemic in May 2021") [June](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_June_2021 "Timeline of the COVID-19 pandemic in June 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_June_2021 "Responses to the COVID-19 pandemic in June 2021") [July](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_July_2021 "Timeline of the COVID-19 pandemic in July 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_July_2021 "Responses to the COVID-19 pandemic in July 2021") [August](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_August_2021 "Timeline of the COVID-19 pandemic in August 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_August_2021 "Responses to the COVID-19 pandemic in August 2021") [September](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_September_2021 "Timeline of the COVID-19 pandemic in September 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_September_2021 "Responses to the COVID-19 pandemic in September 2021") [October](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_October_2021 "Timeline of the COVID-19 pandemic in October 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_October_2021 "Responses to the COVID-19 pandemic in October 2021") [November](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_November_2021 "Timeline of the COVID-19 pandemic in November 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_November_2021 "Responses to the COVID-19 pandemic in November 2021") [December](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_December_2021 "Timeline of the COVID-19 pandemic in December 2021") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_December_2021 "Responses to the COVID-19 pandemic in December 2021") |
| 2022 | [January](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_January_2022 "Timeline of the COVID-19 pandemic in January 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_January_2022 "Responses to the COVID-19 pandemic in January 2022") [February](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_February_2022 "Timeline of the COVID-19 pandemic in February 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_February_2022 "Responses to the COVID-19 pandemic in February 2022") [March](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_March_2022 "Timeline of the COVID-19 pandemic in March 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_March_2022 "Responses to the COVID-19 pandemic in March 2022") [April](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_April_2022 "Timeline of the COVID-19 pandemic in April 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_April_2022 "Responses to the COVID-19 pandemic in April 2022") [May](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_May_2022 "Timeline of the COVID-19 pandemic in May 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_May_2022 "Responses to the COVID-19 pandemic in May 2022") [June](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_June_2022 "Timeline of the COVID-19 pandemic in June 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_June_2022 "Responses to the COVID-19 pandemic in June 2022") [July](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_July_2022 "Timeline of the COVID-19 pandemic in July 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_July_2022 "Responses to the COVID-19 pandemic in July 2022") [August](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_August_2022 "Timeline of the COVID-19 pandemic in August 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_August_2022 "Responses to the COVID-19 pandemic in August 2022") [September](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_September_2022 "Timeline of the COVID-19 pandemic in September 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_September_2022 "Responses to the COVID-19 pandemic in September 2022") [October](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_October_2022 "Timeline of the COVID-19 pandemic in October 2022") [responses](https://en.wikipedia.org/wiki/Responses_to_the_COVID-19_pandemic_in_October_2022 "Responses to the COVID-19 pandemic in October 2022") [November](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_November_2022 "Timeline of the COVID-19 pandemic in November 2022") [December](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_December_2022 "Timeline of the COVID-19 pandemic in December 2022") |
| 2023 | [Timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_2023 "Timeline of the COVID-19 pandemic in 2023") |
| [Locations](https://en.wikipedia.org/wiki/COVID-19_pandemic_by_country_and_territory "COVID-19 pandemic by country and territory") | |
| | |
| [Africa](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Africa "COVID-19 pandemic in Africa")([national responses](https://en.wikipedia.org/wiki/National_responses_to_the_COVID-19_pandemic_in_Africa "National responses to the COVID-19 pandemic in Africa")) | |
| | |
| Northern | [Algeria](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Algeria "COVID-19 pandemic in Algeria") [Canary Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Canary_Islands "COVID-19 pandemic in the Canary Islands") [Ceuta](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Ceuta "COVID-19 pandemic in Ceuta") [Egypt](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Egypt "COVID-19 pandemic in Egypt") [Libya](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Libya "COVID-19 pandemic in Libya") [Mauritania](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Mauritania "COVID-19 pandemic in Mauritania") [Melilla](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Melilla "COVID-19 pandemic in Melilla") [Morocco](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Morocco "COVID-19 pandemic in Morocco") [Sudan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sudan "COVID-19 pandemic in Sudan") [Tunisia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Tunisia "COVID-19 pandemic in Tunisia") [Western Sahara](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Western_Sahara "COVID-19 pandemic in Western Sahara") [Sahrawi Arab Democratic Republic](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Sahrawi_Arab_Democratic_Republic "COVID-19 pandemic in the Sahrawi Arab Democratic Republic") |
| Eastern | [Burundi](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Burundi "COVID-19 pandemic in Burundi") [Comoros](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Comoros "COVID-19 pandemic in the Comoros") [Djibouti](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Djibouti "COVID-19 pandemic in Djibouti") [Eritrea](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Eritrea "COVID-19 pandemic in Eritrea") [Ethiopia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Ethiopia "COVID-19 pandemic in Ethiopia") [Kenya](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Kenya "COVID-19 pandemic in Kenya") [Madagascar](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Madagascar "COVID-19 pandemic in Madagascar") [Mauritius](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Mauritius "COVID-19 pandemic in Mauritius") [Mayotte](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Mayotte "COVID-19 pandemic in Mayotte") [Réunion](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_R%C3%A9union "COVID-19 pandemic in Réunion") [Rwanda](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Rwanda "COVID-19 pandemic in Rwanda") [Seychelles](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Seychelles "COVID-19 pandemic in Seychelles") [Somalia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Somalia "COVID-19 pandemic in Somalia") [Puntland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Puntland "COVID-19 pandemic in Puntland") [Somaliland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Somaliland "COVID-19 pandemic in Somaliland") [South Sudan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_South_Sudan "COVID-19 pandemic in South Sudan") [Tanzania](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Tanzania "COVID-19 pandemic in Tanzania") [Uganda](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Uganda "COVID-19 pandemic in Uganda") |
| Southern | [Angola](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Angola "COVID-19 pandemic in Angola") [Botswana](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Botswana "COVID-19 pandemic in Botswana") [Eswatini](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Eswatini "COVID-19 pandemic in Eswatini") [Lesotho](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Lesotho "COVID-19 pandemic in Lesotho") [Malawi](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Malawi "COVID-19 pandemic in Malawi") [Mozambique](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Mozambique "COVID-19 pandemic in Mozambique") [Namibia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Namibia "COVID-19 pandemic in Namibia") [South Africa](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_South_Africa "COVID-19 pandemic in South Africa") [list of deaths](https://en.wikipedia.org/wiki/List_of_COVID-19_deaths_in_South_Africa "List of COVID-19 deaths in South Africa") [Zambia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Zambia "COVID-19 pandemic in Zambia") [Zimbabwe](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Zimbabwe "COVID-19 pandemic in Zimbabwe") |
| Central | [Cameroon](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Cameroon "COVID-19 pandemic in Cameroon") [Central African Republic](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Central_African_Republic "COVID-19 pandemic in the Central African Republic") [Chad](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Chad "COVID-19 pandemic in Chad") [Democratic Republic of the Congo](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Democratic_Republic_of_the_Congo "COVID-19 pandemic in the Democratic Republic of the Congo") [Republic of the Congo](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Republic_of_the_Congo "COVID-19 pandemic in the Republic of the Congo") [Gabon](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Gabon "COVID-19 pandemic in Gabon") [São Tomé and Príncipe](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_S%C3%A3o_Tom%C3%A9_and_Pr%C3%ADncipe "COVID-19 pandemic in São Tomé and Príncipe") |
| Western | [Benin](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Benin "COVID-19 pandemic in Benin") [Burkina Faso](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Burkina_Faso "COVID-19 pandemic in Burkina Faso") [Cape Verde](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Cape_Verde "COVID-19 pandemic in Cape Verde") [Equatorial Guinea](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Equatorial_Guinea "COVID-19 pandemic in Equatorial Guinea") [Gambia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Gambia "COVID-19 pandemic in the Gambia") [Ghana](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Ghana "COVID-19 pandemic in Ghana") timeline 2020 [March–July](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Ghana_\(March%E2%80%93July_2020\) "Timeline of the COVID-19 pandemic in Ghana (March–July 2020)") [August–December](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Ghana_\(August%E2%80%93December_2020\) "Timeline of the COVID-19 pandemic in Ghana (August–December 2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Ghana_\(2021\) "Timeline of the COVID-19 pandemic in Ghana (2021)") [government response](https://en.wikipedia.org/wiki/Ghanaian_government_response_to_the_COVID-19_pandemic "Ghanaian government response to the COVID-19 pandemic") impact [education](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_education_in_Ghana "Impact of the COVID-19 pandemic on education in Ghana") [Guinea](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Guinea "COVID-19 pandemic in Guinea") [Guinea-Bissau](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Guinea-Bissau "COVID-19 pandemic in Guinea-Bissau") [Ivory Coast](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Ivory_Coast "COVID-19 pandemic in Ivory Coast") [Liberia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Liberia "COVID-19 pandemic in Liberia") [Mali](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Mali "COVID-19 pandemic in Mali") [Niger](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Niger "COVID-19 pandemic in Niger") [Nigeria](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Nigeria "COVID-19 pandemic in Nigeria") [government response](https://en.wikipedia.org/wiki/Nigerian_government_response_to_the_COVID-19_pandemic "Nigerian government response to the COVID-19 pandemic") [Saint Helena, Ascension and Tristan da Cunha](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Saint_Helena,_Ascension_and_Tristan_da_Cunha "COVID-19 pandemic in Saint Helena, Ascension and Tristan da Cunha") [Senegal](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Senegal "COVID-19 pandemic in Senegal") [Sierra Leone](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sierra_Leone "COVID-19 pandemic in Sierra Leone") [Togo](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Togo "COVID-19 pandemic in Togo") |
| [Asia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Asia "COVID-19 pandemic in Asia") | |
| | |
| Central/North | [Kazakhstan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Kazakhstan "COVID-19 pandemic in Kazakhstan") [Kyrgyzstan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Kyrgyzstan "COVID-19 pandemic in Kyrgyzstan") [Russia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Russia "COVID-19 pandemic in Russia") timeline [January–June](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Russia_\(January%E2%80%93June_2020\) "Timeline of the COVID-19 pandemic in Russia (January–June 2020)") [July–December](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Russia_\(July%E2%80%93December_2020\) "Timeline of the COVID-19 pandemic in Russia (July–December 2020)") impact [economic](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_Russia "Economic impact of the COVID-19 pandemic in Russia") [social](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic_in_Russia "Social impact of the COVID-19 pandemic in Russia") [political](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_politics_in_Russia "Impact of the COVID-19 pandemic on politics in Russia") [Tajikistan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Tajikistan "COVID-19 pandemic in Tajikistan") [Turkmenistan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Turkmenistan "COVID-19 pandemic in Turkmenistan") [Uzbekistan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Uzbekistan "COVID-19 pandemic in Uzbekistan") |
| East | |
| | |
| [Hong Kong](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Hong_Kong "COVID-19 pandemic in Hong Kong") [Japan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Japan "COVID-19 pandemic in Japan") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Japan "Timeline of the COVID-19 pandemic in Japan") [Tokyo](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Tokyo "COVID-19 pandemic in Tokyo") [2020 Summer Olympics and Paralympics](https://en.wikipedia.org/wiki/COVID-19_cases_at_the_2020_Summer_Olympics_and_2020_Summer_Paralympics "COVID-19 cases at the 2020 Summer Olympics and 2020 Summer Paralympics") [North Korea](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_North_Korea "COVID-19 pandemic in North Korea") [South Korea](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_South_Korea "COVID-19 pandemic in South Korea") [Macau](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Macau "COVID-19 pandemic in Macau") [Mongolia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Mongolia "COVID-19 pandemic in Mongolia") [Taiwan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Taiwan "COVID-19 pandemic in Taiwan") [respirator diplomacy](https://en.wikipedia.org/wiki/Respirator_diplomacy_of_Taiwan "Respirator diplomacy of Taiwan") | |
| [Mainland China](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_mainland_China "COVID-19 pandemic in mainland China") | [lockdown](https://en.wikipedia.org/wiki/COVID-19_lockdown_in_China "COVID-19 lockdown in China") [detail](https://en.wikipedia.org/w/index.php?title=Template:COVID-19_pandemic_lockdowns_in_mainland_China&action=edit&redlink=1 "Template:COVID-19 pandemic lockdowns in mainland China (page does not exist)") [statistics](https://en.wikipedia.org/wiki/Statistics_of_the_COVID-19_pandemic_in_mainland_China "Statistics of the COVID-19 pandemic in mainland China") [vaccination](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_mainland_China "COVID-19 vaccination in mainland China") [Beijing](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Beijing "COVID-19 pandemic in Beijing") [2022 Winter Olympics and Paralympics](https://en.wikipedia.org/wiki/COVID-19_cases_at_the_2022_Winter_Olympics_and_2022_Winter_Paralympics "COVID-19 cases at the 2022 Winter Olympics and 2022 Winter Paralympics") [Heilongjiang](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Heilongjiang "COVID-19 pandemic in Heilongjiang") [Henan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Henan "COVID-19 pandemic in Henan") [Hubei](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Hubei "COVID-19 pandemic in Hubei") [Inner Mongolia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Inner_Mongolia "COVID-19 pandemic in Inner Mongolia") [Liaoning](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Liaoning "COVID-19 pandemic in Liaoning") [Shanghai](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Shanghai "COVID-19 pandemic in Shanghai") [2022 outbreak](https://en.wikipedia.org/wiki/2022_Shanghai_COVID-19_outbreak "2022 Shanghai COVID-19 outbreak") [Sichuan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sichuan "COVID-19 pandemic in Sichuan") [Tibet](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Tibet "COVID-19 pandemic in Tibet") [Xinjiang](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Xinjiang "COVID-19 pandemic in Xinjiang") |
| [South](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_South_Asia "COVID-19 pandemic in South Asia") | |
| | |
| [Afghanistan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Afghanistan "COVID-19 pandemic in Afghanistan") [Bangladesh](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Bangladesh "COVID-19 pandemic in Bangladesh") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Bangladesh "Timeline of the COVID-19 pandemic in Bangladesh") [Bhutan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Bhutan "COVID-19 pandemic in Bhutan") [Maldives](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Maldives "COVID-19 pandemic in Maldives") [Nepal](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Nepal "COVID-19 pandemic in Nepal") [Pakistan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Pakistan "COVID-19 pandemic in Pakistan") [Tablighi Jamaat hotspot](https://en.wikipedia.org/wiki/2020_Tablighi_Jamaat_COVID-19_hotspot_in_Pakistan "2020 Tablighi Jamaat COVID-19 hotspot in Pakistan") [Sri Lanka](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sri_Lanka "COVID-19 pandemic in Sri Lanka") | |
| [India](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_India "COVID-19 pandemic in India") | |
| | |
| [economic impact](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_India "Economic impact of the COVID-19 pandemic in India") [lockdown](https://en.wikipedia.org/wiki/COVID-19_lockdown_in_India "COVID-19 lockdown in India") [migrant workers' crisis](https://en.wikipedia.org/wiki/Indian_migrant_workers_during_the_COVID-19_pandemic "Indian migrant workers during the COVID-19 pandemic") [statistics](https://en.wikipedia.org/wiki/Statistics_of_the_COVID-19_pandemic_in_India "Statistics of the COVID-19 pandemic in India") timeline 2020 [January–May](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_India_\(January%E2%80%93May_2020\) "Timeline of the COVID-19 pandemic in India (January–May 2020)") [June–December](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_India_\(June%E2%80%93December_2020\) "Timeline of the COVID-19 pandemic in India (June–December 2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_India_\(2021\) "Timeline of the COVID-19 pandemic in India (2021)") [union government response](https://en.wikipedia.org/wiki/Indian_government_response_to_the_COVID-19_pandemic "Indian government response to the COVID-19 pandemic") [PM CARES Fund](https://en.wikipedia.org/wiki/PM_CARES_Fund "PM CARES Fund") [state government responses](https://en.wikipedia.org/wiki/Indian_state_government_responses_to_the_COVID-19_pandemic "Indian state government responses to the COVID-19 pandemic") [vaccination](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_India "COVID-19 vaccination in India") [Vaccine Maitri](https://en.wikipedia.org/wiki/Vaccine_Maitri "Vaccine Maitri") | |
| By location | [Andaman and Nicobar Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Andaman_and_Nicobar_Islands "COVID-19 pandemic in the Andaman and Nicobar Islands") [Andhra Pradesh](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Andhra_Pradesh "COVID-19 pandemic in Andhra Pradesh") [Arunachal Pradesh](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Arunachal_Pradesh "COVID-19 pandemic in Arunachal Pradesh") [Assam](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Assam "COVID-19 pandemic in Assam") [Bihar](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Bihar "COVID-19 pandemic in Bihar") [Chandigarh](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Chandigarh "COVID-19 pandemic in Chandigarh") [Chhattisgarh](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Chhattisgarh "COVID-19 pandemic in Chhattisgarh") [Dadra and Nagar Haveli and Daman and Diu](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Dadra_and_Nagar_Haveli_and_Daman_and_Diu "COVID-19 pandemic in Dadra and Nagar Haveli and Daman and Diu") [Delhi](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Delhi "COVID-19 pandemic in Delhi") [Tablighi Jamaat hotspot](https://en.wikipedia.org/wiki/2020_Tablighi_Jamaat_COVID-19_hotspot_in_Delhi "2020 Tablighi Jamaat COVID-19 hotspot in Delhi") [Goa](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Goa "COVID-19 pandemic in Goa") [Gujarat](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Gujarat "COVID-19 pandemic in Gujarat") [Haryana](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Haryana "COVID-19 pandemic in Haryana") [Himachal Pradesh](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Himachal_Pradesh "COVID-19 pandemic in Himachal Pradesh") [Jammu and Kashmir](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Jammu_and_Kashmir "COVID-19 pandemic in Jammu and Kashmir") [Jharkhand](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Jharkhand "COVID-19 pandemic in Jharkhand") [Karnataka](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Karnataka "COVID-19 pandemic in Karnataka") [Kerala](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Kerala "COVID-19 pandemic in Kerala") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Kerala "Timeline of the COVID-19 pandemic in Kerala") [Ladakh](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Ladakh "COVID-19 pandemic in Ladakh") [Lakshadweep](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Lakshadweep "COVID-19 pandemic in Lakshadweep") [Madhya Pradesh](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Madhya_Pradesh "COVID-19 pandemic in Madhya Pradesh") [Maharashtra](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Maharashtra "COVID-19 pandemic in Maharashtra") [Manipur](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Manipur "COVID-19 pandemic in Manipur") [Meghalaya](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Meghalaya "COVID-19 pandemic in Meghalaya") [Mizoram](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Mizoram "COVID-19 pandemic in Mizoram") [Nagaland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Nagaland "COVID-19 pandemic in Nagaland") [Odisha](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Odisha "COVID-19 pandemic in Odisha") [Puducherry](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Puducherry "COVID-19 pandemic in Puducherry") [Punjab](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Punjab,_India "COVID-19 pandemic in Punjab, India") [Rajasthan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Rajasthan "COVID-19 pandemic in Rajasthan") [Sikkim](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sikkim "COVID-19 pandemic in Sikkim") [Tamil Nadu](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Tamil_Nadu "COVID-19 pandemic in Tamil Nadu") [Telangana](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Telangana "COVID-19 pandemic in Telangana") [Tripura](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Tripura "COVID-19 pandemic in Tripura") [Uttar Pradesh](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Uttar_Pradesh "COVID-19 pandemic in Uttar Pradesh") [Uttarakhand](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Uttarakhand "COVID-19 pandemic in Uttarakhand") [West Bengal](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_West_Bengal "COVID-19 pandemic in West Bengal") |
| [Southeast](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Southeast_Asia "COVID-19 pandemic in Southeast Asia") | |
| | |
| [Brunei](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Brunei "COVID-19 pandemic in Brunei") [Cambodia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Cambodia "COVID-19 pandemic in Cambodia") [Indonesia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Indonesia "COVID-19 pandemic in Indonesia") timeline [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Indonesia_\(2021\) "Timeline of the COVID-19 pandemic in Indonesia (2021)") [social restrictions](https://en.wikipedia.org/wiki/Indonesia_large-scale_social_restrictions "Indonesia large-scale social restrictions") [Community Activities Restrictions Enforcement](https://en.wikipedia.org/wiki/Community_Activities_Restrictions_Enforcement "Community Activities Restrictions Enforcement") [Laos](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Laos "COVID-19 pandemic in Laos") [Myanmar](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Myanmar "COVID-19 pandemic in Myanmar") [Singapore](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Singapore "COVID-19 pandemic in Singapore") timeline [2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Singapore_\(2020\) "Timeline of the COVID-19 pandemic in Singapore (2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Singapore_\(2021\) "Timeline of the COVID-19 pandemic in Singapore (2021)") [2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Singapore_\(2022\) "Timeline of the COVID-19 pandemic in Singapore (2022)") [circuit breaker response](https://en.wikipedia.org/wiki/2020%E2%80%9321_Singapore_circuit_breaker_measures "2020–21 Singapore circuit breaker measures") [vaccination](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Singapore "COVID-19 vaccination in Singapore") [statistics](https://en.wikipedia.org/wiki/Statistics_of_the_COVID-19_pandemic_in_Singapore "Statistics of the COVID-19 pandemic in Singapore") [Thailand](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Thailand "COVID-19 pandemic in Thailand") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Thailand "Timeline of the COVID-19 pandemic in Thailand") [vaccination](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Thailand "COVID-19 vaccination in Thailand") [statistics](https://en.wikipedia.org/wiki/Statistics_of_the_COVID-19_pandemic_in_Thailand "Statistics of the COVID-19 pandemic in Thailand") [Timor-Leste](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Timor-Leste "COVID-19 pandemic in Timor-Leste") [Vietnam](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Vietnam "COVID-19 pandemic in Vietnam") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Vietnam "Timeline of the COVID-19 pandemic in Vietnam") [government response](https://en.wikipedia.org/wiki/Vietnamese_government_response_to_the_COVID-19_pandemic "Vietnamese government response to the COVID-19 pandemic") | |
| [Malaysia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Malaysia "COVID-19 pandemic in Malaysia") | impact [social](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic_in_Malaysia "Social impact of the COVID-19 pandemic in Malaysia") [economic](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_Malaysia "Economic impact of the COVID-19 pandemic in Malaysia") [political](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_politics_in_Malaysia "Impact of the COVID-19 pandemic on politics in Malaysia") [Aid and relief efforts](https://en.wikipedia.org/wiki/Aid_and_relief_efforts_during_the_COVID-19_pandemic_in_Malaysia "Aid and relief efforts during the COVID-19 pandemic in Malaysia") [movement control order](https://en.wikipedia.org/wiki/Malaysian_movement_control_order "Malaysian movement control order") [Tablighi Jamaat COVID-19 hotspot](https://en.wikipedia.org/wiki/2020_Tablighi_Jamaat_COVID-19_hotspot_in_Malaysia "2020 Tablighi Jamaat COVID-19 hotspot in Malaysia") timeline [2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Malaysia_\(2020\) "Timeline of the COVID-19 pandemic in Malaysia (2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Malaysia_\(2021\) "Timeline of the COVID-19 pandemic in Malaysia (2021)") [2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Malaysia_\(2022\) "Timeline of the COVID-19 pandemic in Malaysia (2022)") [2023](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Malaysia_\(2023\) "Timeline of the COVID-19 pandemic in Malaysia (2023)") [statistics](https://en.wikipedia.org/wiki/Statistics_of_the_COVID-19_pandemic_in_Malaysia "Statistics of the COVID-19 pandemic in Malaysia") [Johor](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Johor "COVID-19 pandemic in Johor") [Kuala Lumpur](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Kuala_Lumpur "COVID-19 pandemic in Kuala Lumpur") [Sabah](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sabah "COVID-19 pandemic in Sabah") [Sarawak](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sarawak "COVID-19 pandemic in Sarawak") [Selangor](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Selangor "COVID-19 pandemic in Selangor") |
| [Philippines](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Philippines "COVID-19 pandemic in the Philippines") | timeline [2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_Philippines_\(2020\) "Timeline of the COVID-19 pandemic in the Philippines (2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_Philippines_\(2021\) "Timeline of the COVID-19 pandemic in the Philippines (2021)") [2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_Philippines_\(2022\) "Timeline of the COVID-19 pandemic in the Philippines (2022)") [government response](https://en.wikipedia.org/wiki/Philippine_government_response_to_the_COVID-19_pandemic "Philippine government response to the COVID-19 pandemic") [community quarantines](https://en.wikipedia.org/wiki/COVID-19_community_quarantines_in_the_Philippines "COVID-19 community quarantines in the Philippines") [Luzon](https://en.wikipedia.org/wiki/Enhanced_community_quarantine_in_Luzon "Enhanced community quarantine in Luzon") [evacuations](https://en.wikipedia.org/wiki/Evacuations_by_the_Philippines_related_to_the_COVID-19_pandemic "Evacuations by the Philippines related to the COVID-19 pandemic") [vaccination](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_the_Philippines "COVID-19 vaccination in the Philippines") [Bangsamoro](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Bangsamoro "COVID-19 pandemic in Bangsamoro") [Bicol Region](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Bicol_Region "COVID-19 pandemic in the Bicol Region") [Cagayan Valley](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Cagayan_Valley "COVID-19 pandemic in Cagayan Valley") [Calabarzon](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Calabarzon "COVID-19 pandemic in Calabarzon") [Caraga](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Caraga "COVID-19 pandemic in Caraga") [Central Luzon](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Central_Luzon "COVID-19 pandemic in Central Luzon") [Central Visayas](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Central_Visayas "COVID-19 pandemic in Central Visayas") [Cordillera](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Cordillera_Administrative_Region "COVID-19 pandemic in the Cordillera Administrative Region") [Davao Region](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Davao_Region "COVID-19 pandemic in the Davao Region") [Eastern Visayas](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Eastern_Visayas "COVID-19 pandemic in Eastern Visayas") [Ilocos Region](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Ilocos_Region "COVID-19 pandemic in the Ilocos Region") [Metro Manila](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Metro_Manila "COVID-19 pandemic in Metro Manila") [Mimaropa](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Mimaropa "COVID-19 pandemic in Mimaropa") [Northern Mindanao](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Northern_Mindanao "COVID-19 pandemic in Northern Mindanao") [Soccsksargen](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Soccsksargen "COVID-19 pandemic in Soccsksargen") [Western Visayas](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Western_Visayas "COVID-19 pandemic in Western Visayas") [Zamboanga Peninsula](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Zamboanga_Peninsula "COVID-19 pandemic in Zamboanga Peninsula") [Overseas Filipinos](https://en.wikipedia.org/wiki/Overseas_Filipinos_during_the_COVID-19_pandemic "Overseas Filipinos during the COVID-19 pandemic") |
| West | [Armenia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Armenia "COVID-19 pandemic in Armenia") [Azerbaijan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Azerbaijan "COVID-19 pandemic in Azerbaijan") [Artsakh](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Republic_of_Artsakh "COVID-19 pandemic in the Republic of Artsakh") [Bahrain](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Bahrain "COVID-19 pandemic in Bahrain") [Cyprus](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Cyprus "COVID-19 pandemic in Cyprus") [Northern Cyprus](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Northern_Cyprus "COVID-19 pandemic in Northern Cyprus") [Egypt](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Egypt "COVID-19 pandemic in Egypt") [Georgia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Georgia_\(country\) "COVID-19 pandemic in Georgia (country)") [Abkhazia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Abkhazia "COVID-19 pandemic in Abkhazia") [South Ossetia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_South_Ossetia "COVID-19 pandemic in South Ossetia") [Iran](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Iran "COVID-19 pandemic in Iran") [Iraq](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Iraq "COVID-19 pandemic in Iraq") [Kurdistan Region](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Kurdistan_Region "COVID-19 pandemic in the Kurdistan Region") [Israel](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Israel "COVID-19 pandemic in Israel") [Jordan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Jordan "COVID-19 pandemic in Jordan") [Kuwait](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Kuwait "COVID-19 pandemic in Kuwait") [Lebanon](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Lebanon "COVID-19 pandemic in Lebanon") [Oman](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Oman "COVID-19 pandemic in Oman") [Palestine](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_State_of_Palestine "COVID-19 pandemic in the State of Palestine") [Qatar](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Qatar "COVID-19 pandemic in Qatar") [Saudi Arabia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Saudi_Arabia "COVID-19 pandemic in Saudi Arabia") [vaccination](https://en.wikipedia.org/wiki/COVID-19_vaccination_programme_in_Saudi_Arabia "COVID-19 vaccination programme in Saudi Arabia") [Syria](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Syria "COVID-19 pandemic in Syria") [Turkey](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Turkey "COVID-19 pandemic in Turkey") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Turkey "Timeline of the COVID-19 pandemic in Turkey") [United Arab Emirates](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_United_Arab_Emirates "COVID-19 pandemic in the United Arab Emirates") [Yemen](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Yemen "COVID-19 pandemic in Yemen") |
| [Europe](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Europe "COVID-19 pandemic in Europe") | |
| | |
| [United Kingdom](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_United_Kingdom "COVID-19 pandemic in the United Kingdom") | |
| | |
| [history](https://en.wikipedia.org/wiki/History_of_the_COVID-19_pandemic_in_the_United_Kingdom "History of the COVID-19 pandemic in the United Kingdom") timeline [January–June 2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_United_Kingdom_\(January%E2%80%93June_2020\) "Timeline of the COVID-19 pandemic in the United Kingdom (January–June 2020)") [July–December 2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_United_Kingdom_\(July%E2%80%93December_2020\) "Timeline of the COVID-19 pandemic in the United Kingdom (July–December 2020)") [January–June 2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_United_Kingdom_\(January%E2%80%93June_2021\) "Timeline of the COVID-19 pandemic in the United Kingdom (January–June 2021)") [July–December 2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_United_Kingdom_\(July%E2%80%93December_2021\) "Timeline of the COVID-19 pandemic in the United Kingdom (July–December 2021)") [January–June 2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_United_Kingdom_\(January%E2%80%93June_2022\) "Timeline of the COVID-19 pandemic in the United Kingdom (January–June 2022)") [July–December 2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_United_Kingdom_\(July%E2%80%93December_2022\) "Timeline of the COVID-19 pandemic in the United Kingdom (July–December 2022)") [2023](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_United_Kingdom_\(2023\) "Timeline of the COVID-19 pandemic in the United Kingdom (2023)") [responses](https://en.wikipedia.org/wiki/United_Kingdom_responses_to_the_COVID-19_pandemic "United Kingdom responses to the COVID-19 pandemic") [government response](https://en.wikipedia.org/wiki/British_government_response_to_the_COVID-19_pandemic "British government response to the COVID-19 pandemic") [response](https://en.wikipedia.org/wiki/Operation_Broadshare "Operation Broadshare") [Operation Rescript](https://en.wikipedia.org/wiki/Operation_Rescript "Operation Rescript") [contracts](https://en.wikipedia.org/wiki/Controversies_regarding_COVID-19_contracts_in_the_United_Kingdom "Controversies regarding COVID-19 contracts in the United Kingdom") impact [social](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic_in_the_United_Kingdom "Social impact of the COVID-19 pandemic in the United Kingdom") [economic](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_the_United_Kingdom "Economic impact of the COVID-19 pandemic in the United Kingdom") [education](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_education_in_the_United_Kingdom "Impact of the COVID-19 pandemic on education in the United Kingdom") | |
| By location | [England](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_England "COVID-19 pandemic in England") timeline 2020 [January–June](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_England_\(January%E2%80%93June_2020\) "Timeline of the COVID-19 pandemic in England (January–June 2020)") [July–December](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_England_\(July%E2%80%93December_2020\) "Timeline of the COVID-19 pandemic in England (July–December 2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_England_\(2021\) "Timeline of the COVID-19 pandemic in England (2021)") [2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_England_\(2022\) "Timeline of the COVID-19 pandemic in England (2022)") [London](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_London "COVID-19 pandemic in London") [local lockdown regulations](https://en.wikipedia.org/wiki/COVID-19_local_lockdown_regulations_in_England "COVID-19 local lockdown regulations in England") [first tier regulations](https://en.wikipedia.org/wiki/First_COVID-19_tier_regulations_in_England "First COVID-19 tier regulations in England") [Northern Ireland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Northern_Ireland "COVID-19 pandemic in Northern Ireland") timeline [2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Northern_Ireland_\(2020\) "Timeline of the COVID-19 pandemic in Northern Ireland (2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Northern_Ireland_\(2021\) "Timeline of the COVID-19 pandemic in Northern Ireland (2021)") [2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Northern_Ireland_\(2022\) "Timeline of the COVID-19 pandemic in Northern Ireland (2022)") [Scotland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Scotland "COVID-19 pandemic in Scotland") timeline [2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Scotland_\(2020\) "Timeline of the COVID-19 pandemic in Scotland (2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Scotland_\(2021\) "Timeline of the COVID-19 pandemic in Scotland (2021)") [2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Scotland_\(2022\) "Timeline of the COVID-19 pandemic in Scotland (2022)") [Wales](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Wales "COVID-19 pandemic in Wales") timeline [2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Wales_\(2020\) "Timeline of the COVID-19 pandemic in Wales (2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Wales_\(2021\) "Timeline of the COVID-19 pandemic in Wales (2021)") [2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Wales_\(2021\) "Timeline of the COVID-19 pandemic in Wales (2021)") [Crown Dependencies](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Crown_Dependencies "COVID-19 pandemic in the Crown Dependencies") [Isle of Man](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Isle_of_Man "COVID-19 pandemic in the Isle of Man") [Jersey](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Jersey "COVID-19 pandemic in Jersey") [Guernsey](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Guernsey "COVID-19 pandemic in Guernsey") [Overseas territories](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_British_Overseas_Territories "COVID-19 pandemic in the British Overseas Territories") [Akrotiri and Dhekelia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Akrotiri_and_Dhekelia "COVID-19 pandemic in Akrotiri and Dhekelia") [British Indian Ocean Territory](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_British_Indian_Ocean_Territory "COVID-19 pandemic in the British Indian Ocean Territory") [Gibraltar](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Gibraltar "COVID-19 pandemic in Gibraltar") |
| Eastern | [Belarus](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Belarus "COVID-19 pandemic in Belarus") timeline [2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Belarus_\(2020\) "Timeline of the COVID-19 pandemic in Belarus (2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Belarus_\(2021\) "Timeline of the COVID-19 pandemic in Belarus (2021)") [2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Belarus_\(2022\) "Timeline of the COVID-19 pandemic in Belarus (2022)") [Kazakhstan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Kazakhstan "COVID-19 pandemic in Kazakhstan") [Moldova](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Moldova "COVID-19 pandemic in Moldova") [Gagauzia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Gagauzia "COVID-19 pandemic in Gagauzia") [Transnistria](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Transnistria "COVID-19 pandemic in Transnistria") [Russia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Russia "COVID-19 pandemic in Russia") timeline [January–June 2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Russia_\(January%E2%80%93June_2020\) "Timeline of the COVID-19 pandemic in Russia (January–June 2020)") [July–December 2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Russia_\(July%E2%80%93December_2020\) "Timeline of the COVID-19 pandemic in Russia (July–December 2020)") [government responses](https://en.wikipedia.org/wiki/Russian_government_response_to_the_COVID-19_pandemic "Russian government response to the COVID-19 pandemic") [political impact](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_politics_in_Russia "Impact of the COVID-19 pandemic on politics in Russia") [Turkey](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Turkey "COVID-19 pandemic in Turkey") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Turkey "Timeline of the COVID-19 pandemic in Turkey") [Ukraine](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Ukraine "COVID-19 pandemic in Ukraine") [Crimea](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Crimea "COVID-19 pandemic in Crimea") [Sevastopol](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sevastopol "COVID-19 pandemic in Sevastopol") |
| Western Balkans | [Albania](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Albania "COVID-19 pandemic in Albania") [Bosnia and Herzegovina](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Bosnia_and_Herzegovina "COVID-19 pandemic in Bosnia and Herzegovina") [Kosovo](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Kosovo "COVID-19 pandemic in Kosovo") [Montenegro](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Montenegro "COVID-19 pandemic in Montenegro") [North Macedonia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_North_Macedonia "COVID-19 pandemic in North Macedonia") [Serbia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Serbia "COVID-19 pandemic in Serbia") [statistics](https://en.wikipedia.org/wiki/Statistics_of_the_COVID-19_pandemic_in_Serbia "Statistics of the COVID-19 pandemic in Serbia") |
| [European Union](https://en.wikipedia.org/wiki/European_Union_response_to_the_COVID-19_pandemic "European Union response to the COVID-19 pandemic") | [Austria](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Austria "COVID-19 pandemic in Austria") [Belgium](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Belgium "COVID-19 pandemic in Belgium") [Bulgaria](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Bulgaria "COVID-19 pandemic in Bulgaria") [Croatia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Croatia "COVID-19 pandemic in Croatia") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Croatia "Timeline of the COVID-19 pandemic in Croatia") [Cyprus](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Cyprus "COVID-19 pandemic in Cyprus") [Northern Cyprus](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Northern_Cyprus "COVID-19 pandemic in Northern Cyprus") [Czech Republic](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Czech_Republic "COVID-19 pandemic in the Czech Republic") [Denmark](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Denmark "COVID-19 pandemic in Denmark") [Faroe Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Faroe_Islands "COVID-19 pandemic in the Faroe Islands") [Estonia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Estonia "COVID-19 pandemic in Estonia") [Finland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Finland "COVID-19 pandemic in Finland") [Åland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_%C3%85land "COVID-19 pandemic in Åland") [France](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_France "COVID-19 pandemic in France") [Guadeloupe](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Guadeloupe "COVID-19 pandemic in Guadeloupe") [French Guiana](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_French_Guiana "COVID-19 pandemic in French Guiana") [Réunion](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_R%C3%A9union "COVID-19 pandemic in Réunion") [Martinique](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Martinique "COVID-19 pandemic in Martinique") [Mayotte](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Mayotte "COVID-19 pandemic in Mayotte") [Normandy](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Normandy "COVID-19 pandemic in Normandy") [Saint Martin](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Collectivity_of_Saint_Martin "COVID-19 pandemic in the Collectivity of Saint Martin") [Germany](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Germany "COVID-19 pandemic in Germany") [North Rhine-Westphalia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_North_Rhine-Westphalia "COVID-19 pandemic in North Rhine-Westphalia") [government response](https://en.wikipedia.org/wiki/German_government_response_to_the_COVID-19_pandemic "German government response to the COVID-19 pandemic") [Greece](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Greece "COVID-19 pandemic in Greece") [Hungary](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Hungary "COVID-19 pandemic in Hungary") [Ireland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Republic_of_Ireland "COVID-19 pandemic in the Republic of Ireland") timeline [2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_Republic_of_Ireland_\(2020\) "Timeline of the COVID-19 pandemic in the Republic of Ireland (2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_Republic_of_Ireland_\(2021\) "Timeline of the COVID-19 pandemic in the Republic of Ireland (2021)") [2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_Republic_of_Ireland_\(2022\) "Timeline of the COVID-19 pandemic in the Republic of Ireland (2022)") [economic impact](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_the_Republic_of_Ireland "Economic impact of the COVID-19 pandemic in the Republic of Ireland") [social impact](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic_in_the_Republic_of_Ireland "Social impact of the COVID-19 pandemic in the Republic of Ireland") [vaccination](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_the_Republic_of_Ireland "COVID-19 vaccination in the Republic of Ireland") [Italy](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Italy "COVID-19 pandemic in Italy") [lockdowns](https://en.wikipedia.org/wiki/COVID-19_lockdowns_in_Italy "COVID-19 lockdowns in Italy") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Italy "Timeline of the COVID-19 pandemic in Italy") [Latvia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Latvia "COVID-19 pandemic in Latvia") [Lithuania](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Lithuania "COVID-19 pandemic in Lithuania") [Luxembourg](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Luxembourg "COVID-19 pandemic in Luxembourg") [Malta](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Malta "COVID-19 pandemic in Malta") [Netherlands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Netherlands "COVID-19 pandemic in the Netherlands") [government response](https://en.wikipedia.org/wiki/Dutch_government_response_to_the_COVID-19_pandemic "Dutch government response to the COVID-19 pandemic") [Poland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Poland "COVID-19 pandemic in Poland") [Portugal](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Portugal "COVID-19 pandemic in Portugal") [Romania](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Romania "COVID-19 pandemic in Romania") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Romania "Timeline of the COVID-19 pandemic in Romania") [Slovakia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Slovakia "COVID-19 pandemic in Slovakia") [Slovenia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Slovenia "COVID-19 pandemic in Slovenia") [Spain](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Spain "COVID-19 pandemic in Spain") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Spain "Timeline of the COVID-19 pandemic in Spain") [Asturias](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Asturias "COVID-19 pandemic in Asturias") [Canary Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Canary_Islands "COVID-19 pandemic in the Canary Islands") [Ceuta](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Ceuta "COVID-19 pandemic in Ceuta") [Community of Madrid](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Community_of_Madrid "COVID-19 pandemic in the Community of Madrid") [Melilla](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Melilla "COVID-19 pandemic in Melilla") [Sweden](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sweden "COVID-19 pandemic in Sweden") [government response](https://en.wikipedia.org/wiki/Swedish_government_response_to_the_COVID-19_pandemic "Swedish government response to the COVID-19 pandemic") [Operation Gloria](https://en.wikipedia.org/wiki/Operation_Gloria "Operation Gloria") |
| EFTA countries | [Iceland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Iceland "COVID-19 pandemic in Iceland") [Liechtenstein](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Liechtenstein "COVID-19 pandemic in Liechtenstein") [Norway](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Norway "COVID-19 pandemic in Norway") [Svalbard](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Svalbard "COVID-19 pandemic in Svalbard") [Switzerland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Switzerland "COVID-19 pandemic in Switzerland") |
| Microstates | [Andorra](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Andorra "COVID-19 pandemic in Andorra") [Monaco](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Monaco "COVID-19 pandemic in Monaco") [San Marino](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_San_Marino "COVID-19 pandemic in San Marino") [Vatican City](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Vatican_City "COVID-19 pandemic in Vatican City") |
| [North America](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_North_America "COVID-19 pandemic in North America") | |
| | |
| Atlantic | [Bermuda](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Bermuda "COVID-19 pandemic in Bermuda") [Greenland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Greenland "COVID-19 pandemic in Greenland") [Saint Pierre and Miquelon](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Saint_Pierre_and_Miquelon "COVID-19 pandemic in Saint Pierre and Miquelon") |
| Canada | [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Canada "Timeline of the COVID-19 pandemic in Canada") [economic impact](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_Canada "Economic impact of the COVID-19 pandemic in Canada") [federal aid](https://en.wikipedia.org/wiki/Federal_aid_during_the_COVID-19_pandemic_in_Canada "Federal aid during the COVID-19 pandemic in Canada") [vaccination](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Canada "COVID-19 vaccination in Canada") [military response](https://en.wikipedia.org/wiki/Operation_Laser "Operation Laser") [Atlantic Bubble](https://en.wikipedia.org/wiki/Atlantic_Bubble "Atlantic Bubble") [Alberta](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Alberta "COVID-19 pandemic in Alberta") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Alberta "Timeline of the COVID-19 pandemic in Alberta") [British Columbia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_British_Columbia "COVID-19 pandemic in British Columbia") [Manitoba](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Manitoba "COVID-19 pandemic in Manitoba") [New Brunswick](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_New_Brunswick "COVID-19 pandemic in New Brunswick") [Newfoundland and Labrador](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Newfoundland_and_Labrador "COVID-19 pandemic in Newfoundland and Labrador") [Northwest Territories](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Northwest_Territories "COVID-19 pandemic in the Northwest Territories") [Nova Scotia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Nova_Scotia "COVID-19 pandemic in Nova Scotia") [Nunavut](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Nunavut "COVID-19 pandemic in Nunavut") [Ontario](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Ontario "COVID-19 pandemic in Ontario") timeline [2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Ontario_\(2020\) "Timeline of the COVID-19 pandemic in Ontario (2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Ontario_\(2021\) "Timeline of the COVID-19 pandemic in Ontario (2021)") [2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Ontario_\(2022\) "Timeline of the COVID-19 pandemic in Ontario (2022)") [Ottawa](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Ottawa "COVID-19 pandemic in Ottawa") [Peel Region](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Regional_Municipality_of_Peel "COVID-19 pandemic in the Regional Municipality of Peel") [Toronto](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Toronto "COVID-19 pandemic in Toronto") [York Region](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Regional_Municipality_of_York "COVID-19 pandemic in the Regional Municipality of York") [Provincial government response](https://en.wikipedia.org/wiki/Provincial_government_response_to_the_COVID-19_pandemic_in_Ontario "Provincial government response to the COVID-19 pandemic in Ontario") [Vaccination](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Ontario "COVID-19 vaccination in Ontario") [Prince Edward Island](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Prince_Edward_Island "COVID-19 pandemic in Prince Edward Island") [Quebec](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Quebec "COVID-19 pandemic in Quebec") [Montreal](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Montreal "COVID-19 pandemic in Montreal") [boroughs](https://en.wikipedia.org/wiki/Boroughs_of_Montreal_during_the_COVID-19_pandemic "Boroughs of Montreal during the COVID-19 pandemic") [Saskatchewan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Saskatchewan "COVID-19 pandemic in Saskatchewan") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Saskatchewan "Timeline of the COVID-19 pandemic in Saskatchewan") [Yukon](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Yukon "COVID-19 pandemic in Yukon") |
| Caribbean | |
| | |
| Countries | [Antigua and Barbuda](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Antigua_and_Barbuda "COVID-19 pandemic in Antigua and Barbuda") [Bahamas](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Bahamas "COVID-19 pandemic in the Bahamas") [Barbados](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Barbados "COVID-19 pandemic in Barbados") [Cuba](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Cuba "COVID-19 pandemic in Cuba") [Guantanamo Bay Naval Base](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Guantanamo_Bay_Naval_Base "COVID-19 pandemic in the Guantanamo Bay Naval Base") [Dominica](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Dominica "COVID-19 pandemic in Dominica") [Dominican Republic](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Dominican_Republic "COVID-19 pandemic in the Dominican Republic") [Grenada](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Grenada "COVID-19 pandemic in Grenada") [Haiti](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Haiti "COVID-19 pandemic in Haiti") [Jamaica](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Jamaica "COVID-19 pandemic in Jamaica") [Saint Kitts and Nevis](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Saint_Kitts_and_Nevis "COVID-19 pandemic in Saint Kitts and Nevis") [Saint Lucia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Saint_Lucia "COVID-19 pandemic in Saint Lucia") [Saint Vincent and the Grenadines](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Saint_Vincent_and_the_Grenadines "COVID-19 pandemic in Saint Vincent and the Grenadines") [Trinidad and Tobago](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Trinidad_and_Tobago "COVID-19 pandemic in Trinidad and Tobago") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Trinidad_and_Tobago "Timeline of the COVID-19 pandemic in Trinidad and Tobago") |
| [British Overseas Territories](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_British_Overseas_Territories "COVID-19 pandemic in the British Overseas Territories") | [Anguilla](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Anguilla "COVID-19 pandemic in Anguilla") [British Virgin Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_British_Virgin_Islands "COVID-19 pandemic in the British Virgin Islands") [Cayman Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Cayman_Islands "COVID-19 pandemic in the Cayman Islands") [Montserrat](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Montserrat "COVID-19 pandemic in Montserrat") [Turks and Caicos Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Turks_and_Caicos_Islands "COVID-19 pandemic in the Turks and Caicos Islands") [response](https://en.wikipedia.org/wiki/Operation_Broadshare "Operation Broadshare") |
| | |
| [Aruba](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Aruba "COVID-19 pandemic in Aruba") [Curaçao](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Cura%C3%A7ao "COVID-19 pandemic in Curaçao") [Sint Maarten](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sint_Maarten "COVID-19 pandemic in Sint Maarten") | |
| Caribbean Netherlands | [Bonaire](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Bonaire "COVID-19 pandemic in Bonaire") [Saba](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Saba "COVID-19 pandemic in Saba") [Sint Eustatius](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Sint_Eustatius "COVID-19 pandemic in Sint Eustatius") |
| French West Indies | [Guadeloupe](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Guadeloupe "COVID-19 pandemic in Guadeloupe") [Martinique](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Martinique "COVID-19 pandemic in Martinique") [Saint Barthélemy](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Saint_Barth%C3%A9lemy "COVID-19 pandemic in Saint Barthélemy") [Saint Martin](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Collectivity_of_Saint_Martin "COVID-19 pandemic in the Collectivity of Saint Martin") |
| US insular areas | [Puerto Rico](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Puerto_Rico "COVID-19 pandemic in Puerto Rico") [U.S. Virgin Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_United_States_Virgin_Islands "COVID-19 pandemic in the United States Virgin Islands") |
| Central America | [Belize](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Belize "COVID-19 pandemic in Belize") [Costa Rica](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Costa_Rica "COVID-19 pandemic in Costa Rica") [El Salvador](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_El_Salvador "COVID-19 pandemic in El Salvador") [Guatemala](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Guatemala "COVID-19 pandemic in Guatemala") [Honduras](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Honduras "COVID-19 pandemic in Honduras") [Mexico](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Mexico "COVID-19 pandemic in Mexico") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Mexico "Timeline of the COVID-19 pandemic in Mexico") [vaccination](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Mexico "COVID-19 vaccination in Mexico") [Nicaragua](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Nicaragua "COVID-19 pandemic in Nicaragua") [Panama](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Panama "COVID-19 pandemic in Panama") |
| [United States](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_United_States "COVID-19 pandemic in the United States") | |
| | |
| [Trump administration communication](https://en.wikipedia.org/wiki/Communication_of_the_Trump_administration_during_the_COVID-19_pandemic "Communication of the Trump administration during the COVID-19 pandemic") timeline [2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_United_States_\(2020\) "Timeline of the COVID-19 pandemic in the United States (2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_the_United_States_\(2021\) "Timeline of the COVID-19 pandemic in the United States (2021)") [social impact](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic_in_the_United_States "Social impact of the COVID-19 pandemic in the United States") [economic impact](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_the_United_States "Economic impact of the COVID-19 pandemic in the United States") [2021 hospital crisis](https://en.wikipedia.org/wiki/2021_hospital_crisis_in_the_U.S._from_COVID-19 "2021 hospital crisis in the U.S. from COVID-19") | |
| [responses](https://en.wikipedia.org/wiki/United_States_responses_to_the_COVID-19_pandemic "United States responses to the COVID-19 pandemic") | [federal government](https://en.wikipedia.org/wiki/U.S._federal_government_response_to_the_COVID-19_pandemic "U.S. federal government response to the COVID-19 pandemic") [state and local governments](https://en.wikipedia.org/wiki/U.S._state_and_local_government_responses_to_the_COVID-19_pandemic "U.S. state and local government responses to the COVID-19 pandemic") [California government response](https://en.wikipedia.org/wiki/California_government_response_to_the_COVID-19_pandemic "California government response to the COVID-19 pandemic") [New York government response](https://en.wikipedia.org/wiki/New_York_state_government_response_to_the_COVID-19_pandemic "New York state government response to the COVID-19 pandemic") [Texas government response](https://en.wikipedia.org/wiki/Texas_government_response_to_the_COVID-19_pandemic "Texas government response to the COVID-19 pandemic") [Eastern States Multi-state Council](https://en.wikipedia.org/wiki/Eastern_States_Multi-state_Council "Eastern States Multi-state Council") [Midwest Governors Regional Pact](https://en.wikipedia.org/wiki/Midwest_Governors_Regional_Pact "Midwest Governors Regional Pact") [Western States Pact](https://en.wikipedia.org/wiki/Western_States_Pact "Western States Pact") |
| By location | [Alabama](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Alabama "COVID-19 pandemic in Alabama") [Alaska](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Alaska "COVID-19 pandemic in Alaska") [American Samoa](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_American_Samoa "COVID-19 pandemic in American Samoa") [Arizona](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Arizona "COVID-19 pandemic in Arizona") [Navajo Nation](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Navajo_Nation "COVID-19 pandemic in the Navajo Nation") [Arkansas](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Arkansas "COVID-19 pandemic in Arkansas") [California](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_California "COVID-19 pandemic in California") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_California "Timeline of the COVID-19 pandemic in California") [S.F. Bay Area](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_San_Francisco_Bay_Area "COVID-19 pandemic in the San Francisco Bay Area") [Colorado](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Colorado "COVID-19 pandemic in Colorado") [Connecticut](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Connecticut "COVID-19 pandemic in Connecticut") [Delaware](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Delaware "COVID-19 pandemic in Delaware") [Florida](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Florida "COVID-19 pandemic in Florida") [Georgia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Georgia_\(U.S._state\) "COVID-19 pandemic in Georgia (U.S. state)") [Guam](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Guam "COVID-19 pandemic in Guam") [Hawaii](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Hawaii "COVID-19 pandemic in Hawaii") [Idaho](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Idaho "COVID-19 pandemic in Idaho") [Illinois](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Illinois "COVID-19 pandemic in Illinois") [Indiana](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Indiana "COVID-19 pandemic in Indiana") [Iowa](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Iowa "COVID-19 pandemic in Iowa") [Kansas](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Kansas "COVID-19 pandemic in Kansas") [Kentucky](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Kentucky "COVID-19 pandemic in Kentucky") [Louisiana](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Louisiana "COVID-19 pandemic in Louisiana") [Maine](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Maine "COVID-19 pandemic in Maine") [Maryland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Maryland "COVID-19 pandemic in Maryland") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Maryland "Timeline of the COVID-19 pandemic in Maryland") [Massachusetts](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Massachusetts "COVID-19 pandemic in Massachusetts") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Massachusetts "Timeline of the COVID-19 pandemic in Massachusetts") [Boston](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Boston "COVID-19 pandemic in Boston") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Boston "Timeline of the COVID-19 pandemic in Boston") [Michigan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Michigan "COVID-19 pandemic in Michigan") [Minnesota](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Minnesota "COVID-19 pandemic in Minnesota") [Mississippi](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Mississippi "COVID-19 pandemic in Mississippi") [Missouri](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Missouri "COVID-19 pandemic in Missouri") [Montana](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Montana "COVID-19 pandemic in Montana") [Nebraska](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Nebraska "COVID-19 pandemic in Nebraska") [Nevada](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Nevada "COVID-19 pandemic in Nevada") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Nevada "Timeline of the COVID-19 pandemic in Nevada") [New Hampshire](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_New_Hampshire "COVID-19 pandemic in New Hampshire") [New Jersey](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_New_Jersey "COVID-19 pandemic in New Jersey") [New Mexico](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_New_Mexico "COVID-19 pandemic in New Mexico") [New York](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_New_York_\(state\) "COVID-19 pandemic in New York (state)") [New York City](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_New_York_City "COVID-19 pandemic in New York City") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_New_York_City "Timeline of the COVID-19 pandemic in New York City") [North Carolina](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_North_Carolina "COVID-19 pandemic in North Carolina") [North Dakota](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_North_Dakota "COVID-19 pandemic in North Dakota") [Northern Mariana Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Northern_Mariana_Islands "COVID-19 pandemic in the Northern Mariana Islands") [Ohio](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Ohio "COVID-19 pandemic in Ohio") [Columbus](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Columbus,_Ohio "COVID-19 pandemic in Columbus, Ohio") [Oklahoma](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Oklahoma "COVID-19 pandemic in Oklahoma") [Oregon](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Oregon "COVID-19 pandemic in Oregon") [Portland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Portland,_Oregon "COVID-19 pandemic in Portland, Oregon") [Pennsylvania](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Pennsylvania "COVID-19 pandemic in Pennsylvania") [Philadelphia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Philadelphia "COVID-19 pandemic in Philadelphia") [Puerto Rico](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Puerto_Rico "COVID-19 pandemic in Puerto Rico") [Rhode Island](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Rhode_Island "COVID-19 pandemic in Rhode Island") [South Carolina](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_South_Carolina "COVID-19 pandemic in South Carolina") [South Dakota](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_South_Dakota "COVID-19 pandemic in South Dakota") [Tennessee](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Tennessee "COVID-19 pandemic in Tennessee") [Texas](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Texas "COVID-19 pandemic in Texas") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Texas "Timeline of the COVID-19 pandemic in Texas") [Austin](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Austin,_Texas "COVID-19 pandemic in Austin, Texas") [U.S. Virgin Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_United_States_Virgin_Islands "COVID-19 pandemic in the United States Virgin Islands") [Utah](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Utah "COVID-19 pandemic in Utah") [Vermont](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Vermont "COVID-19 pandemic in Vermont") [Virginia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Virginia "COVID-19 pandemic in Virginia") [Washington](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Washington_\(state\) "COVID-19 pandemic in Washington (state)") [Washington, D.C.](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Washington,_D.C. "COVID-19 pandemic in Washington, D.C.") [White House](https://en.wikipedia.org/wiki/White_House_COVID-19_outbreak "White House COVID-19 outbreak") [West Virginia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_West_Virginia "COVID-19 pandemic in West Virginia") [Wisconsin](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Wisconsin "COVID-19 pandemic in Wisconsin") [Wyoming](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Wyoming "COVID-19 pandemic in Wyoming") |
| [Oceania](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Oceania "COVID-19 pandemic in Oceania") | |
| | |
| [American Samoa](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_American_Samoa "COVID-19 pandemic in American Samoa") [Cook Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Cook_Islands "COVID-19 pandemic in the Cook Islands") [Easter Island](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Easter_Island "COVID-19 pandemic in Easter Island") [Federated States of Micronesia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Federated_States_of_Micronesia "COVID-19 pandemic in the Federated States of Micronesia") [Fiji](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Fiji "COVID-19 pandemic in Fiji") [French Polynesia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_French_Polynesia "COVID-19 pandemic in French Polynesia") [Guam](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Guam "COVID-19 pandemic in Guam") [Hawaii](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Hawaii "COVID-19 pandemic in Hawaii") [Kiribati](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Kiribati "COVID-19 pandemic in Kiribati") [Marshall Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Marshall_Islands "COVID-19 pandemic in the Marshall Islands") [Nauru](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Nauru "COVID-19 pandemic in Nauru") [New Caledonia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_New_Caledonia "COVID-19 pandemic in New Caledonia") [Niue](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Niue "COVID-19 pandemic in Niue") [Northern Mariana Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Northern_Mariana_Islands "COVID-19 pandemic in the Northern Mariana Islands") [Palau](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Palau "COVID-19 pandemic in Palau") [Papua New Guinea](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Papua_New_Guinea "COVID-19 pandemic in Papua New Guinea") [Bougainville](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Autonomous_Region_of_Bougainville "COVID-19 pandemic in the Autonomous Region of Bougainville") [Pitcairn Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Pitcairn_Islands "COVID-19 pandemic in the Pitcairn Islands") [Samoa](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Samoa "COVID-19 pandemic in Samoa") [Solomon Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Solomon_Islands "COVID-19 pandemic in the Solomon Islands") [Tokelau](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Tokelau "COVID-19 pandemic in Tokelau") [Tonga](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Tonga "COVID-19 pandemic in Tonga") [Tuvalu](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Tuvalu "COVID-19 pandemic in Tuvalu") [Vanuatu](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Vanuatu "COVID-19 pandemic in Vanuatu") [Wallis and Futuna](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Wallis_and_Futuna "COVID-19 pandemic in Wallis and Futuna") | |
| [Australia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Australia "COVID-19 pandemic in Australia") | timeline [2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Australia_\(2020\) "Timeline of the COVID-19 pandemic in Australia (2020)") 2021 [January–June](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Australia_\(January%E2%80%93June_2021\) "Timeline of the COVID-19 pandemic in Australia (January–June 2021)") [July–December](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Australia_\(July%E2%80%93December_2021\) "Timeline of the COVID-19 pandemic in Australia (July–December 2021)") [2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Australia_\(2022\) "Timeline of the COVID-19 pandemic in Australia (2022)") [Australian Capital Territory](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Australian_Capital_Territory "COVID-19 pandemic in the Australian Capital Territory") [Christmas Island](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Christmas_Island "COVID-19 pandemic in Christmas Island") [Cocos (Keeling) Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Cocos_\(Keeling\)_Islands "COVID-19 pandemic in the Cocos (Keeling) Islands") [New South Wales](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_New_South_Wales "COVID-19 pandemic in New South Wales") [Norfolk Island](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Norfolk_Island "COVID-19 pandemic in Norfolk Island") [Northern Territory](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Northern_Territory "COVID-19 pandemic in the Northern Territory") [Queensland](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Queensland "COVID-19 pandemic in Queensland") [South Australia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_South_Australia "COVID-19 pandemic in South Australia") [Tasmania](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Tasmania "COVID-19 pandemic in Tasmania") [Victoria](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Victoria "COVID-19 pandemic in Victoria") [Western Australia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Western_Australia "COVID-19 pandemic in Western Australia") |
| [New Zealand](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_New_Zealand "COVID-19 pandemic in New Zealand") | timeline [2020](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_New_Zealand_\(2020\) "Timeline of the COVID-19 pandemic in New Zealand (2020)") [2021](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_New_Zealand_\(2021\) "Timeline of the COVID-19 pandemic in New Zealand (2021)") [2022](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_New_Zealand_\(2022\) "Timeline of the COVID-19 pandemic in New Zealand (2022)") [2023](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_New_Zealand_\(2023\) "Timeline of the COVID-19 pandemic in New Zealand (2023)") [economic impact](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_New_Zealand "Economic impact of the COVID-19 pandemic in New Zealand") [government response](https://en.wikipedia.org/wiki/New_Zealand_government_response_to_the_COVID-19_pandemic "New Zealand government response to the COVID-19 pandemic") [Alert levels](https://en.wikipedia.org/wiki/COVID-19_alert_levels_in_New_Zealand "COVID-19 alert levels in New Zealand") [Traffic light system](https://en.wikipedia.org/wiki/COVID-19_Protection_Framework "COVID-19 Protection Framework") [social impact](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic_in_New_Zealand "Social impact of the COVID-19 pandemic in New Zealand") [managed isolation](https://en.wikipedia.org/wiki/COVID-19_managed_isolation_in_New_Zealand "COVID-19 managed isolation in New Zealand") |
| [South America](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_South_America "COVID-19 pandemic in South America") | [Argentina](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Argentina "COVID-19 pandemic in Argentina") [statistics](https://en.wikipedia.org/wiki/Statistics_of_the_COVID-19_pandemic_in_Argentina "Statistics of the COVID-19 pandemic in Argentina") [human rights](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_human_rights_in_Argentina "Impact of the COVID-19 pandemic on human rights in Argentina") [Bolivia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Bolivia "COVID-19 pandemic in Bolivia") [Brazil](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Brazil "COVID-19 pandemic in Brazil") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Brazil "Timeline of the COVID-19 pandemic in Brazil") [São Paulo](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_S%C3%A3o_Paulo_\(state\) "COVID-19 pandemic in São Paulo (state)") [Chile](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Chile "COVID-19 pandemic in Chile") [statistics](https://en.wikipedia.org/wiki/Statistics_of_the_COVID-19_pandemic_in_Chile "Statistics of the COVID-19 pandemic in Chile") [Easter Island](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Easter_Island "COVID-19 pandemic in Easter Island") [Colombia](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Colombia "COVID-19 pandemic in Colombia") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_COVID-19_pandemic_in_Colombia "Timeline of the COVID-19 pandemic in Colombia") [Ecuador](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Ecuador "COVID-19 pandemic in Ecuador") [Falkland Islands](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_the_Falkland_Islands "COVID-19 pandemic in the Falkland Islands") [French Guiana](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_French_Guiana "COVID-19 pandemic in French Guiana") [Guyana](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Guyana "COVID-19 pandemic in Guyana") [Paraguay](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Paraguay "COVID-19 pandemic in Paraguay") [Peru](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Peru "COVID-19 pandemic in Peru") [statistics](https://en.wikipedia.org/wiki/Statistics_of_the_COVID-19_pandemic_in_Peru "Statistics of the COVID-19 pandemic in Peru") [Cusco](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Cusco "COVID-19 pandemic in Cusco") [Suriname](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Suriname "COVID-19 pandemic in Suriname") [Uruguay](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Uruguay "COVID-19 pandemic in Uruguay") [Venezuela](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Venezuela "COVID-19 pandemic in Venezuela") |
| Others | [Antarctica](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Antarctica "COVID-19 pandemic in Antarctica") [Cruise ships](https://en.wikipedia.org/wiki/COVID-19_pandemic_on_cruise_ships "COVID-19 pandemic on cruise ships") [*Diamond Princess*](https://en.wikipedia.org/wiki/COVID-19_pandemic_on_Diamond_Princess "COVID-19 pandemic on Diamond Princess") [*Grand Princess*](https://en.wikipedia.org/wiki/COVID-19_pandemic_on_Grand_Princess "COVID-19 pandemic on Grand Princess") [Naval ships](https://en.wikipedia.org/wiki/COVID-19_pandemic_on_naval_ships "COVID-19 pandemic on naval ships") [*Charles de Gaulle*](https://en.wikipedia.org/wiki/COVID-19_pandemic_on_Charles_de_Gaulle "COVID-19 pandemic on Charles de Gaulle") [USS *Theodore Roosevelt*](https://en.wikipedia.org/wiki/COVID-19_pandemic_on_USS_Theodore_Roosevelt "COVID-19 pandemic on USS Theodore Roosevelt") |
| [Impact](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic "Impact of the COVID-19 pandemic") | |
| | |
| Culture and entertainment | |
| | |
| [Arts and cultural heritage](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_arts_and_cultural_heritage "Impact of the COVID-19 pandemic on the arts and cultural heritage") | [References in popular culture](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_popular_culture "COVID-19 pandemic in popular culture") [Cinema](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_cinema "Impact of the COVID-19 pandemic on cinema") [films affected](https://en.wikipedia.org/wiki/List_of_films_impacted_by_the_COVID-19_pandemic "List of films impacted by the COVID-19 pandemic") [Corona-chan](https://en.wikipedia.org/wiki/Corona-chan "Corona-chan") [Disney](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_Walt_Disney_Company "Impact of the COVID-19 pandemic on the Walt Disney Company") [Fashion industry](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_fashion_industry "Impact of the COVID-19 pandemic on the fashion industry") [Music industry](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_music_industry "Impact of the COVID-19 pandemic on the music industry") [Performing arts](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_performing_arts "Impact of the COVID-19 pandemic on the performing arts") [Television](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_television "Impact of the COVID-19 pandemic on television") [U.S.](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_television_in_the_United_States "Impact of the COVID-19 pandemic on television in the United States") [U.S. sports](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_American_sports_broadcasting "Impact of the COVID-19 pandemic on American sports broadcasting") [programs affected](https://en.wikipedia.org/wiki/List_of_American_television_series_impacted_by_the_COVID-19_pandemic "List of American television series impacted by the COVID-19 pandemic") [Video games](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_video_game_industry "Impact of the COVID-19 pandemic on the video game industry") |
| [Education](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_education "Impact of the COVID-19 pandemic on education") | |
| | |
| [Female education](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_female_education "Impact of the COVID-19 pandemic on female education") [Homeschooling](https://en.wikipedia.org/wiki/Homeschooling_during_the_COVID-19_pandemic "Homeschooling during the COVID-19 pandemic") | |
| By country | [Ghana](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_education_in_Ghana "Impact of the COVID-19 pandemic on education in Ghana") [Ireland](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_education_in_the_Republic_of_Ireland "Impact of the COVID-19 pandemic on education in the Republic of Ireland") [United Kingdom](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_education_in_the_United_Kingdom "Impact of the COVID-19 pandemic on education in the United Kingdom") [exam grading controversy](https://en.wikipedia.org/wiki/2020_United_Kingdom_school_exam_grading_controversy "2020 United Kingdom school exam grading controversy") [United States](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_education_in_the_United_States "Impact of the COVID-19 pandemic on education in the United States") |
| [Sports](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_sports "Impact of the COVID-19 pandemic on sports") | |
| | |
| [Bio-secure bubble](https://en.wikipedia.org/wiki/Bio-secure_bubble "Bio-secure bubble") | |
| By country | [Ireland](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_sports_in_the_Republic_of_Ireland "Impact of the COVID-19 pandemic on sports in the Republic of Ireland") [Philippines](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_Philippine_sports "Impact of the COVID-19 pandemic on Philippine sports") |
| By sport | [Association football](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_association_football "Impact of the COVID-19 pandemic on association football") [Baseball](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_baseball "Impact of the COVID-19 pandemic on baseball") [Basketball](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_basketball "Impact of the COVID-19 pandemic on basketball") [NBA](https://en.wikipedia.org/wiki/Suspension_of_the_2019%E2%80%9320_NBA_season "Suspension of the 2019–20 NBA season") [Combat sports](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_combat_sports "Impact of the COVID-19 pandemic on combat sports") [Cricket](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_cricket "Impact of the COVID-19 pandemic on cricket") [Disc golf](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_disc_golf "Impact of the COVID-19 pandemic on disc golf") [Gaelic games](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_Gaelic_games "Impact of the COVID-19 pandemic on Gaelic games") [Gridirion football (NCAAF, NFL, and CFL)](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_gridiron_football "Impact of the COVID-19 pandemic on gridiron football") [Ice hockey](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_ice_hockey "Impact of the COVID-19 pandemic on ice hockey") [Motorsport](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_motorsport "Impact of the COVID-19 pandemic on motorsport") [Rugby league](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_rugby_league "Impact of the COVID-19 pandemic on rugby league") |
| Society and rights | |
| | |
| [Social impact](https://en.wikipedia.org/wiki/Social_impact_of_the_COVID-19_pandemic "Social impact of the COVID-19 pandemic") | [Social media](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_social_media "Impact of the COVID-19 pandemic on social media") [Stigma](https://en.wikipedia.org/wiki/Social_stigma_associated_with_COVID-19 "Social stigma associated with COVID-19") [Children](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_children "Impact of the COVID-19 pandemic on children") [foster care in the U.S.](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_foster_care_in_the_United_States "Impact of the COVID-19 pandemic on foster care in the United States") [Pandemic baking](https://en.wikipedia.org/wiki/Pandemic_baking "Pandemic baking") |
| Labor | [Healthcare workers](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_healthcare_workers "Impact of the COVID-19 pandemic on healthcare workers") [Indian migrant workers](https://en.wikipedia.org/wiki/Indian_migrant_workers_during_the_COVID-19_pandemic "Indian migrant workers during the COVID-19 pandemic") [Great Resignation](https://en.wikipedia.org/wiki/Great_Resignation "Great Resignation") [Strikes](https://en.wikipedia.org/wiki/Strikes_during_the_COVID-19_pandemic "Strikes during the COVID-19 pandemic") |
| [Human rights](https://en.wikipedia.org/wiki/Human_rights_issues_related_to_the_COVID-19_pandemic "Human rights issues related to the COVID-19 pandemic") | [Argentina](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_human_rights_in_Argentina "Impact of the COVID-19 pandemic on human rights in Argentina") [Myanmar](https://en.wikipedia.org/wiki/2021_Myanmar_coup_d%27%C3%A9tat "2021 Myanmar coup d'état") |
| Legal | [Abortion in the U.S.](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_abortion_in_the_United_States "Impact of the COVID-19 pandemic on abortion in the United States") [Crime](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_crime "Impact of the COVID-19 pandemic on crime") [Domestic violence](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_domestic_violence "Impact of the COVID-19 pandemic on domestic violence") [Prisons](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_prisons "Impact of the COVID-19 pandemic on prisons") [U.S. immigration detention](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_U.S._immigration_detention "COVID-19 pandemic in U.S. immigration detention") |
| Minority | [Gender](https://en.wikipedia.org/wiki/Gendered_impact_of_the_COVID-19_pandemic "Gendered impact of the COVID-19 pandemic") [LGBT community](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_LGBT_community "Impact of the COVID-19 pandemic on the LGBT community") [African communities](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_African_communities "Impact of the COVID-19 pandemic on African communities") [Indian migrant workers](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_Indian_migrant_workers "Impact of the COVID-19 pandemic on Indian migrant workers") [Disability community](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_people_with_disabilities "Impact of the COVID-19 pandemic on people with disabilities") [Native American communities](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_Native_American_tribes_and_tribal_communities "Impact of the COVID-19 pandemic on Native American tribes and tribal communities") [Xenophobia and racism](https://en.wikipedia.org/wiki/Xenophobia_and_racism_related_to_the_COVID-19_pandemic "Xenophobia and racism related to the COVID-19 pandemic") |
| [Religion](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_religion "Impact of the COVID-19 pandemic on religion") | [Catholic Church](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_Catholic_Church "Impact of the COVID-19 pandemic on the Catholic Church") [Hajj](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_Hajj "Impact of the COVID-19 pandemic on Hajj") |
| [Economic](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic "Economic impact of the COVID-19 pandemic") | |
| | |
| [Charitable activity](https://en.wikipedia.org/wiki/Charitable_activities_related_to_the_COVID-19_pandemic "Charitable activities related to the COVID-19 pandemic") [COVID-19 scams](https://en.wikipedia.org/wiki/COVID-19_scams "COVID-19 scams") [Travel restrictions](https://en.wikipedia.org/wiki/Travel_during_the_COVID-19_pandemic "Travel during the COVID-19 pandemic") | |
| By country | [Canada](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_Canada "Economic impact of the COVID-19 pandemic in Canada") [India](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_India "Economic impact of the COVID-19 pandemic in India") [Ireland](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_the_Republic_of_Ireland "Economic impact of the COVID-19 pandemic in the Republic of Ireland") [COVID-19 Pandemic Unemployment Payment](https://en.wikipedia.org/wiki/COVID-19_Pandemic_Unemployment_Payment "COVID-19 Pandemic Unemployment Payment") [Malaysia](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_Malaysia "Economic impact of the COVID-19 pandemic in Malaysia") [New Zealand](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_New_Zealand "Economic impact of the COVID-19 pandemic in New Zealand") [Russia](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_Russia "Economic impact of the COVID-19 pandemic in Russia") [U.K.](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_the_United_Kingdom "Economic impact of the COVID-19 pandemic in the United Kingdom") [U.S.](https://en.wikipedia.org/wiki/Economic_impact_of_the_COVID-19_pandemic_in_the_United_States "Economic impact of the COVID-19 pandemic in the United States") |
| By industry | [Aviation](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_commercial_air_transport "Impact of the COVID-19 pandemic on commercial air transport") [Airlines](https://en.wikipedia.org/wiki/List_of_airlines_impacted_by_the_COVID-19_pandemic "List of airlines impacted by the COVID-19 pandemic") [Cannabis industry](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_cannabis_industry "Impact of the COVID-19 pandemic on the cannabis industry") [Food industry](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_food_industry "Impact of the COVID-19 pandemic on the food industry") [meat industry in Canada](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_meat_industry_in_Canada "Impact of the COVID-19 pandemic on the meat industry in Canada") [meat industry in the U.S.](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_meat_industry_in_the_United_States "Impact of the COVID-19 pandemic on the meat industry in the United States") [restaurant industry in the U.S.](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_restaurant_industry_in_the_United_States "Impact of the COVID-19 pandemic on the restaurant industry in the United States") [Hospitals](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_hospitals "Impact of the COVID-19 pandemic on hospitals") [ICU capacity](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_ICU_capacity "Impact of the COVID-19 pandemic on ICU capacity") [Long-term care facilities](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_long-term_care_facilities "Impact of the COVID-19 pandemic on long-term care facilities") [Mink farming](https://en.wikipedia.org/wiki/Cluster_5 "Cluster 5") [Public transport](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_public_transport "Impact of the COVID-19 pandemic on public transport") [Retail](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_retail "Impact of the COVID-19 pandemic on retail") [Tourism](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_tourism "Impact of the COVID-19 pandemic on tourism") |
| Supply and trade | [Shortages](https://en.wikipedia.org/wiki/Shortages_related_to_the_COVID-19_pandemic "Shortages related to the COVID-19 pandemic") [Chip supply](https://en.wikipedia.org/wiki/2020%E2%80%932023_global_chip_shortage "2020–2023 global chip shortage") [Energy](https://en.wikipedia.org/wiki/2021%E2%80%932023_global_energy_crisis "2021–2023 global energy crisis") [Global supply chain](https://en.wikipedia.org/wiki/2021%E2%80%932023_global_supply_chain_crisis "2021–2023 global supply chain crisis") [Oil price war](https://en.wikipedia.org/wiki/2020_Russia%E2%80%93Saudi_Arabia_oil_price_war "2020 Russia–Saudi Arabia oil price war") [Food security](https://en.wikipedia.org/wiki/Food_security_during_the_COVID-19_pandemic "Food security during the COVID-19 pandemic") |
| [Financial markets](https://en.wikipedia.org/wiki/Financial_market_impact_of_the_COVID-19_pandemic "Financial market impact of the COVID-19 pandemic") | [Global stock market crash](https://en.wikipedia.org/wiki/2020_stock_market_crash "2020 stock market crash") [COVID-19 recession](https://en.wikipedia.org/wiki/COVID-19_recession "COVID-19 recession") [Inflation](https://en.wikipedia.org/wiki/2021%E2%80%932022_inflation_surge "2021–2022 inflation surge") |
| Information | |
| | |
| [Journalism](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_journalism "Impact of the COVID-19 pandemic on journalism") [Media coverage](https://en.wikipedia.org/wiki/Media_coverage_of_the_COVID-19_pandemic "Media coverage of the COVID-19 pandemic") [Wikipedia's response](https://en.wikipedia.org/wiki/Wikipedia_and_the_COVID-19_pandemic "Wikipedia and the COVID-19 pandemic") | |
| [Misinformation](https://en.wikipedia.org/wiki/COVID-19_misinformation "COVID-19 misinformation") | [Governments](https://en.wikipedia.org/wiki/COVID-19_misinformation_by_governments "COVID-19 misinformation by governments") [China](https://en.wikipedia.org/wiki/COVID-19_misinformation_by_China "COVID-19 misinformation by China") [United States](https://en.wikipedia.org/wiki/COVID-19_misinformation_by_the_United_States "COVID-19 misinformation by the United States") By country [Canada](https://en.wikipedia.org/wiki/COVID-19_misinformation_in_Canada "COVID-19 misinformation in Canada") [Philippines](https://en.wikipedia.org/wiki/COVID-19_misinformation_in_the_Philippines "COVID-19 misinformation in the Philippines") [Ivermectin](https://en.wikipedia.org/wiki/Ivermectin_during_the_COVID-19_pandemic "Ivermectin during the COVID-19 pandemic") *[Plandemic](https://en.wikipedia.org/wiki/Plandemic "Plandemic")* |
| [Politics](https://en.wikipedia.org/wiki/Political_impact_of_the_COVID-19_pandemic "Political impact of the COVID-19 pandemic") | |
| | |
| [National responses](https://en.wikipedia.org/wiki/National_responses_to_the_COVID-19_pandemic "National responses to the COVID-19 pandemic") [Legislation](https://en.wikipedia.org/wiki/List_of_COVID-19_pandemic_legislation "List of COVID-19 pandemic legislation") [List of political officials who have tested positive](https://en.wikipedia.org/wiki/List_of_political_officials_who_have_tested_positive_for_COVID-19 "List of political officials who have tested positive for COVID-19") [European Union](https://en.wikipedia.org/wiki/European_Union_response_to_the_COVID-19_pandemic "European Union response to the COVID-19 pandemic") | |
| [Political impact](https://en.wikipedia.org/wiki/Political_impact_of_the_COVID-19_pandemic "Political impact of the COVID-19 pandemic") | [Ireland](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_politics_in_the_Republic_of_Ireland "Impact of the COVID-19 pandemic on politics in the Republic of Ireland") [Malaysia](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_politics_in_Malaysia "Impact of the COVID-19 pandemic on politics in Malaysia") [Russia](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_politics_in_Russia "Impact of the COVID-19 pandemic on politics in Russia") |
| [Protests](https://en.wikipedia.org/wiki/Protests_against_responses_to_the_COVID-19_pandemic "Protests against responses to the COVID-19 pandemic") | [Abkhazia](https://en.wikipedia.org/wiki/2021_Abkhazia_unrest "2021 Abkhazia unrest") [Argentina](https://en.wikipedia.org/wiki/17A "17A") [Australia](https://en.wikipedia.org/wiki/COVID-19_protests_in_Australia "COVID-19 protests in Australia") [Convoy to Canberra](https://en.wikipedia.org/wiki/Convoy_to_Canberra "Convoy to Canberra") [Azerbaijan](https://en.wikipedia.org/wiki/2020_Azerbaijani_protests "2020 Azerbaijani protests") [Belarus](https://en.wikipedia.org/wiki/2020%E2%80%932021_Belarusian_protests "2020–2021 Belarusian protests") [Belgium](https://en.wikipedia.org/wiki/2022_Brussels_protests "2022 Brussels protests") [2020 protests](https://en.wikipedia.org/wiki/2020_Brazilian_protests "2020 Brazilian protests") [2021 protests](https://en.wikipedia.org/wiki/2021_Brazilian_protests "2021 Brazilian protests") [Bulgaria](https://en.wikipedia.org/wiki/2020%E2%80%932021_Bulgarian_protests "2020–2021 Bulgarian protests") [Canada](https://en.wikipedia.org/wiki/COVID-19_protests_in_Canada "COVID-19 protests in Canada") [convoy protest](https://en.wikipedia.org/wiki/Canada_convoy_protest "Canada convoy protest") [Chile](https://en.wikipedia.org/wiki/2019%E2%80%932022_Chilean_protests "2019–2022 Chilean protests") [China](https://en.wikipedia.org/wiki/2022_COVID-19_protests_in_China "2022 COVID-19 protests in China") [Beijing Sitong Bridge protest](https://en.wikipedia.org/wiki/2022_Beijing_Sitong_Bridge_protest "2022 Beijing Sitong Bridge protest") [healthcare reform protests](https://en.wikipedia.org/wiki/2023_Chinese_healthcare_reform_protests "2023 Chinese healthcare reform protests") [2021 protests](https://en.wikipedia.org/wiki/2021_Colombian_protests "2021 Colombian protests") [2022 protests](https://en.wikipedia.org/wiki/2022_Colombian_protests "2022 Colombian protests") [Cuba](https://en.wikipedia.org/wiki/2021_Cuban_protests "2021 Cuban protests") [Yellow vests protests](https://en.wikipedia.org/wiki/Yellow_vests_protests "Yellow vests protests") [labor protests](https://en.wikipedia.org/wiki/2021_French_labor_protests "2021 French labor protests") [French West Indies social unrest](https://en.wikipedia.org/wiki/2021%E2%80%932022_social_unrest_in_the_French_West_Indies "2021–2022 social unrest in the French West Indies") [convoy protest](https://en.wikipedia.org/wiki/France_convoy_protest "France convoy protest") [Germany](https://en.wikipedia.org/wiki/COVID-19_protests_in_Germany "COVID-19 protests in Germany") [Idar-Oberstein shooting](https://en.wikipedia.org/wiki/2021_Idar-Oberstein_shooting "2021 Idar-Oberstein shooting") [Greece](https://en.wikipedia.org/wiki/2021_Greek_protests "2021 Greek protests") [Israel](https://en.wikipedia.org/wiki/COVID-19_protests_in_Israel "COVID-19 protests in Israel") [protests against Benjamin Netanyahu](https://en.wikipedia.org/wiki/2020%E2%80%932021_protests_against_Benjamin_Netanyahu "2020–2021 protests against Benjamin Netanyahu") [Italy](https://en.wikipedia.org/wiki/Protests_over_COVID-19_policies_in_Italy "Protests over COVID-19 policies in Italy") [Mongolia](https://en.wikipedia.org/wiki/2021_Mongolian_protests "2021 Mongolian protests") [Netherlands](https://en.wikipedia.org/wiki/COVID-19_protests_in_the_Netherlands "COVID-19 protests in the Netherlands") [curfew riots](https://en.wikipedia.org/wiki/2021_Dutch_curfew_riots "2021 Dutch curfew riots") [New Zealand](https://en.wikipedia.org/wiki/COVID-19_protests_in_New_Zealand "COVID-19 protests in New Zealand") [Wellington protest](https://en.wikipedia.org/wiki/2022_Wellington_protest "2022 Wellington protest") [Paraguay](https://en.wikipedia.org/wiki/2021_Paraguayan_protests "2021 Paraguayan protests") [Serbia](https://en.wikipedia.org/wiki/2020%E2%80%932022_Serbian_protests "2020–2022 Serbian protests") [Tunisia](https://en.wikipedia.org/wiki/2021_Tunisian_protests "2021 Tunisian protests") [United Kingdom](https://en.wikipedia.org/wiki/COVID-19_protests_in_the_United_Kingdom "COVID-19 protests in the United Kingdom") [United States](https://en.wikipedia.org/wiki/COVID-19_protests_in_the_United_States "COVID-19 protests in the United States") [Open the States](https://en.wikipedia.org/wiki/Open_the_States "Open the States") |
| [International relations](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_international_relations "Impact of the COVID-19 pandemic on international relations") | [Aid](https://en.wikipedia.org/wiki/International_aid_related_to_the_COVID-19_pandemic "International aid related to the COVID-19 pandemic") [Italy](https://en.wikipedia.org/wiki/International_reactions_to_the_COVID-19_pandemic_in_Italy "International reactions to the COVID-19 pandemic in Italy") [Moldovan–Romanian collaboration](https://en.wikipedia.org/wiki/Moldovan%E2%80%93Romanian_collaboration_during_the_COVID-19_pandemic "Moldovan–Romanian collaboration during the COVID-19 pandemic") [Respirator diplomacy of Taiwan](https://en.wikipedia.org/wiki/Respirator_diplomacy_of_Taiwan "Respirator diplomacy of Taiwan") [Vaccine diplomacy](https://en.wikipedia.org/wiki/Vaccine_diplomacy "Vaccine diplomacy") |
| [Language](https://en.wikipedia.org/wiki/Glossary_of_the_COVID-19_pandemic "Glossary of the COVID-19 pandemic") | [Anthropause](https://en.wikipedia.org/wiki/Anthropause "Anthropause") [Doomscrolling](https://en.wikipedia.org/wiki/Doomscrolling "Doomscrolling") [Flattening the curve](https://en.wikipedia.org/wiki/Flattening_the_curve "Flattening the curve") [Green recovery](https://en.wikipedia.org/wiki/Green_recovery "Green recovery") [Long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID") [Social distancing](https://en.wikipedia.org/wiki/Social_distancing "Social distancing") [Superspreader](https://en.wikipedia.org/wiki/Superspreading_event "Superspreading event") [Twindemic](https://en.wikipedia.org/wiki/Twindemic "Twindemic") [Zero-COVID](https://en.wikipedia.org/wiki/Zero-COVID "Zero-COVID") [Zoom](https://en.wikipedia.org/wiki/Zoom_\(software\) "Zoom (software)") [Zoom towns](https://en.wikipedia.org/wiki/Zoom_town "Zoom town") |
| Others | [Animals](https://en.wikipedia.org/wiki/COVID-19_pandemic_and_animals "COVID-19 pandemic and animals") [Cluster 5](https://en.wikipedia.org/wiki/Cluster_5 "Cluster 5") [Environment](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_environment "Impact of the COVID-19 pandemic on the environment") [Military](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_the_military "Impact of the COVID-19 pandemic on the military") [Pregnant women](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_pregnant_women "Impact of the COVID-19 pandemic on pregnant women") [Science and technology](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_science_and_technology "Impact of the COVID-19 pandemic on science and technology") |
| Health issues | |
| | |
| Medical topics | [Transmission](https://en.wikipedia.org/wiki/Transmission_of_COVID-19 "Transmission of COVID-19") [Symptoms](https://en.wikipedia.org/wiki/Symptoms_of_COVID-19 "Symptoms of COVID-19") [Cancer](https://en.wikipedia.org/wiki/COVID-19_and_cancer "COVID-19 and cancer") [Endemic COVID-19](https://en.wikipedia.org/wiki/Endemic_COVID-19 "Endemic COVID-19") [Skin manifestations](https://en.wikipedia.org/wiki/Cutaneous_manifestations_of_COVID-19 "Cutaneous manifestations of COVID-19") [Long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID") [Mental health](https://en.wikipedia.org/wiki/Mental_health_during_the_COVID-19_pandemic "Mental health during the COVID-19 pandemic") [neurological, psychological and other mental health outcomes](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_neurological,_psychological_and_other_mental_health_outcomes "Impact of the COVID-19 pandemic on neurological, psychological and other mental health outcomes") [Pregnancy](https://en.wikipedia.org/wiki/COVID-19_in_pregnancy "COVID-19 in pregnancy") [Non-COVID-19–related health issues](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_other_health_issues "Impact of the COVID-19 pandemic on other health issues") [Shortages](https://en.wikipedia.org/wiki/Shortages_related_to_the_COVID-19_pandemic "Shortages related to the COVID-19 pandemic") [Rehabilitation](https://en.wikipedia.org/wiki/Rehabilitation_after_COVID-19 "Rehabilitation after COVID-19") [Unproven medical methods](https://en.wikipedia.org/wiki/List_of_unproven_methods_against_COVID-19 "List of unproven methods against COVID-19") |
| Testing and epidemiology | |
| | |
| [Datasets](https://en.wikipedia.org/wiki/COVID-19_datasets "COVID-19 datasets") [Death rates by country](https://en.wikipedia.org/wiki/COVID-19_pandemic_death_rates_by_country "COVID-19 pandemic death rates by country") [Disease testing](https://en.wikipedia.org/wiki/COVID-19_testing "COVID-19 testing") [Breathalyzer](https://en.wikipedia.org/wiki/Coronavirus_breathalyzer "Coronavirus breathalyzer") [Operation Moonshot](https://en.wikipedia.org/wiki/Operation_Moonshot "Operation Moonshot") [Test to Release](https://en.wikipedia.org/wiki/Test_to_Release "Test to Release") [UK Rapid Test Consortium](https://en.wikipedia.org/wiki/UK_Rapid_Test_Consortium "UK Rapid Test Consortium") [AbC-19 rapid antibody test](https://en.wikipedia.org/wiki/AbC-19_rapid_antibody_test "AbC-19 rapid antibody test") [investigations into the origins](https://en.wikipedia.org/wiki/Investigations_into_the_origin_of_COVID-19 "Investigations into the origin of COVID-19") [lab leak theory](https://en.wikipedia.org/wiki/COVID-19_lab_leak_theory "COVID-19 lab leak theory") [Rapid antigen test](https://en.wikipedia.org/wiki/COVID-19_rapid_antigen_test "COVID-19 rapid antigen test") [Software](https://en.wikipedia.org/wiki/Software_for_COVID-19_pandemic_mitigation "Software for COVID-19 pandemic mitigation") [Surveillance](https://en.wikipedia.org/wiki/COVID-19_surveillance "COVID-19 surveillance") [Undercounting COVID-19 deaths](https://en.wikipedia.org/wiki/Undercounting_of_COVID-19_pandemic_deaths_by_country "Undercounting of COVID-19 pandemic deaths by country") | |
| [Apps](https://en.wikipedia.org/wiki/COVID-19_apps "COVID-19 apps") | [Aarogya Setu](https://en.wikipedia.org/wiki/Aarogya_Setu "Aarogya Setu") [BlueTrace](https://en.wikipedia.org/wiki/BlueTrace "BlueTrace") [careFIJI](https://en.wikipedia.org/wiki/CareFIJI "CareFIJI") [Coronavirus Australia](https://en.wikipedia.org/wiki/Coronavirus_Australia "Coronavirus Australia") [Corona-Warn-App](https://en.wikipedia.org/wiki/Corona-Warn-App "Corona-Warn-App") [COVID-19 Contact-Confirming Application](https://en.wikipedia.org/wiki/COVID-19_Contact-Confirming_Application "COVID-19 Contact-Confirming Application") [COVID Alert](https://en.wikipedia.org/wiki/COVID_Alert "COVID Alert") (Canada) [COVIDSafe](https://en.wikipedia.org/wiki/COVIDSafe "COVIDSafe") [COVID Tracker Ireland](https://en.wikipedia.org/wiki/COVID_Tracker_Ireland "COVID Tracker Ireland") [Covid Watch](https://en.wikipedia.org/wiki/Covid_Watch "Covid Watch") [Decentralized Privacy-Preserving Proximity Tracing](https://en.wikipedia.org/wiki/Decentralized_Privacy-Preserving_Proximity_Tracing "Decentralized Privacy-Preserving Proximity Tracing") [Exposure Notification](https://en.wikipedia.org/wiki/Exposure_Notification "Exposure Notification") [Health Code](https://en.wikipedia.org/wiki/Health_Code "Health Code") [Healthy Together](https://en.wikipedia.org/wiki/Healthy_Together "Healthy Together") [Immuni](https://en.wikipedia.org/wiki/Immuni "Immuni") [Koronavilkku](https://en.wikipedia.org/wiki/Koronavilkku "Koronavilkku") [LeaveHomeSafe](https://en.wikipedia.org/wiki/LeaveHomeSafe "LeaveHomeSafe") [MySejahtera](https://en.wikipedia.org/wiki/MySejahtera "MySejahtera") [NHS COVID-19](https://en.wikipedia.org/wiki/NHS_COVID-19 "NHS COVID-19") [NZ COVID Tracer](https://en.wikipedia.org/wiki/NZ_COVID_Tracer "NZ COVID Tracer") [NZ Pass Verifier](https://en.wikipedia.org/wiki/NZ_Pass_Verifier "NZ Pass Verifier") [PathCheck](https://en.wikipedia.org/wiki/PathCheck "PathCheck") [PeduliLindungi](https://en.wikipedia.org/wiki/PeduliLindungi "PeduliLindungi") [SafeEntry](https://en.wikipedia.org/wiki/SafeEntry "SafeEntry") [SafePass](https://en.wikipedia.org/wiki/SafePass "SafePass") [StaySafe.ph](https://en.wikipedia.org/wiki/StaySafe.ph "StaySafe.ph") [SwissCovid](https://en.wikipedia.org/wiki/SwissCovid "SwissCovid") [TCN Protocol](https://en.wikipedia.org/wiki/TCN_Protocol "TCN Protocol") [Test, Trace, Protect](https://en.wikipedia.org/wiki/Test,_Trace,_Protect "Test, Trace, Protect") [Thai Chana](https://en.wikipedia.org/wiki/Thai_Chana "Thai Chana") [TousAntiCovid](https://en.wikipedia.org/wiki/TousAntiCovid "TousAntiCovid") [TraceTogether](https://en.wikipedia.org/wiki/TraceTogether "TraceTogether") [Valtrace](https://en.wikipedia.org/wiki/Valtrace "Valtrace") [Zoe Health Study](https://en.wikipedia.org/wiki/Zoe_Health_Study "Zoe Health Study") |
| Prevention | [Air purifier](https://en.wikipedia.org/wiki/Air_purifier "Air purifier") ([Corsi–Rosenthal Box](https://en.wikipedia.org/wiki/Corsi%E2%80%93Rosenthal_Box "Corsi–Rosenthal Box")) [Chloroquine and hydroxychloroquine](https://en.wikipedia.org/wiki/Chloroquine_and_hydroxychloroquine_during_the_COVID-19_pandemic "Chloroquine and hydroxychloroquine during the COVID-19 pandemic") [Evacuations](https://en.wikipedia.org/wiki/Evacuations_related_to_the_COVID-19_pandemic "Evacuations related to the COVID-19 pandemic") [Face masks](https://en.wikipedia.org/wiki/Face_masks_during_the_COVID-19_pandemic "Face masks during the COVID-19 pandemic") [Anti-mask sentiment](https://en.wikipedia.org/wiki/Anti-mask_sentiment "Anti-mask sentiment") [United States](https://en.wikipedia.org/wiki/Face_masks_during_the_COVID-19_pandemic_in_the_United_States "Face masks during the COVID-19 pandemic in the United States") [Flattening the curve](https://en.wikipedia.org/wiki/Flattening_the_curve "Flattening the curve") [Great Barrington Declaration](https://en.wikipedia.org/wiki/Great_Barrington_Declaration "Great Barrington Declaration") [International aid](https://en.wikipedia.org/wiki/International_aid_related_to_the_COVID-19_pandemic "International aid related to the COVID-19 pandemic") [Lockdowns](https://en.wikipedia.org/wiki/COVID-19_lockdowns "COVID-19 lockdowns") [Public health mitigation](https://en.wikipedia.org/wiki/Public_health_mitigation_of_COVID-19 "Public health mitigation of COVID-19") [Safe Hands Challenge](https://en.wikipedia.org/wiki/Safe_Hands_Challenge "Safe Hands Challenge") [Social distancing](https://en.wikipedia.org/wiki/Social_distancing_measures_related_to_the_COVID-19_pandemic "Social distancing measures related to the COVID-19 pandemic") [Workplace hazard controls](https://en.wikipedia.org/wiki/Workplace_hazard_controls_for_COVID-19 "Workplace hazard controls for COVID-19") [Zero-COVID](https://en.wikipedia.org/wiki/Zero-COVID "Zero-COVID") |
| [Vaccines](https://en.wikipedia.org/wiki/COVID-19_vaccine "COVID-19 vaccine") | |
| | |
| Topics | [Authorizations](https://en.wikipedia.org/wiki/List_of_COVID-19_vaccine_authorizations "List of COVID-19 vaccine authorizations") [Clinical research](https://en.wikipedia.org/wiki/COVID-19_vaccine_clinical_research "COVID-19 vaccine clinical research") [Deployment](https://en.wikipedia.org/wiki/Deployment_of_COVID-19_vaccines "Deployment of COVID-19 vaccines") [Development](https://en.wikipedia.org/wiki/History_of_COVID-19_vaccine_development "History of COVID-19 vaccine development") [EU Certificate](https://en.wikipedia.org/wiki/EU_Digital_COVID_Certificate "EU Digital COVID Certificate") [Misinformation and hesitancy](https://en.wikipedia.org/wiki/COVID-19_vaccine_misinformation_and_hesitancy "COVID-19 vaccine misinformation and hesitancy") [Deaths of anti-vaccine advocates](https://en.wikipedia.org/wiki/Deaths_of_anti-vaccine_advocates_from_COVID-19 "Deaths of anti-vaccine advocates from COVID-19") [US](https://en.wikipedia.org/wiki/COVID-19_vaccine_hesitancy_in_the_United_States "COVID-19 vaccine hesitancy in the United States") [Operation Warp Speed](https://en.wikipedia.org/wiki/Operation_Warp_Speed "Operation Warp Speed") (U.S.) [Post-vaccination complications](https://en.wikipedia.org/wiki/Embolic_and_thrombotic_events_after_COVID-19_vaccination "Embolic and thrombotic events after COVID-19 vaccination") [Vaccine card](https://en.wikipedia.org/wiki/COVID-19_vaccine_card "COVID-19 vaccine card") [Vaccine passports](https://en.wikipedia.org/wiki/Vaccine_passports_during_the_COVID-19_pandemic "Vaccine passports during the COVID-19 pandemic") |
| Authorized | |
| | |
| [DNA](https://en.wikipedia.org/wiki/DNA_vaccine "DNA vaccine") | [ZyCoV-D](https://en.wikipedia.org/wiki/ZyCoV-D "ZyCoV-D") |
| [Inactivated](https://en.wikipedia.org/wiki/Inactivated_vaccine "Inactivated vaccine") | [Chinese Academy of Medical Sciences](https://en.wikipedia.org/wiki/Chinese_Academy_of_Medical_Sciences_COVID-19_vaccine "Chinese Academy of Medical Sciences COVID-19 vaccine") [CoronaVac](https://en.wikipedia.org/wiki/CoronaVac "CoronaVac") [Covaxin](https://en.wikipedia.org/wiki/Covaxin "Covaxin") [COVIran Barekat](https://en.wikipedia.org/wiki/COVIran_Barekat "COVIran Barekat") [CoviVac (Russia)](https://en.wikipedia.org/wiki/CoviVac_\(Russia_COVID-19_vaccine\) "CoviVac (Russia COVID-19 vaccine)") [FAKHRAVAC](https://en.wikipedia.org/wiki/FAKHRAVAC "FAKHRAVAC") [Minhai](https://en.wikipedia.org/wiki/Minhai_COVID-19_vaccine "Minhai COVID-19 vaccine") [QazCovid-in](https://en.wikipedia.org/wiki/QazCovid-in "QazCovid-in") [Sinopharm BIBP](https://en.wikipedia.org/wiki/Sinopharm_BIBP_COVID-19_vaccine "Sinopharm BIBP COVID-19 vaccine") [Sinopharm WIBP](https://en.wikipedia.org/wiki/Sinopharm_WIBP_COVID-19_vaccine "Sinopharm WIBP COVID-19 vaccine") [Turkovac](https://en.wikipedia.org/wiki/Turkovac "Turkovac") [Valneva](https://en.wikipedia.org/wiki/Valneva_COVID-19_vaccine "Valneva COVID-19 vaccine") |
| [mRNA](https://en.wikipedia.org/wiki/MRNA_vaccine "MRNA vaccine") | [Moderna](https://en.wikipedia.org/wiki/Moderna_COVID-19_vaccine "Moderna COVID-19 vaccine") [Pfizer–BioNTech](https://en.wikipedia.org/wiki/Pfizer%E2%80%93BioNTech_COVID-19_vaccine "Pfizer–BioNTech COVID-19 vaccine") |
| [Subunit](https://en.wikipedia.org/wiki/Subunit_vaccine "Subunit vaccine") | [Abdala](https://en.wikipedia.org/wiki/Abdala_\(vaccine\) "Abdala (vaccine)") [Corbevax](https://en.wikipedia.org/wiki/Corbevax "Corbevax") (Bio E COVID-19) [COVAX-19](https://en.wikipedia.org/wiki/COVAX-19 "COVAX-19") [EpiVacCorona](https://en.wikipedia.org/wiki/EpiVacCorona "EpiVacCorona") [IndoVac](https://en.wikipedia.org/wiki/IndoVac "IndoVac") [MVC](https://en.wikipedia.org/wiki/MVC_COVID-19_vaccine "MVC COVID-19 vaccine") [Noora](https://en.wikipedia.org/wiki/Noora_\(vaccine\) "Noora (vaccine)") [Novavax](https://en.wikipedia.org/wiki/Novavax_COVID-19_vaccine "Novavax COVID-19 vaccine") [Razi Cov Pars](https://en.wikipedia.org/wiki/Razi_Cov_Pars "Razi Cov Pars") [Sinopharm CNBG](https://en.wikipedia.org/wiki/Sinopharm_CNBG_COVID-19_vaccine "Sinopharm CNBG COVID-19 vaccine") [Soberana 02](https://en.wikipedia.org/wiki/Soberana_02 "Soberana 02") [Soberana Plus](https://en.wikipedia.org/wiki/Soberana_Plus "Soberana Plus") [ZF2001](https://en.wikipedia.org/wiki/ZF2001 "ZF2001") (Zifivax) |
| [Viral vector](https://en.wikipedia.org/wiki/Viral_vector_vaccine "Viral vector vaccine") | [Convidecia](https://en.wikipedia.org/wiki/Convidecia "Convidecia") [Janssen](https://en.wikipedia.org/wiki/Janssen_COVID-19_vaccine "Janssen COVID-19 vaccine") [Oxford–AstraZeneca](https://en.wikipedia.org/wiki/Oxford%E2%80%93AstraZeneca_COVID-19_vaccine "Oxford–AstraZeneca COVID-19 vaccine") [Sputnik V](https://en.wikipedia.org/wiki/Sputnik_V_COVID-19_vaccine "Sputnik V COVID-19 vaccine") [Sputnik Light](https://en.wikipedia.org/wiki/Sputnik_Light "Sputnik Light") |
| [Virus-like particles](https://en.wikipedia.org/wiki/Virus-like_particle "Virus-like particle") | [CoVLP](https://en.wikipedia.org/wiki/CoVLP "CoVLP") |
| In trials | |
| | |
| [Attenuated](https://en.wikipedia.org/wiki/Attenuated_vaccine "Attenuated vaccine") | [COVI-VAC (United States)](https://en.wikipedia.org/wiki/COVI-VAC_\(U.S._COVID-19_vaccine\) "COVI-VAC (U.S. COVID-19 vaccine)") |
| DNA | [AG0302-COVID‑19](https://en.wikipedia.org/wiki/AG0302-COVID%E2%80%9119 "AG0302-COVID‑19") [GX-19](https://en.wikipedia.org/wiki/GX-19 "GX-19") [Inovio](https://en.wikipedia.org/wiki/Inovio_COVID-19_vaccine "Inovio COVID-19 vaccine") |
| Inactivated | [KD-414](https://en.wikipedia.org/wiki/KD-414 "KD-414") [NDV-HXP-S](https://en.wikipedia.org/wiki/NDV-HXP-S "NDV-HXP-S") |
| RNA | [ARCT-021](https://en.wikipedia.org/wiki/ARCT-021 "ARCT-021") [ARCT-154](https://en.wikipedia.org/wiki/ARCT-154 "ARCT-154") [Bangavax](https://en.wikipedia.org/wiki/Bangavax "Bangavax") [CureVac](https://en.wikipedia.org/wiki/CureVac_COVID-19_vaccine "CureVac COVID-19 vaccine") (terminated) [HGC019](https://en.wikipedia.org/wiki/HGC019 "HGC019") [mRNA-1283](https://en.wikipedia.org/wiki/MRNA-1283 "MRNA-1283") [PTX-COVID19-B](https://en.wikipedia.org/wiki/PTX-COVID19-B "PTX-COVID19-B") [Sanofi–Translate Bio](https://en.wikipedia.org/wiki/Sanofi%E2%80%93Translate_Bio_COVID-19_vaccine "Sanofi–Translate Bio COVID-19 vaccine") (terminated) [Stemirna COVID-19 vaccine](https://en.wikipedia.org/wiki/Stemirna_COVID-19_vaccine "Stemirna COVID-19 vaccine") [Walvax](https://en.wikipedia.org/wiki/Walvax_COVID-19_vaccine "Walvax COVID-19 vaccine") |
| Subunit | [202-CoV](https://en.wikipedia.org/wiki/202-CoV "202-CoV") [AKS-452](https://en.wikipedia.org/wiki/AKS-452 "AKS-452") [EuCorVac-19](https://en.wikipedia.org/wiki/EuCorVac-19 "EuCorVac-19") [IVX-411](https://en.wikipedia.org/wiki/IVX-411 "IVX-411") [Nanocovax](https://en.wikipedia.org/wiki/Nanocovax "Nanocovax") [ReCOV](https://en.wikipedia.org/wiki/ReCOV "ReCOV") [Sanofi–GSK](https://en.wikipedia.org/wiki/Sanofi%E2%80%93GSK_COVID-19_vaccine "Sanofi–GSK COVID-19 vaccine") [S-268019](https://en.wikipedia.org/wiki/S-268019 "S-268019") [SCB-2019](https://en.wikipedia.org/wiki/SCB-2019 "SCB-2019") [SCTV01C](https://en.wikipedia.org/wiki/SCTV01C "SCTV01C") [Skycovione](https://en.wikipedia.org/wiki/Skycovione "Skycovione") [UB-612](https://en.wikipedia.org/wiki/UB-612 "UB-612") [V-01](https://en.wikipedia.org/wiki/V-01 "V-01") [V451](https://en.wikipedia.org/wiki/V451_vaccine "V451 vaccine") (terminated) [Vabiotech](https://en.wikipedia.org/wiki/Vabiotech_COVID-19_vaccine "Vabiotech COVID-19 vaccine") [West China Hospital](https://en.wikipedia.org/wiki/West_China_Hospital_COVID-19_vaccine "West China Hospital COVID-19 vaccine") [Zhongyianke Biotech–Liaoning Maokangyuan Biotech](https://en.wikipedia.org/wiki/ZF2001 "ZF2001") |
| Viral vector | [AdCLD-CoV19](https://en.wikipedia.org/wiki/AdCLD-CoV19 "AdCLD-CoV19") [BriLife](https://en.wikipedia.org/wiki/BriLife "BriLife") [COH04S1](https://en.wikipedia.org/wiki/COH04S1 "COH04S1") [DelNS1-2019-nCoV-RBD-OPT](https://en.wikipedia.org/wiki/DelNS1-2019-nCoV-RBD-OPT "DelNS1-2019-nCoV-RBD-OPT") [GRAd-COV2](https://en.wikipedia.org/wiki/GRAd-COV2 "GRAd-COV2") [ImmunityBio](https://en.wikipedia.org/wiki/ImmunityBio_COVID-19_vaccine "ImmunityBio COVID-19 vaccine") [iNCOVACC](https://en.wikipedia.org/wiki/INCOVACC "INCOVACC") [INNA-051](https://en.wikipedia.org/wiki/INNA-051 "INNA-051") [NDV-HXP-S](https://en.wikipedia.org/wiki/NDV-HXP-S "NDV-HXP-S") [Vaxart COVID-19 vaccine](https://en.wikipedia.org/wiki/Vaxart_COVID-19_vaccine "Vaxart COVID-19 vaccine") |
| [Virus-like particles](https://en.wikipedia.org/wiki/Virus-like_particle "Virus-like particle") | [ABNCoV2](https://en.wikipedia.org/wiki/ABNCoV2 "ABNCoV2") [LYB001](https://en.wikipedia.org/wiki/LYB001 "LYB001") [MigVax-101](https://en.wikipedia.org/wiki/MigVax-101 "MigVax-101") [VBI-2902](https://en.wikipedia.org/wiki/VBI-2902 "VBI-2902") |
| [Deployment by location](https://en.wikipedia.org/wiki/Deployment_of_COVID-19_vaccines "Deployment of COVID-19 vaccines") | |
| | |
| [Africa](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Africa "COVID-19 vaccination in Africa") | [Algeria](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Algeria "COVID-19 vaccination in Algeria") [Angola](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Angola "COVID-19 vaccination in Angola") [Botswana](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Botswana "COVID-19 vaccination in Botswana") [Burkina Faso](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Burkina_Faso "COVID-19 vaccination in Burkina Faso") [Burundi](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Burundi "COVID-19 vaccination in Burundi") [Cameroon](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Cameroon "COVID-19 vaccination in Cameroon") [Cape Verde](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Cape_Verde "COVID-19 vaccination in Cape Verde") [Cameroon](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Cameroon "COVID-19 vaccination in Cameroon") [Chad](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Chad "COVID-19 vaccination in Chad") [Comoros](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_the_Comoros "COVID-19 vaccination in the Comoros") [Democratic Republic of the Congo](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_the_Democratic_Republic_of_the_Congo "COVID-19 vaccination in the Democratic Republic of the Congo") [Djibouti](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Djibouti "COVID-19 vaccination in Djibouti") [Egypt](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Egypt "COVID-19 vaccination in Egypt") [Equatorial Guinea](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Equatorial_Guinea "COVID-19 vaccination in Equatorial Guinea") [Eswatini](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Eswatini "COVID-19 vaccination in Eswatini") [Ghana](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Ghana "COVID-19 vaccination in Ghana") [Morocco](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Morocco "COVID-19 vaccination in Morocco") [Nigeria](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Nigeria "COVID-19 vaccination in Nigeria") [Senegal](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Senegal "COVID-19 vaccination in Senegal") [South Africa](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_South_Africa "COVID-19 vaccination in South Africa") [Zimbabwe](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Zimbabwe "COVID-19 vaccination in Zimbabwe") |
| Asia | [Bangladesh](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Bangladesh "COVID-19 vaccination in Bangladesh") [Bhutan](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Bhutan "COVID-19 vaccination in Bhutan") [Mainland China](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_mainland_China "COVID-19 vaccination in mainland China") [India](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_India "COVID-19 vaccination in India") [Indonesia](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Indonesia "COVID-19 vaccination in Indonesia") [Iran](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Iran "COVID-19 vaccination in Iran") [Israel](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Israel "COVID-19 vaccination in Israel") [Japan](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Japan "COVID-19 vaccination in Japan") [Kazakhstan](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Kazakhstan "COVID-19 vaccination in Kazakhstan") [Malaysia](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Malaysia "COVID-19 vaccination in Malaysia") [Nepal](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Nepal "COVID-19 vaccination in Nepal") [Philippines](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_the_Philippines "COVID-19 vaccination in the Philippines") [Russia](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Russia "COVID-19 vaccination in Russia") [Singapore](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Singapore "COVID-19 vaccination in Singapore") [South Korea](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_South_Korea "COVID-19 vaccination in South Korea") [Sri Lanka](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Sri_Lanka "COVID-19 vaccination in Sri Lanka") [Taiwan](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Taiwan "COVID-19 vaccination in Taiwan") [Thailand](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Thailand "COVID-19 vaccination in Thailand") [Turkey](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Turkey "COVID-19 vaccination in Turkey") [United Arab Emirates](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_the_United_Arab_Emirates "COVID-19 vaccination in the United Arab Emirates") [Vietnam](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Vietnam "COVID-19 vaccination in Vietnam") |
| Europe | [Albania](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Albania "COVID-19 vaccination in Albania") [Bosnia and Herzegovina](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Bosnia_and_Herzegovina "COVID-19 vaccination in Bosnia and Herzegovina") [Bulgaria](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Bulgaria "COVID-19 vaccination in Bulgaria") [Croatia](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Croatia "COVID-19 vaccination in Croatia") [Denmark](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Denmark "COVID-19 vaccination in Denmark") [France](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_France "COVID-19 vaccination in France") [Germany](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Germany "COVID-19 vaccination in Germany") [Greece](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Greece "COVID-19 vaccination in Greece") [Hungary](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Hungary "COVID-19 vaccination in Hungary") [Iceland](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Iceland "COVID-19 vaccination in Iceland") [Ireland](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_the_Republic_of_Ireland "COVID-19 vaccination in the Republic of Ireland") [Italy](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Italy "COVID-19 vaccination in Italy") [Moldova](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Moldova "COVID-19 vaccination in Moldova") [Norway](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Norway "COVID-19 vaccination in Norway") [Portugal](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Portugal "COVID-19 vaccination in Portugal") [Romania](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Romania "COVID-19 vaccination in Romania") [Russia](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Russia "COVID-19 vaccination in Russia") [Spain](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Spain "COVID-19 vaccination in Spain") [Sweden](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Sweden "COVID-19 vaccination in Sweden") [Switzerland](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Switzerland "COVID-19 vaccination in Switzerland") [Ukraine](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Ukraine "COVID-19 vaccination in Ukraine") [United Kingdom](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_the_United_Kingdom "COVID-19 vaccination in the United Kingdom") |
| North America | [Canada](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Canada "COVID-19 vaccination in Canada") [Ontario](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Ontario "COVID-19 vaccination in Ontario") [Quebec](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Quebec "COVID-19 vaccination in Quebec") [Haiti](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Haiti "COVID-19 vaccination in Haiti") [Mexico](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Mexico "COVID-19 vaccination in Mexico") [United States](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_the_United_States "COVID-19 vaccination in the United States") [mandates](https://en.wikipedia.org/wiki/COVID-19_vaccination_mandates_in_the_United_States "COVID-19 vaccination mandates in the United States") |
| Oceania | [Australia](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Australia "COVID-19 vaccination in Australia") [Fiji](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Fiji "COVID-19 vaccination in Fiji") [New Zealand](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_New_Zealand "COVID-19 vaccination in New Zealand") |
| South America | [Argentina](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Argentina "COVID-19 vaccination in Argentina") [Brazil](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Brazil "COVID-19 vaccination in Brazil") [Colombia](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Colombia "COVID-19 vaccination in Colombia") [Peru](https://en.wikipedia.org/wiki/COVID-19_vaccination_in_Peru "COVID-19 vaccination in Peru") |
| Others | |
| [Treatment](https://en.wikipedia.org/wiki/Treatment_and_management_of_COVID-19 "Treatment and management of COVID-19") | |
| | |
| [Drug development](https://en.wikipedia.org/wiki/COVID-19_drug_development "COVID-19 drug development") [Drug repurposing research](https://en.wikipedia.org/wiki/COVID-19_drug_repurposing_research "COVID-19 drug repurposing research") [Baricitinib](https://en.wikipedia.org/wiki/Baricitinib "Baricitinib") [PANORAMIC trial](https://en.wikipedia.org/wiki/PANORAMIC_trial "PANORAMIC trial") (UK) [RECOVERY Trial](https://en.wikipedia.org/wiki/RECOVERY_Trial "RECOVERY Trial") (UK) [Solidarity trial](https://en.wikipedia.org/wiki/Solidarity_trial "Solidarity trial") (WHO) | |
| [Monoclonal antibodies](https://en.wikipedia.org/wiki/Monoclonal_antibody "Monoclonal antibody") | [Bamlanivimab/etesevimab](https://en.wikipedia.org/wiki/Bamlanivimab/etesevimab "Bamlanivimab/etesevimab") [Bamlanivimab](https://en.wikipedia.org/wiki/Bamlanivimab "Bamlanivimab") Etesevimab [Bebtelovimab](https://en.wikipedia.org/wiki/Bebtelovimab "Bebtelovimab") [Casirivimab/imdevimab](https://en.wikipedia.org/wiki/Casirivimab/imdevimab "Casirivimab/imdevimab") [Regdanvimab](https://en.wikipedia.org/wiki/Regdanvimab "Regdanvimab") [Sarilumab](https://en.wikipedia.org/wiki/Sarilumab "Sarilumab") [Sotrovimab](https://en.wikipedia.org/wiki/Sotrovimab "Sotrovimab") [Tixagevimab/cilgavimab](https://en.wikipedia.org/wiki/Tixagevimab/cilgavimab "Tixagevimab/cilgavimab") [Tocilizumab](https://en.wikipedia.org/wiki/Tocilizumab "Tocilizumab") |
| [Small molecule antivirals](https://en.wikipedia.org/wiki/Antiviral_drug "Antiviral drug") | [Broad-spectrum](https://en.wikipedia.org/wiki/Broad-spectrum_antiviral_drug "Broad-spectrum antiviral drug") [Ensitrelvir](https://en.wikipedia.org/wiki/Ensitrelvir "Ensitrelvir") [Molnupiravir](https://en.wikipedia.org/wiki/Molnupiravir "Molnupiravir") Co-packaged [Nirmatrelvir](https://en.wikipedia.org/wiki/Nirmatrelvir "Nirmatrelvir") [ritonavir](https://en.wikipedia.org/wiki/Nirmatrelvir/ritonavir "Nirmatrelvir/ritonavir") |
| [Variants](https://en.wikipedia.org/wiki/Variants_of_SARS-CoV-2 "Variants of SARS-CoV-2") | |
| | |
| Specific | [Alpha](https://en.wikipedia.org/wiki/SARS-CoV-2_Alpha_variant "SARS-CoV-2 Alpha variant") [Beta](https://en.wikipedia.org/wiki/SARS-CoV-2_Beta_variant "SARS-CoV-2 Beta variant") [Gamma](https://en.wikipedia.org/wiki/SARS-CoV-2_Gamma_variant "SARS-CoV-2 Gamma variant") [Delta](https://en.wikipedia.org/wiki/SARS-CoV-2_Delta_variant "SARS-CoV-2 Delta variant") [Epsilon](https://en.wikipedia.org/wiki/SARS-CoV-2_Epsilon_variant "SARS-CoV-2 Epsilon variant") [Zeta](https://en.wikipedia.org/wiki/SARS-CoV-2_Zeta_variant "SARS-CoV-2 Zeta variant") [Eta](https://en.wikipedia.org/wiki/SARS-CoV-2_Eta_variant "SARS-CoV-2 Eta variant") [Theta](https://en.wikipedia.org/wiki/SARS-CoV-2_Theta_variant "SARS-CoV-2 Theta variant") [Iota](https://en.wikipedia.org/wiki/SARS-CoV-2_Iota_variant "SARS-CoV-2 Iota variant") [Kappa](https://en.wikipedia.org/wiki/SARS-CoV-2_Kappa_variant "SARS-CoV-2 Kappa variant") [Lambda](https://en.wikipedia.org/wiki/SARS-CoV-2_Lambda_variant "SARS-CoV-2 Lambda variant") [Mu](https://en.wikipedia.org/wiki/SARS-CoV-2_Mu_variant "SARS-CoV-2 Mu variant") [Omicron](https://en.wikipedia.org/wiki/SARS-CoV-2_Omicron_variant "SARS-CoV-2 Omicron variant") [timeline](https://en.wikipedia.org/wiki/Timeline_of_the_SARS-CoV-2_Omicron_variant "Timeline of the SARS-CoV-2 Omicron variant") |
| General | [Cluster 5](https://en.wikipedia.org/wiki/Cluster_5 "Cluster 5") [Lineage B.1.617](https://en.wikipedia.org/wiki/SARS-CoV-2_lineage_B.1.617 "SARS-CoV-2 lineage B.1.617") [Variant of concern](https://en.wikipedia.org/wiki/SARS-CoV-2_variant_of_concern "SARS-CoV-2 variant of concern") |
| Institutions | |
| | |
| Hospitals and medical clinics | |
| | |
| Mainland China | [Central Hospital of Wuhan](https://en.wikipedia.org/wiki/Central_Hospital_of_Wuhan "Central Hospital of Wuhan") [Dabie Mountain Regional Medical Centre](https://en.wikipedia.org/wiki/Dabie_Mountain_Regional_Medical_Centre "Dabie Mountain Regional Medical Centre") [Fangcang hospitals](https://en.wikipedia.org/wiki/Fangcang_hospital "Fangcang hospital") [Huoshenshan Hospital](https://en.wikipedia.org/wiki/Huoshenshan_Hospital "Huoshenshan Hospital") [Leishenshan Hospital](https://en.wikipedia.org/wiki/Leishenshan_Hospital "Leishenshan Hospital") [Xinjia Express Hotel](https://en.wikipedia.org/wiki/Collapse_of_Xinjia_Express_Hotel "Collapse of Xinjia Express Hotel") [Wuhan Jinyintan Hospital](https://en.wikipedia.org/wiki/Wuhan_Jinyintan_Hospital "Wuhan Jinyintan Hospital") |
| Others | [Hospital ships](https://en.wikipedia.org/wiki/Hospital_ships_designated_for_the_COVID-19_pandemic "Hospital ships designated for the COVID-19 pandemic") [Garran Surge Centre](https://en.wikipedia.org/wiki/Garran_Surge_Centre "Garran Surge Centre") (Australia) [Hospital El Salvador](https://en.wikipedia.org/wiki/Hospital_El_Salvador "Hospital El Salvador") [Kemayoran Athletes Village](https://en.wikipedia.org/wiki/Kemayoran_Athletes_Village "Kemayoran Athletes Village") (Indonesia) [Pyongyang General Hospital](https://en.wikipedia.org/wiki/Pyongyang_General_Hospital "Pyongyang General Hospital") (North Korea) [Malaysia Agro Exposition Park Serdang](https://en.wikipedia.org/wiki/Malaysia_Agro_Exposition_Park_Serdang "Malaysia Agro Exposition Park Serdang") (Malaysia) [Mega Ligtas COVID Centers](https://en.wikipedia.org/wiki/Mega_Ligtas_COVID_Centers "Mega Ligtas COVID Centers") (Philippines) [Kandakadu Treatment and Rehabilitation Centre](https://en.wikipedia.org/wiki/Kandakadu_Treatment_and_Rehabilitation_Centre "Kandakadu Treatment and Rehabilitation Centre") (Sri Lanka) [Sancaktepe Prof. Dr. Feriha Öz Emergency Hospital](https://en.wikipedia.org/wiki/Sancaktepe_Prof._Dr._Feriha_%C3%96z_Emergency_Hospital "Sancaktepe Prof. Dr. Feriha Öz Emergency Hospital") (Turkey) [Yeşilköy Prof. Dr. Murat Dilmener Emergency Hospital](https://en.wikipedia.org/wiki/Ye%C5%9Filk%C3%B6y_Prof._Dr._Murat_Dilmener_Emergency_Hospital "Yeşilköy Prof. Dr. Murat Dilmener Emergency Hospital") (Turkey) [COVID-19 hospitals in the United Kingdom](https://en.wikipedia.org/wiki/COVID-19_hospitals_in_the_United_Kingdom "COVID-19 hospitals in the United Kingdom") [Birmingham](https://en.wikipedia.org/wiki/NHS_Nightingale_Hospital_Birmingham "NHS Nightingale Hospital Birmingham") [London](https://en.wikipedia.org/wiki/NHS_Nightingale_Hospital_London "NHS Nightingale Hospital London") [North East](https://en.wikipedia.org/wiki/NHS_Nightingale_Hospital_North_East "NHS Nightingale Hospital North East") [North West](https://en.wikipedia.org/wiki/NHS_Nightingale_Hospital_North_West "NHS Nightingale Hospital North West") [Yorkshire and the Humber](https://en.wikipedia.org/wiki/NHS_Nightingale_Hospital_Yorkshire_and_the_Humber "NHS Nightingale Hospital Yorkshire and the Humber") [NHS Louisa Jordan](https://en.wikipedia.org/wiki/NHS_Louisa_Jordan "NHS Louisa Jordan") (Scotland) [Dragon's Heart Hospital](https://en.wikipedia.org/wiki/Dragon%27s_Heart_Hospital "Dragon's Heart Hospital") (Wales) |
| Organizations | |
| | |
| [National Cabinet](https://en.wikipedia.org/wiki/National_Cabinet_\(Australia\) "National Cabinet (Australia)") (Australia) [ScienceUpFirst](https://en.wikipedia.org/wiki/ScienceUpFirst "ScienceUpFirst") (Canada) [Wuhan Institute of Virology](https://en.wikipedia.org/wiki/Wuhan_Institute_of_Virology "Wuhan Institute of Virology") (China) [Independent SAGE](https://en.wikipedia.org/wiki/Independent_SAGE "Independent SAGE") (United Kingdom) | |
| Health institutes | [Africa Centres for Disease Control and Prevention](https://en.wikipedia.org/wiki/Africa_Centres_for_Disease_Control_and_Prevention "Africa Centres for Disease Control and Prevention") (African Union) [Ghana Infectious Disease Centre](https://en.wikipedia.org/wiki/Ghana_Infectious_Disease_Centre "Ghana Infectious Disease Centre") (Ghana) [Department of Health (Hong Kong)](https://en.wikipedia.org/wiki/Department_of_Health_\(Hong_Kong\) "Department of Health (Hong Kong)") [Korea Disease Control and Prevention Agency](https://en.wikipedia.org/wiki/Korea_Disease_Control_and_Prevention_Agency "Korea Disease Control and Prevention Agency") (South Korea) [National Institute for Communicable Diseases](https://en.wikipedia.org/wiki/National_Institute_for_Communicable_Diseases "National Institute for Communicable Diseases") (South Africa) [Taiwan Centers for Disease Control](https://en.wikipedia.org/wiki/Taiwan_Centers_for_Disease_Control "Taiwan Centers for Disease Control") (Taiwan) |
| Pandemic institutes | [National COVID-19 Commission Advisory Board](https://en.wikipedia.org/wiki/National_COVID-19_Commission_Advisory_Board "National COVID-19 Commission Advisory Board") (Australia) [COVID-19 Immunity Task Force](https://en.wikipedia.org/wiki/COVID-19_Immunity_Task_Force "COVID-19 Immunity Task Force") (Canada) [COVID-19 Supply Council](https://en.wikipedia.org/wiki/COVID-19_Supply_Council "COVID-19 Supply Council") (Canada) [PREPARE](https://en.wikipedia.org/wiki/PREPARE "PREPARE") (European Union) [National Expert Group on Vaccine Administration for COVID-19](https://en.wikipedia.org/wiki/National_Expert_Group_on_Vaccine_Administration_for_COVID-19 "National Expert Group on Vaccine Administration for COVID-19") (India) [COVID-19 Response Acceleration Task Force](https://en.wikipedia.org/wiki/COVID-19_Response_Acceleration_Task_Force "COVID-19 Response Acceleration Task Force") (Indonesia) [National Public Health Emergency Team](https://en.wikipedia.org/wiki/National_Public_Health_Emergency_Team_\(2020\) "National Public Health Emergency Team (2020)") (Ireland) [Novel Coronavirus Expert Meeting](https://en.wikipedia.org/wiki/Novel_Coronavirus_Expert_Meeting "Novel Coronavirus Expert Meeting") (Japan) [Crisis Preparedness and Response Centre](https://en.wikipedia.org/wiki/Crisis_Preparedness_and_Response_Centre "Crisis Preparedness and Response Centre") (Malaysia) [Defeat COVID-19 Ad Hoc Committee](https://en.wikipedia.org/wiki/Defeat_COVID-19_Ad_Hoc_Committee "Defeat COVID-19 Ad Hoc Committee") (Philippines) [Inter-Agency Task Force for the Management of Emerging Infectious Diseases](https://en.wikipedia.org/wiki/Inter-Agency_Task_Force_for_the_Management_of_Emerging_Infectious_Diseases "Inter-Agency Task Force for the Management of Emerging Infectious Diseases") (Philippines) [Central Epidemic Command Center](https://en.wikipedia.org/wiki/Central_Epidemic_Command_Center "Central Epidemic Command Center") (Taiwan) [Coronavirus Scientific Advisory Board](https://en.wikipedia.org/wiki/Coronavirus_Scientific_Advisory_Board "Coronavirus Scientific Advisory Board") (Turkey) [COVID-19 Genomics UK Consortium](https://en.wikipedia.org/wiki/COVID-19_Genomics_UK_Consortium "COVID-19 Genomics UK Consortium") (United Kingdom) [Imperial College COVID-19 Response Team](https://en.wikipedia.org/wiki/Imperial_College_COVID-19_Response_Team "Imperial College COVID-19 Response Team") (United Kingdom) [Joint Biosecurity Centre](https://en.wikipedia.org/wiki/Joint_Biosecurity_Centre "Joint Biosecurity Centre") (United Kingdom) [Vaccine Taskforce](https://en.wikipedia.org/wiki/Vaccine_Taskforce "Vaccine Taskforce") (United Kingdom) [COVID-19 Advisory Board](https://en.wikipedia.org/wiki/COVID-19_Advisory_Board "COVID-19 Advisory Board") (United States) [Great American Economic Revival Industry Groups](https://en.wikipedia.org/wiki/Great_American_Economic_Revival_Industry_Groups "Great American Economic Revival Industry Groups") (United States) [White House Coronavirus Task Force](https://en.wikipedia.org/wiki/White_House_Coronavirus_Task_Force "White House Coronavirus Task Force") (United States) [White House COVID-19 Response Team](https://en.wikipedia.org/wiki/White_House_COVID-19_Response_Team "White House COVID-19 Response Team") (United States) [GACH](https://en.wikipedia.org/wiki/GACH "GACH") (Uruguay) |
| Relief funds | [PM CARES Fund](https://en.wikipedia.org/wiki/PM_CARES_Fund "PM CARES Fund") (India) [Artist Relief](https://en.wikipedia.org/wiki/Artist_Relief "Artist Relief") (United States) |
| People | |
| | |
| Medical professionals | [Ai Fen](https://en.wikipedia.org/wiki/Ai_Fen "Ai Fen") [Corona Rintawan](https://en.wikipedia.org/wiki/Corona_Rintawan "Corona Rintawan") [Li Wenliang](https://en.wikipedia.org/wiki/Li_Wenliang "Li Wenliang") [Liu Wen](https://en.wikipedia.org/wiki/Liu_Wen_\(doctor\) "Liu Wen (doctor)") [Xie Linka](https://en.wikipedia.org/wiki/Xie_Linka "Xie Linka") [Zhang Wenhong](https://en.wikipedia.org/wiki/Zhang_Wenhong "Zhang Wenhong") |
| [Researchers](https://en.wikipedia.org/wiki/Category:Coronavirus_researchers "Category:Coronavirus researchers") | [Awang Bulgiba Awang Mahmud](https://en.wikipedia.org/wiki/Awang_Bulgiba_Awang_Mahmud "Awang Bulgiba Awang Mahmud") [Roberto Burioni](https://en.wikipedia.org/wiki/Roberto_Burioni "Roberto Burioni") [Chen Wei](https://en.wikipedia.org/wiki/Chen_Wei_\(medical_scientist\) "Chen Wei (medical scientist)") [Kizzmekia Corbett](https://en.wikipedia.org/wiki/Kizzmekia_Corbett "Kizzmekia Corbett") [Andrea Crisanti](https://en.wikipedia.org/wiki/Andrea_Crisanti_\(scientist\) "Andrea Crisanti (scientist)") [Peter Daszak](https://en.wikipedia.org/wiki/Peter_Daszak "Peter Daszak") [Christian Drosten](https://en.wikipedia.org/wiki/Christian_Drosten "Christian Drosten") [Neil Ferguson](https://en.wikipedia.org/wiki/Neil_Ferguson_\(epidemiologist\) "Neil Ferguson (epidemiologist)") [Dale Fisher](https://en.wikipedia.org/wiki/Dale_Fisher "Dale Fisher") [George F. Gao](https://en.wikipedia.org/wiki/George_F._Gao "George F. Gao") [Azra Ghani](https://en.wikipedia.org/wiki/Azra_Ghani "Azra Ghani") [Sarah Gilbert](https://en.wikipedia.org/wiki/Sarah_Gilbert "Sarah Gilbert") [Guan Yi](https://en.wikipedia.org/wiki/Guan_Yi "Guan Yi") [Kentaro Iwata](https://en.wikipedia.org/wiki/Kentaro_Iwata "Kentaro Iwata") [Katalin Karikó](https://en.wikipedia.org/wiki/Katalin_Karik%C3%B3 "Katalin Karikó") [Matt Keeling](https://en.wikipedia.org/wiki/Matt_Keeling "Matt Keeling") [Trudie Lang](https://en.wikipedia.org/wiki/Trudie_Lang "Trudie Lang") [Li Lanjuan](https://en.wikipedia.org/wiki/Li_Lanjuan "Li Lanjuan") [W. Ian Lipkin](https://en.wikipedia.org/wiki/W._Ian_Lipkin "W. Ian Lipkin") [Ma Xiaowei](https://en.wikipedia.org/wiki/Ma_Xiaowei "Ma Xiaowei") [Shabir Madhi](https://en.wikipedia.org/wiki/Shabir_Madhi "Shabir Madhi") [Allison McGeer](https://en.wikipedia.org/wiki/Allison_McGeer "Allison McGeer") [Camilla Rothe](https://en.wikipedia.org/wiki/Camilla_Rothe "Camilla Rothe") [Shi Zhengli](https://en.wikipedia.org/wiki/Shi_Zhengli "Shi Zhengli") [Moncef Slaoui](https://en.wikipedia.org/wiki/Moncef_Slaoui "Moncef Slaoui") [Mike Tildesley](https://en.wikipedia.org/wiki/Mike_Tildesley "Mike Tildesley") [John Todd](https://en.wikipedia.org/wiki/John_Todd_\(British_biologist\) "John Todd (British biologist)") [Wang Chen](https://en.wikipedia.org/wiki/Wang_Chen_\(physician\) "Wang Chen (physician)") [Wang Guangfa](https://en.wikipedia.org/wiki/Wang_Guangfa "Wang Guangfa") [Drew Weissman](https://en.wikipedia.org/wiki/Drew_Weissman "Drew Weissman") [Yuen Kwok-yung](https://en.wikipedia.org/wiki/Yuen_Kwok-yung "Yuen Kwok-yung") [Zeng Guang](https://en.wikipedia.org/wiki/Zeng_Guang "Zeng Guang") [Zhang Jixian](https://en.wikipedia.org/wiki/Zhang_Jixian "Zhang Jixian") [Zhang Yongzhen](https://en.wikipedia.org/wiki/Zhang_Yongzhen "Zhang Yongzhen") [Zhong Nanshan](https://en.wikipedia.org/wiki/Zhong_Nanshan "Zhong Nanshan") |
| Officials | |
| | |
| WHO | [Tedros Adhanom](https://en.wikipedia.org/wiki/Tedros_Adhanom_Ghebreyesus "Tedros Adhanom Ghebreyesus") (Director-General of the WHO) [Bruce Aylward](https://en.wikipedia.org/wiki/Bruce_Aylward "Bruce Aylward") (Team lead of WHO-China COVID-19 mission) [Maria Van Kerkhove](https://en.wikipedia.org/wiki/Maria_Van_Kerkhove "Maria Van Kerkhove") (Technical Lead for COVID-19 response) [Michael J. Ryan](https://en.wikipedia.org/wiki/Michael_J._Ryan_\(doctor\) "Michael J. Ryan (doctor)") (Executive Director of the WHO Health Emergencies Programme) |
| By location | [Frank Atherton](https://en.wikipedia.org/wiki/Frank_Atherton "Frank Atherton") (Wales) [Ashley Bloomfield](https://en.wikipedia.org/wiki/Ashley_Bloomfield "Ashley Bloomfield") (New Zealand) [Catherine Calderwood](https://en.wikipedia.org/wiki/Catherine_Calderwood "Catherine Calderwood") (Scotland) [Chang Shan-chwen](https://en.wikipedia.org/wiki/Chang_Shan-chwen "Chang Shan-chwen") (Taiwan) [Anutin Charnvirakul](https://en.wikipedia.org/wiki/Anutin_Charnvirakul "Anutin Charnvirakul") (Thailand) [Chen Shih-chung](https://en.wikipedia.org/wiki/Chen_Shih-chung "Chen Shih-chung") (Taiwan) [Kenneth Chuang Yin-ching](https://en.wikipedia.org/wiki/Chuang_Yin-ching "Chuang Yin-ching") (Taiwan) [Victor Costache](https://en.wikipedia.org/wiki/Victor_Costache "Victor Costache") (Romania) [Fabrizio Curcio](https://en.wikipedia.org/wiki/Fabrizio_Curcio "Fabrizio Curcio") (Italy) [Carmen Deseda](https://en.wikipedia.org/wiki/Carmen_Deseda "Carmen Deseda") (Puerto Rico) [Jaap van Dissel](https://en.wikipedia.org/wiki/Jaap_van_Dissel "Jaap van Dissel") (the Netherlands) [Christian Drosten](https://en.wikipedia.org/wiki/Christian_Drosten "Christian Drosten") (Germany) [Francisco Duque III](https://en.wikipedia.org/wiki/Francisco_Duque_III "Francisco Duque III") (Philippines) [Anthony Fauci](https://en.wikipedia.org/wiki/Anthony_Fauci "Anthony Fauci") (United States) [Francesco Paolo Figliuolo](https://en.wikipedia.org/wiki/Francesco_Paolo_Figliuolo "Francesco Paolo Figliuolo") (Italy) [Graça Freitas](https://en.wikipedia.org/wiki/Gra%C3%A7a_Freitas "Graça Freitas") (Portugal) [Henrique Gouveia e Melo](https://en.wikipedia.org/wiki/Henrique_Gouveia_e_Melo "Henrique Gouveia e Melo") (Portugal) [Matt Hancock](https://en.wikipedia.org/wiki/Matt_Hancock "Matt Hancock") (United Kingdom) [Hamad Hasan](https://en.wikipedia.org/wiki/Hamad_Hasan "Hamad Hasan") (Lebanon) [Greg Hunt](https://en.wikipedia.org/wiki/Greg_Hunt "Greg Hunt") (Australia) [Tony Holohan](https://en.wikipedia.org/wiki/Tony_Holohan "Tony Holohan") (Ireland) [Jeong Eun-kyeong](https://en.wikipedia.org/wiki/Jeong_Eun-kyeong "Jeong Eun-kyeong") (South Korea) [Fahrettin Koca](https://en.wikipedia.org/wiki/Fahrettin_Koca "Fahrettin Koca") (Turkey) [Li Keqiang](https://en.wikipedia.org/wiki/Li_Keqiang "Li Keqiang") (China) [Hugo López-Gatell Ramírez](https://en.wikipedia.org/wiki/Hugo_L%C3%B3pez-Gatell_Ram%C3%ADrez "Hugo López-Gatell Ramírez") (Mexico) [Michael McBride](https://en.wikipedia.org/wiki/Michael_McBride_\(doctor\) "Michael McBride (doctor)") (Northern Ireland) [Oriol Mitjà](https://en.wikipedia.org/wiki/Oriol_Mitj%C3%A0 "Oriol Mitjà") (Andorra) [Zweli Mkhize](https://en.wikipedia.org/wiki/Zweli_Mkhize "Zweli Mkhize") (South Africa) [Doni Monardo](https://en.wikipedia.org/wiki/Doni_Monardo "Doni Monardo") (Indonesia) [Alma Möller](https://en.wikipedia.org/wiki/Alma_M%C3%B6ller "Alma Möller") (Iceland) [Saeed Namaki](https://en.wikipedia.org/wiki/Saeed_Namaki "Saeed Namaki") (Iran) [Ala Nemerenco](https://en.wikipedia.org/wiki/Ala_Nemerenco "Ala Nemerenco") (Moldova) [Nguyễn Thanh Long](https://en.wikipedia.org/wiki/Nguy%E1%BB%85n_Thanh_Long "Nguyễn Thanh Long") (Vietnam) [Noor Hisham Abdullah](https://en.wikipedia.org/wiki/Noor_Hisham_Abdullah "Noor Hisham Abdullah") (Malaysia) [Ali Pilli](https://en.wikipedia.org/wiki/Ali_Pilli "Ali Pilli") (Northern Cyprus) [Daniel Salinas](https://en.wikipedia.org/wiki/Daniel_Salinas "Daniel Salinas") (Uruguay) [Jérôme Salomon](https://en.wikipedia.org/wiki/J%C3%A9r%C3%B4me_Salomon "Jérôme Salomon") (France) [Fernando Simón](https://en.wikipedia.org/wiki/Fernando_Sim%C3%B3n "Fernando Simón") (Spain) [Gregor Smith](https://en.wikipedia.org/wiki/Gregor_Smith "Gregor Smith") (Scotland) [Su Ih-jen](https://en.wikipedia.org/wiki/Su_Ih-jen "Su Ih-jen") (Taiwan) [Łukasz Szumowski](https://en.wikipedia.org/wiki/%C5%81ukasz_Szumowski "Łukasz Szumowski") (Poland) [Theresa Tam](https://en.wikipedia.org/wiki/Theresa_Tam "Theresa Tam") (Canada) [Anders Tegnell](https://en.wikipedia.org/wiki/Anders_Tegnell "Anders Tegnell") (Sweden) [Þórólfur Guðnason](https://en.wikipedia.org/wiki/%C3%9E%C3%B3r%C3%B3lfur_Gu%C3%B0nason "Þórólfur Guðnason") (Iceland) [Sotiris Tsiodras](https://en.wikipedia.org/wiki/Sotiris_Tsiodras "Sotiris Tsiodras") (Greece) [Harsh Vardhan](https://en.wikipedia.org/wiki/Harsh_Vardhan_\(Delhi_politician\) "Harsh Vardhan (Delhi politician)") (India) [Víðir Reynisson](https://en.wikipedia.org/wiki/V%C3%AD%C3%B0ir_Reynisson "Víðir Reynisson") (Iceland) [Carla Vizzotti](https://en.wikipedia.org/wiki/Carla_Vizzotti "Carla Vizzotti") (Argentina) [Vlad Voiculescu](https://en.wikipedia.org/wiki/Vlad_Voiculescu "Vlad Voiculescu") (Romania) [Chris Whitty](https://en.wikipedia.org/wiki/Chris_Whitty "Chris Whitty") (United Kingdom) [Lawrence Wong](https://en.wikipedia.org/wiki/Lawrence_Wong "Lawrence Wong") (Singapore) [Jeff Zients](https://en.wikipedia.org/wiki/Jeff_Zients "Jeff Zients") (United States) |
| Others | [Chen Qiushi](https://en.wikipedia.org/wiki/Chen_Qiushi "Chen Qiushi") [Brett Crozier](https://en.wikipedia.org/wiki/Brett_Crozier "Brett Crozier") [Fang Bin](https://en.wikipedia.org/wiki/Fang_Bin "Fang Bin") [Fang Fang](https://en.wikipedia.org/wiki/Fang_Fang "Fang Fang") [Joseph Ashitey Hammond](https://en.wikipedia.org/wiki/Joseph_Ashitey_Hammond "Joseph Ashitey Hammond") [Li Zehua](https://en.wikipedia.org/wiki/Li_Zehua "Li Zehua") [Captain Tom Moore](https://en.wikipedia.org/wiki/Captain_Tom_Moore "Captain Tom Moore") [Qiu Menghuang](https://en.wikipedia.org/wiki/Qiu_Menghuang "Qiu Menghuang") [Ren Zhiqiang](https://en.wikipedia.org/wiki/Ren_Zhiqiang "Ren Zhiqiang") |
| [List of deaths due to COVID-19](https://en.wikipedia.org/wiki/List_of_deaths_due_to_COVID-19 "List of deaths due to COVID-19") | |
| Data (templates) | |
| | |
| Global | WHO situation reports [cases](https://en.wikipedia.org/wiki/COVID-19_pandemic_cases "COVID-19 pandemic cases") [deaths](https://en.wikipedia.org/wiki/COVID-19_pandemic_deaths "COVID-19 pandemic deaths") [World map by countries: confirmed per capita](https://en.wikipedia.org/wiki/COVID-19_pandemic "COVID-19 pandemic") |
| Asia | [Armenia](https://en.wikipedia.org/wiki/Template:COVID-19_pandemic_data/Armenia_medical_cases_chart "Template:COVID-19 pandemic data/Armenia medical cases chart") [Artsakh](https://en.wikipedia.org/wiki/Template:COVID-19_pandemic_data/Republic_of_Artsakh_medical_cases_chart "Template:COVID-19 pandemic data/Republic of Artsakh medical cases chart") China [confirmed per capita](https://en.wikipedia.org/wiki/Template:COVID-19_pandemic_data/Mainland_China_medical_cases_map_\(dots\) "Template:COVID-19 pandemic data/Mainland China medical cases map (dots)") |
| [v](https://en.wikipedia.org/wiki/Template:Respiratory_pathology "Template:Respiratory pathology") [t](https://en.wikipedia.org/wiki/Template_talk:Respiratory_pathology "Template talk:Respiratory pathology") [e](https://en.wikipedia.org/wiki/Special:EditPage/Template:Respiratory_pathology "Special:EditPage/Template:Respiratory pathology")[Diseases of the respiratory system](https://en.wikipedia.org/wiki/Respiratory_disease "Respiratory disease") | |
|---|---|
| [Upper RT](https://en.wikipedia.org/wiki/Upper_respiratory_tract_infection "Upper respiratory tract infection") (including [URTIs](https://en.wikipedia.org/wiki/Upper_respiratory_tract_infection "Upper respiratory tract infection"), [common cold](https://en.wikipedia.org/wiki/Common_cold "Common cold")) | |
| | |
| [Head](https://en.wikipedia.org/wiki/Human_head "Human head") | *[sinuses](https://en.wikipedia.org/wiki/Paranasal_sinuses "Paranasal sinuses")* [Sinusitis](https://en.wikipedia.org/wiki/Sinusitis "Sinusitis") *[nose](https://en.wikipedia.org/wiki/Human_nose "Human nose")* [Rhinitis](https://en.wikipedia.org/wiki/Rhinitis "Rhinitis") [Vasomotor rhinitis](https://en.wikipedia.org/wiki/Nonallergic_rhinitis "Nonallergic rhinitis") [Atrophic rhinitis](https://en.wikipedia.org/wiki/Chronic_atrophic_rhinitis "Chronic atrophic rhinitis") [Hay fever](https://en.wikipedia.org/wiki/Allergic_rhinitis "Allergic rhinitis") [Nasal polyp](https://en.wikipedia.org/wiki/Nasal_polyp "Nasal polyp") [Rhinorrhea](https://en.wikipedia.org/wiki/Rhinorrhea "Rhinorrhea") *[nasal septum](https://en.wikipedia.org/wiki/Nasal_septum "Nasal septum")* [Nasal septum deviation](https://en.wikipedia.org/wiki/Nasal_septum_deviation "Nasal septum deviation") [Nasal septum perforation](https://en.wikipedia.org/wiki/Nasal_septum_perforation "Nasal septum perforation") [Cocaine-induced midline destructive lesions](https://en.wikipedia.org/wiki/Cocaine-induced_midline_destructive_lesions "Cocaine-induced midline destructive lesions") (CIMDL) [Nasal septal hematoma](https://en.wikipedia.org/wiki/Nasal_septal_hematoma "Nasal septal hematoma") *[tonsil](https://en.wikipedia.org/wiki/Tonsil "Tonsil")* [Tonsillitis](https://en.wikipedia.org/wiki/Tonsillitis "Tonsillitis") [Adenoid hypertrophy](https://en.wikipedia.org/wiki/Adenoid_hypertrophy "Adenoid hypertrophy") [Peritonsillar abscess](https://en.wikipedia.org/wiki/Peritonsillar_abscess "Peritonsillar abscess") |
| [Neck](https://en.wikipedia.org/wiki/Neck "Neck") | *[pharynx](https://en.wikipedia.org/wiki/Pharynx "Pharynx")* [Pharyngitis](https://en.wikipedia.org/wiki/Pharyngitis "Pharyngitis") [Strep throat](https://en.wikipedia.org/wiki/Streptococcal_pharyngitis "Streptococcal pharyngitis") [Laryngopharyngeal reflux](https://en.wikipedia.org/wiki/Laryngopharyngeal_reflux "Laryngopharyngeal reflux") (LPR) [Retropharyngeal abscess](https://en.wikipedia.org/wiki/Retropharyngeal_abscess "Retropharyngeal abscess") *[larynx](https://en.wikipedia.org/wiki/Larynx "Larynx")* [Croup](https://en.wikipedia.org/wiki/Croup "Croup") [Laryngomalacia](https://en.wikipedia.org/wiki/Laryngomalacia "Laryngomalacia") [Laryngeal cyst](https://en.wikipedia.org/wiki/Laryngeal_cyst "Laryngeal cyst") [Laryngitis](https://en.wikipedia.org/wiki/Laryngitis "Laryngitis") [Laryngopharyngeal reflux](https://en.wikipedia.org/wiki/Laryngopharyngeal_reflux "Laryngopharyngeal reflux") (LPR) [Laryngospasm](https://en.wikipedia.org/wiki/Laryngospasm "Laryngospasm") *[vocal cords](https://en.wikipedia.org/wiki/Vocal_cords "Vocal cords")* [Laryngopharyngeal reflux](https://en.wikipedia.org/wiki/Laryngopharyngeal_reflux "Laryngopharyngeal reflux") (LPR) [Vocal fold nodule](https://en.wikipedia.org/wiki/Vocal_cord_nodule "Vocal cord nodule") [Vocal fold paresis](https://en.wikipedia.org/wiki/Vocal_cord_paresis "Vocal cord paresis") [Vocal cord dysfunction](https://en.wikipedia.org/wiki/Vocal_cord_dysfunction "Vocal cord dysfunction") *[epiglottis](https://en.wikipedia.org/wiki/Epiglottis "Epiglottis")* [Epiglottitis](https://en.wikipedia.org/wiki/Epiglottitis "Epiglottitis") *[trachea](https://en.wikipedia.org/wiki/Trachea "Trachea")* [Tracheitis](https://en.wikipedia.org/wiki/Tracheitis "Tracheitis") [Laryngotracheal stenosis](https://en.wikipedia.org/wiki/Laryngotracheal_stenosis "Laryngotracheal stenosis") |
| [Lower RT](https://en.wikipedia.org/wiki/Lower_respiratory_tract "Lower respiratory tract")/ [lung disease](https://en.wikipedia.org/wiki/Respiratory_disease "Respiratory disease") (including [LRTIs](https://en.wikipedia.org/wiki/Lower_respiratory_tract_infection "Lower respiratory tract infection")) | |
| | |
| [Bronchial](https://en.wikipedia.org/wiki/Bronchus "Bronchus")/ [obstructive](https://en.wikipedia.org/wiki/Obstructive_lung_disease "Obstructive lung disease") | *acute* [Acute bronchitis](https://en.wikipedia.org/wiki/Acute_bronchitis "Acute bronchitis") *chronic* [COPD](https://en.wikipedia.org/wiki/Chronic_obstructive_pulmonary_disease "Chronic obstructive pulmonary disease") [Chronic bronchitis](https://en.wikipedia.org/wiki/Bronchitis#Chronic_bronchitis "Bronchitis") [Acute exacerbation of COPD](https://en.wikipedia.org/wiki/Acute_exacerbation_of_chronic_obstructive_pulmonary_disease "Acute exacerbation of chronic obstructive pulmonary disease")) [Asthma](https://en.wikipedia.org/wiki/Asthma "Asthma") ([Status asthmaticus](https://en.wikipedia.org/wiki/Status_asthmaticus "Status asthmaticus") [AERD](https://en.wikipedia.org/wiki/Aspirin-exacerbated_respiratory_disease "Aspirin-exacerbated respiratory disease") [Exercise-induced](https://en.wikipedia.org/wiki/Exercise-induced_asthma "Exercise-induced asthma") [Bronchiectasis](https://en.wikipedia.org/wiki/Bronchiectasis "Bronchiectasis") [Cystic fibrosis](https://en.wikipedia.org/wiki/Cystic_fibrosis "Cystic fibrosis") *unspecified* [Bronchitis](https://en.wikipedia.org/wiki/Bronchitis "Bronchitis") [Bronchiolitis](https://en.wikipedia.org/wiki/Bronchiolitis "Bronchiolitis") [Bronchiolitis obliterans](https://en.wikipedia.org/wiki/Bronchiolitis_obliterans "Bronchiolitis obliterans") [Diffuse panbronchiolitis](https://en.wikipedia.org/wiki/Diffuse_panbronchiolitis "Diffuse panbronchiolitis") |
| [Interstitial](https://en.wikipedia.org/wiki/Interstitial_lung_disease "Interstitial lung disease")/ [restrictive](https://en.wikipedia.org/wiki/Restrictive_lung_disease "Restrictive lung disease") ([fibrosis](https://en.wikipedia.org/wiki/Pulmonary_fibrosis "Pulmonary fibrosis")) | |
| | |
| External agents/ [occupational](https://en.wikipedia.org/wiki/Occupational_disease "Occupational disease") [lung disease](https://en.wikipedia.org/wiki/Occupational_lung_disease "Occupational lung disease") | [Pneumoconiosis](https://en.wikipedia.org/wiki/Pneumoconiosis "Pneumoconiosis") [Aluminosis](https://en.wikipedia.org/wiki/Aluminosis "Aluminosis") [Asbestosis](https://en.wikipedia.org/wiki/Asbestosis "Asbestosis") [Baritosis](https://en.wikipedia.org/wiki/Baritosis "Baritosis") [Bauxite fibrosis](https://en.wikipedia.org/wiki/Bauxite_fibrosis "Bauxite fibrosis") [Berylliosis](https://en.wikipedia.org/wiki/Berylliosis "Berylliosis") [Caplan's syndrome](https://en.wikipedia.org/wiki/Caplan%27s_syndrome "Caplan's syndrome") [Chalicosis](https://en.wikipedia.org/wiki/Chalicosis "Chalicosis") [Coalworker's pneumoconiosis](https://en.wikipedia.org/wiki/Coalworker%27s_pneumoconiosis "Coalworker's pneumoconiosis") [Siderosis](https://en.wikipedia.org/wiki/Siderosis "Siderosis") [Silicosis](https://en.wikipedia.org/wiki/Silicosis "Silicosis") [Talcosis](https://en.wikipedia.org/wiki/Pulmonary_talcosis "Pulmonary talcosis") [Byssinosis](https://en.wikipedia.org/wiki/Byssinosis "Byssinosis") [Hypersensitivity pneumonitis](https://en.wikipedia.org/wiki/Hypersensitivity_pneumonitis "Hypersensitivity pneumonitis") [Bagassosis](https://en.wikipedia.org/wiki/Bagassosis "Bagassosis") [Bird fancier's lung](https://en.wikipedia.org/wiki/Bird_fancier%27s_lung "Bird fancier's lung") [Farmer's lung](https://en.wikipedia.org/wiki/Farmer%27s_lung "Farmer's lung") [Lycoperdonosis](https://en.wikipedia.org/wiki/Lycoperdonosis "Lycoperdonosis") |
| Other | [ARDS](https://en.wikipedia.org/wiki/Acute_respiratory_distress_syndrome "Acute respiratory distress syndrome") [Combined pulmonary fibrosis and emphysema](https://en.wikipedia.org/wiki/Combined_pulmonary_fibrosis_and_emphysema "Combined pulmonary fibrosis and emphysema") [Pulmonary edema](https://en.wikipedia.org/wiki/Pulmonary_edema "Pulmonary edema") [Löffler's syndrome](https://en.wikipedia.org/wiki/L%C3%B6ffler%27s_syndrome "Löffler's syndrome")/[Eosinophilic pneumonia](https://en.wikipedia.org/wiki/Eosinophilic_pneumonia "Eosinophilic pneumonia") [Respiratory hypersensitivity](https://en.wikipedia.org/wiki/Respiratory_hypersensitivity "Respiratory hypersensitivity") [Allergic bronchopulmonary aspergillosis](https://en.wikipedia.org/wiki/Allergic_bronchopulmonary_aspergillosis "Allergic bronchopulmonary aspergillosis") [Hamman–Rich syndrome](https://en.wikipedia.org/wiki/Hamman%E2%80%93Rich_syndrome "Hamman–Rich syndrome") [Idiopathic pulmonary fibrosis](https://en.wikipedia.org/wiki/Idiopathic_pulmonary_fibrosis "Idiopathic pulmonary fibrosis") [Sarcoidosis](https://en.wikipedia.org/wiki/Sarcoidosis "Sarcoidosis") [Vaping-associated pulmonary injury](https://en.wikipedia.org/wiki/Vaping-associated_pulmonary_injury "Vaping-associated pulmonary injury") |
| Obstructive / Restrictive | |
| | |
| [Pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia")/ [pneumonitis](https://en.wikipedia.org/wiki/Pneumonitis "Pneumonitis") | |
| | |
| By pathogen | [Viral](https://en.wikipedia.org/wiki/Viral_pneumonia "Viral pneumonia") [Bacterial](https://en.wikipedia.org/wiki/Bacterial_pneumonia "Bacterial pneumonia") [Pneumococcal](https://en.wikipedia.org/wiki/Pneumococcal_infection "Pneumococcal infection") [Klebsiella](https://en.wikipedia.org/wiki/Klebsiella_pneumoniae#Klebsiella_pneumonia "Klebsiella pneumoniae") [Atypical bacterial](https://en.wikipedia.org/wiki/Atypical_pneumonia "Atypical pneumonia") [Mycoplasma](https://en.wikipedia.org/wiki/Mycoplasma_pneumonia "Mycoplasma pneumonia") [Legionnaires' disease](https://en.wikipedia.org/wiki/Legionellosis "Legionellosis") [Chlamydiae](https://en.wikipedia.org/wiki/Chlamydiota "Chlamydiota") [Fungal](https://en.wikipedia.org/wiki/Fungal_pneumonia "Fungal pneumonia") [Pneumocystis](https://en.wikipedia.org/wiki/Pneumocystis_pneumonia "Pneumocystis pneumonia") [Parasitic](https://en.wikipedia.org/wiki/Parasitic_pneumonia "Parasitic pneumonia") *noninfectious* [Chemical](https://en.wikipedia.org/wiki/Chemical_pneumonia "Chemical pneumonia")/[Mendelson's syndrome](https://en.wikipedia.org/wiki/Mendelson%27s_syndrome "Mendelson's syndrome") [Aspiration](https://en.wikipedia.org/wiki/Aspiration_pneumonia "Aspiration pneumonia")/[Lipid](https://en.wikipedia.org/wiki/Lipid_pneumonia "Lipid pneumonia") |
| By vector/route | [Community-acquired](https://en.wikipedia.org/wiki/Community-acquired_pneumonia "Community-acquired pneumonia") [Healthcare-associated](https://en.wikipedia.org/wiki/Healthcare-associated_pneumonia "Healthcare-associated pneumonia") [Hospital-acquired](https://en.wikipedia.org/wiki/Hospital-acquired_pneumonia "Hospital-acquired pneumonia") |
| By distribution | [Broncho-](https://en.wikipedia.org/wiki/Bronchopneumonia "Bronchopneumonia") [Lobar](https://en.wikipedia.org/wiki/Lobar_pneumonia "Lobar pneumonia") |
| [IIP](https://en.wikipedia.org/wiki/Idiopathic_interstitial_pneumonia "Idiopathic interstitial pneumonia") | [UIP](https://en.wikipedia.org/wiki/Usual_interstitial_pneumonia "Usual interstitial pneumonia") [DIP](https://en.wikipedia.org/wiki/Desquamative_interstitial_pneumonia "Desquamative interstitial pneumonia") [BOOP-COP](https://en.wikipedia.org/wiki/Bronchiolitis_obliterans_organizing_pneumonia "Bronchiolitis obliterans organizing pneumonia") [NSIP](https://en.wikipedia.org/wiki/Nonspecific_interstitial_pneumonia "Nonspecific interstitial pneumonia") [RB](https://en.wikipedia.org/wiki/Respiratory_bronchiolitis "Respiratory bronchiolitis") |
| Other | [Atelectasis](https://en.wikipedia.org/wiki/Atelectasis "Atelectasis") *circulatory* [Pulmonary hypertension](https://en.wikipedia.org/wiki/Pulmonary_hypertension "Pulmonary hypertension") [Pulmonary embolism](https://en.wikipedia.org/wiki/Pulmonary_embolism "Pulmonary embolism") [Lung abscess](https://en.wikipedia.org/wiki/Lung_abscess "Lung abscess") |
| [Pleural cavity](https://en.wikipedia.org/wiki/Pleural_cavity "Pleural cavity")/ [mediastinum](https://en.wikipedia.org/wiki/Mediastinum "Mediastinum") | |
| | |
| [Pleural disease](https://en.wikipedia.org/wiki/Pleural_disease "Pleural disease") | [Pleuritis/pleurisy](https://en.wikipedia.org/wiki/Pleurisy "Pleurisy") [Pneumothorax](https://en.wikipedia.org/wiki/Pneumothorax "Pneumothorax")/[Hemopneumothorax](https://en.wikipedia.org/wiki/Hemopneumothorax "Hemopneumothorax") [Pleural effusion](https://en.wikipedia.org/wiki/Pleural_effusion "Pleural effusion") [Hemothorax](https://en.wikipedia.org/wiki/Hemothorax "Hemothorax") [Hydrothorax](https://en.wikipedia.org/wiki/Hydrothorax "Hydrothorax") [Chylothorax](https://en.wikipedia.org/wiki/Chylothorax "Chylothorax") [Empyema/pyothorax](https://en.wikipedia.org/wiki/Pleural_empyema "Pleural empyema") [Malignant](https://en.wikipedia.org/wiki/Malignant_pleural_effusion "Malignant pleural effusion") [Fibrothorax](https://en.wikipedia.org/wiki/Fibrothorax "Fibrothorax") |
| [Mediastinal disease](https://en.wikipedia.org/wiki/Mediastinal_disease "Mediastinal disease") | [Mediastinitis](https://en.wikipedia.org/wiki/Mediastinitis "Mediastinitis") [Mediastinal emphysema](https://en.wikipedia.org/wiki/Pneumomediastinum "Pneumomediastinum") |
| Other/general | [Respiratory failure](https://en.wikipedia.org/wiki/Respiratory_failure "Respiratory failure") [Influenza](https://en.wikipedia.org/wiki/Influenza "Influenza") [Common cold](https://en.wikipedia.org/wiki/Common_cold "Common cold") [SARS](https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome "Severe acute respiratory syndrome") [COVID-19]() [Idiopathic pulmonary haemosiderosis](https://en.wikipedia.org/wiki/Idiopathic_pulmonary_haemosiderosis "Idiopathic pulmonary haemosiderosis") [Pulmonary alveolar proteinosis](https://en.wikipedia.org/wiki/Pulmonary_alveolar_proteinosis "Pulmonary alveolar proteinosis") |
| [v](https://en.wikipedia.org/wiki/Template:Viral_systemic_diseases "Template:Viral systemic diseases") [t](https://en.wikipedia.org/wiki/Template_talk:Viral_systemic_diseases "Template talk:Viral systemic diseases") [e](https://en.wikipedia.org/wiki/Special:EditPage/Template:Viral_systemic_diseases "Special:EditPage/Template:Viral systemic diseases")[Infectious diseases](https://en.wikipedia.org/wiki/Infection "Infection") – [viral systemic diseases](https://en.wikipedia.org/wiki/Viral_disease "Viral disease") | |
|---|---|
| [Oncovirus](https://en.wikipedia.org/wiki/Oncovirus "Oncovirus") | [DNA virus](https://en.wikipedia.org/wiki/DNA_virus "DNA virus") *[HBV](https://en.wikipedia.org/wiki/Hepatitis_B_virus "Hepatitis B virus")* [Hepatocellular carcinoma](https://en.wikipedia.org/wiki/Hepatocellular_carcinoma "Hepatocellular carcinoma") *[HPV](https://en.wikipedia.org/wiki/Papillomaviridae "Papillomaviridae")* [Cervical cancer](https://en.wikipedia.org/wiki/Cervical_cancer "Cervical cancer") [Anal cancer](https://en.wikipedia.org/wiki/Anal_cancer "Anal cancer") [Penile cancer](https://en.wikipedia.org/wiki/Penile_cancer "Penile cancer") [Vulvar cancer](https://en.wikipedia.org/wiki/Vulvar_cancer "Vulvar cancer") [Vaginal cancer](https://en.wikipedia.org/wiki/Vaginal_cancer "Vaginal cancer") [Oropharyngeal cancer](https://en.wikipedia.org/wiki/HPV-positive_oropharyngeal_cancer "HPV-positive oropharyngeal cancer") *[KSHV](https://en.wikipedia.org/wiki/Kaposi%27s_sarcoma-associated_herpesvirus "Kaposi's sarcoma-associated herpesvirus")* [Kaposi's sarcoma](https://en.wikipedia.org/wiki/Kaposi%27s_sarcoma "Kaposi's sarcoma") *[EBV](https://en.wikipedia.org/wiki/Epstein%E2%80%93Barr_virus "Epstein–Barr virus")* [Nasopharyngeal carcinoma](https://en.wikipedia.org/wiki/Nasopharyngeal_carcinoma "Nasopharyngeal carcinoma") [Burkitt's lymphoma](https://en.wikipedia.org/wiki/Burkitt%27s_lymphoma "Burkitt's lymphoma") [Hodgkin lymphoma](https://en.wikipedia.org/wiki/Hodgkin_lymphoma "Hodgkin lymphoma") [Follicular dendritic cell sarcoma](https://en.wikipedia.org/wiki/Follicular_dendritic_cell_sarcoma "Follicular dendritic cell sarcoma") [Extranodal NK/T-cell lymphoma, nasal type](https://en.wikipedia.org/wiki/Extranodal_NK/T-cell_lymphoma,_nasal_type "Extranodal NK/T-cell lymphoma, nasal type") *[MCPyV](https://en.wikipedia.org/wiki/Merkel_cell_polyomavirus "Merkel cell polyomavirus")* [Merkel-cell carcinoma](https://en.wikipedia.org/wiki/Merkel-cell_carcinoma "Merkel-cell carcinoma") [RNA virus](https://en.wikipedia.org/wiki/RNA_virus "RNA virus") *[HCV](https://en.wikipedia.org/wiki/Hepatitis_C_virus "Hepatitis C virus")* [Hepatocellular carcinoma](https://en.wikipedia.org/wiki/Hepatocellular_carcinoma "Hepatocellular carcinoma") [Splenic marginal zone lymphoma](https://en.wikipedia.org/wiki/Splenic_marginal_zone_lymphoma "Splenic marginal zone lymphoma") *[HTLV-I](https://en.wikipedia.org/wiki/Human_T-lymphotropic_virus_1 "Human T-lymphotropic virus 1")* [Adult T-cell leukemia/lymphoma](https://en.wikipedia.org/wiki/Adult_T-cell_leukemia/lymphoma "Adult T-cell leukemia/lymphoma") |
| [Immune disorders](https://en.wikipedia.org/wiki/Immune_disorder "Immune disorder") | *[HIV](https://en.wikipedia.org/wiki/HIV "HIV")* [AIDS](https://en.wikipedia.org/wiki/HIV/AIDS "HIV/AIDS") |
| [Central nervous system](https://en.wikipedia.org/wiki/Central_nervous_system_viral_disease "Central nervous system viral disease") | |
| | |
| [Encephalitis](https://en.wikipedia.org/wiki/Viral_encephalitis "Viral encephalitis")/ [meningitis](https://en.wikipedia.org/wiki/Viral_meningitis "Viral meningitis") | [DNA virus](https://en.wikipedia.org/wiki/DNA_virus "DNA virus") *[Human polyomavirus 2](https://en.wikipedia.org/wiki/Human_polyomavirus_2 "Human polyomavirus 2")* [Progressive multifocal leukoencephalopathy](https://en.wikipedia.org/wiki/Progressive_multifocal_leukoencephalopathy "Progressive multifocal leukoencephalopathy") *[HSV](https://en.wikipedia.org/wiki/Herpes_simplex_virus "Herpes simplex virus")* [Herpes simplex encephalitis](https://en.wikipedia.org/wiki/Herpes_simplex_encephalitis "Herpes simplex encephalitis") [Herpes meningitis](https://en.wikipedia.org/wiki/Herpes_meningitis "Herpes meningitis") *[VZV](https://en.wikipedia.org/wiki/Varicella_zoster_virus "Varicella zoster virus")* [Herpes meningitis](https://en.wikipedia.org/wiki/Herpes_meningitis "Herpes meningitis") [RNA virus](https://en.wikipedia.org/wiki/RNA_virus "RNA virus") *[MeV](https://en.wikipedia.org/wiki/Measles_morbillivirus "Measles morbillivirus")* [Subacute sclerosing panencephalitis](https://en.wikipedia.org/wiki/Subacute_sclerosing_panencephalitis "Subacute sclerosing panencephalitis") *[LCV](https://en.wikipedia.org/wiki/Lymphocytic_choriomeningitis "Lymphocytic choriomeningitis")* [Lymphocytic choriomeningitis](https://en.wikipedia.org/wiki/Lymphocytic_choriomeningitis "Lymphocytic choriomeningitis") [Arbovirus encephalitis](https://en.wikipedia.org/wiki/Arbovirus_encephalitis "Arbovirus encephalitis") *[Orthomyxoviridae](https://en.wikipedia.org/wiki/Orthomyxoviridae "Orthomyxoviridae")* (probable) [Encephalitis lethargica](https://en.wikipedia.org/wiki/Encephalitis_lethargica "Encephalitis lethargica") *[RV](https://en.wikipedia.org/wiki/Rabies_virus "Rabies virus")* [Rabies](https://en.wikipedia.org/wiki/Rabies "Rabies") [Chandipura vesiculovirus](https://en.wikipedia.org/wiki/Chandipura_vesiculovirus "Chandipura vesiculovirus") [Ramsay Hunt syndrome type 2](https://en.wikipedia.org/wiki/Ramsay_Hunt_syndrome_type_2 "Ramsay Hunt syndrome type 2") |
| [Myelitis](https://en.wikipedia.org/wiki/Myelitis "Myelitis") | *[Poliovirus](https://en.wikipedia.org/wiki/Poliovirus "Poliovirus")* [Poliomyelitis](https://en.wikipedia.org/wiki/Polio "Polio") [Post-polio syndrome](https://en.wikipedia.org/wiki/Post-polio_syndrome "Post-polio syndrome") *[HTLV-I](https://en.wikipedia.org/wiki/Human_T-lymphotropic_virus_1 "Human T-lymphotropic virus 1")* [Tropical spastic paraparesis](https://en.wikipedia.org/wiki/Tropical_spastic_paraparesis "Tropical spastic paraparesis") |
| [Eye](https://en.wikipedia.org/wiki/Eye_disease "Eye disease") | *[Cytomegalovirus](https://en.wikipedia.org/wiki/Cytomegalovirus "Cytomegalovirus")* [Cytomegalovirus retinitis](https://en.wikipedia.org/wiki/Cytomegalovirus_retinitis "Cytomegalovirus retinitis") *[HSV](https://en.wikipedia.org/wiki/Herpes_simplex_virus "Herpes simplex virus")* [Herpes of the eye](https://en.wikipedia.org/wiki/Herpes_simplex_keratitis "Herpes simplex keratitis") |
| [Cardiovascular](https://en.wikipedia.org/wiki/Cardiovascular_disease "Cardiovascular disease") | *[CBV](https://en.wikipedia.org/wiki/Coxsackie_B_virus "Coxsackie B virus")* [Pericarditis](https://en.wikipedia.org/wiki/Pericarditis "Pericarditis") [Myocarditis](https://en.wikipedia.org/wiki/Myocarditis "Myocarditis") |
| [Respiratory system](https://en.wikipedia.org/wiki/Respiratory_system "Respiratory system")/ [acute viral nasopharyngitis](https://en.wikipedia.org/wiki/Common_cold "Common cold")/ [viral pneumonia](https://en.wikipedia.org/wiki/Viral_pneumonia "Viral pneumonia") | |
| | |
| [DNA virus](https://en.wikipedia.org/wiki/DNA_virus "DNA virus") | *[Epstein–Barr virus](https://en.wikipedia.org/wiki/Epstein%E2%80%93Barr_virus "Epstein–Barr virus")* [EBV infection](https://en.wikipedia.org/wiki/Epstein%E2%80%93Barr_virus_infection "Epstein–Barr virus infection")/[Infectious mononucleosis](https://en.wikipedia.org/wiki/Infectious_mononucleosis "Infectious mononucleosis") *[Cytomegalovirus](https://en.wikipedia.org/wiki/Cytomegalovirus "Cytomegalovirus")* |
| [RNA virus](https://en.wikipedia.org/wiki/RNA_virus "RNA virus") | [IV](https://en.wikipedia.org/wiki/RNA_virus#Group_IV_%E2%80%93_positive-sense_ssRNA_viruses "RNA virus"): *[Coronavirus](https://en.wikipedia.org/wiki/Coronavirus "Coronavirus") [229E](https://en.wikipedia.org/wiki/Human_coronavirus_229E "Human coronavirus 229E")/[NL63](https://en.wikipedia.org/wiki/Human_coronavirus_NL63 "Human coronavirus NL63")/[HKU1](https://en.wikipedia.org/wiki/Human_coronavirus_HKU1 "Human coronavirus HKU1")/[OC43](https://en.wikipedia.org/wiki/Human_coronavirus_OC43 "Human coronavirus OC43")* [Common cold](https://en.wikipedia.org/wiki/Common_cold "Common cold") *[MERS coronavirus](https://en.wikipedia.org/wiki/Middle_East_respiratory_syndrome%E2%80%93related_coronavirus "Middle East respiratory syndrome–related coronavirus")* [Middle East respiratory syndrome](https://en.wikipedia.org/wiki/Middle_East_respiratory_syndrome "Middle East respiratory syndrome") *[SARS coronavirus](https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus "Severe acute respiratory syndrome coronavirus")* [Severe acute respiratory syndrome](https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome "Severe acute respiratory syndrome") *[SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2")* [COVID-19]() [V](https://en.wikipedia.org/wiki/RNA_virus#Group_V_%E2%80%93_negative-sense_ssRNA_viruses "RNA virus"), *[Orthomyxoviridae](https://en.wikipedia.org/wiki/Orthomyxoviridae "Orthomyxoviridae")*: *[Influenza virus A](https://en.wikipedia.org/wiki/Influenza_A_virus "Influenza A virus")/[B](https://en.wikipedia.org/wiki/Influenza_B_virus "Influenza B virus")/[C](https://en.wikipedia.org/wiki/Influenza_C_virus "Influenza C virus")/[D](https://en.wikipedia.org/wiki/Influenza_D_virus "Influenza D virus")* [Influenza](https://en.wikipedia.org/wiki/Influenza "Influenza")/[Avian influenza](https://en.wikipedia.org/wiki/Avian_influenza "Avian influenza") V, *[Paramyxoviridae](https://en.wikipedia.org/wiki/Paramyxoviridae "Paramyxoviridae")*: *[Human parainfluenza viruses](https://en.wikipedia.org/wiki/Human_parainfluenza_viruses "Human parainfluenza viruses")* [Parainfluenza](https://en.wikipedia.org/wiki/Human_parainfluenza_viruses "Human parainfluenza viruses") *[Human orthopneumovirus](https://en.wikipedia.org/wiki/Human_orthopneumovirus "Human orthopneumovirus")* *[hMPV](https://en.wikipedia.org/wiki/Human_metapneumovirus "Human metapneumovirus")* |
| [Human digestive system](https://en.wikipedia.org/wiki/Human_digestive_system "Human digestive system") | |
| | |
| [Pharynx](https://en.wikipedia.org/wiki/Pharynx "Pharynx")/[Esophagus](https://en.wikipedia.org/wiki/Esophagus "Esophagus") | *[MuV](https://en.wikipedia.org/wiki/Mumps_virus "Mumps virus")* [Mumps](https://en.wikipedia.org/wiki/Mumps "Mumps") *[Cytomegalovirus](https://en.wikipedia.org/wiki/Cytomegalovirus "Cytomegalovirus")* [Cytomegalovirus esophagitis](https://en.wikipedia.org/wiki/Cytomegalovirus_esophagitis "Cytomegalovirus esophagitis") |
| [Gastroenteritis](https://en.wikipedia.org/wiki/Gastroenteritis#Viral "Gastroenteritis")/ [diarrhea](https://en.wikipedia.org/wiki/Gastroenteritis#Virus "Gastroenteritis") | [DNA virus](https://en.wikipedia.org/wiki/DNA_virus "DNA virus") *[Adenovirus](https://en.wikipedia.org/wiki/Adenoviridae "Adenoviridae")* [Adenovirus infection](https://en.wikipedia.org/wiki/Adenovirus_infection "Adenovirus infection") [RNA virus](https://en.wikipedia.org/wiki/RNA_virus "RNA virus") *[Rotavirus](https://en.wikipedia.org/wiki/Rotavirus "Rotavirus")* ([Gastroenteritis](https://en.wikipedia.org/wiki/Rotaviral_gastroenteritis "Rotaviral gastroenteritis")) *[Norovirus](https://en.wikipedia.org/wiki/Norovirus "Norovirus")* *[Astrovirus](https://en.wikipedia.org/wiki/Astrovirus "Astrovirus")* *[Coronavirus](https://en.wikipedia.org/wiki/Coronavirus "Coronavirus")* |
| [Hepatitis](https://en.wikipedia.org/wiki/Viral_hepatitis "Viral hepatitis") | [DNA virus](https://en.wikipedia.org/wiki/DNA_virus "DNA virus") *[HBV](https://en.wikipedia.org/wiki/Hepatitis_B_virus "Hepatitis B virus")* ([B](https://en.wikipedia.org/wiki/Hepatitis_B "Hepatitis B")) [RNA virus](https://en.wikipedia.org/wiki/RNA_virus "RNA virus") *[CBV](https://en.wikipedia.org/wiki/Coxsackie_B_virus "Coxsackie B virus")* *[HAV](https://en.wikipedia.org/wiki/Hepatitis_A#Virology "Hepatitis A")* ([A](https://en.wikipedia.org/wiki/Hepatitis_A "Hepatitis A")) *[HCV](https://en.wikipedia.org/wiki/Hepatitis_C_virus "Hepatitis C virus")* ([C](https://en.wikipedia.org/wiki/Hepatitis_C "Hepatitis C")) *[HDV](https://en.wikipedia.org/wiki/Hepatitis_D "Hepatitis D")* ([D](https://en.wikipedia.org/wiki/Hepatitis_D "Hepatitis D")) *[HEV](https://en.wikipedia.org/wiki/Hepatitis_E_virus "Hepatitis E virus")* ([E](https://en.wikipedia.org/wiki/Hepatitis_E "Hepatitis E")) |
| [Pancreatitis](https://en.wikipedia.org/wiki/Pancreatitis "Pancreatitis") | *[CBV](https://en.wikipedia.org/wiki/Coxsackie_B_virus "Coxsackie B virus")* |
| [Urogenital](https://en.wikipedia.org/wiki/Genitourinary_system "Genitourinary system") | *[BK virus](https://en.wikipedia.org/wiki/BK_virus "BK virus")* *[MuV](https://en.wikipedia.org/wiki/Mumps_virus "Mumps virus")* [Mumps](https://en.wikipedia.org/wiki/Mumps "Mumps") |
**COVID-19** at Wikipedia's [sister projects](https://en.wikipedia.org/wiki/Wikipedia:Wikimedia_sister_projects "Wikipedia:Wikimedia sister projects"):
- [](https://en.wikipedia.org/wiki/File:Commons-logo.svg)[**Media**](https://commons.wikimedia.org/wiki/COVID-19 "c:COVID-19") from Commons
- [](https://en.wikipedia.org/wiki/File:Wikinews-logo.svg)[**News**](https://en.wikinews.org/wiki/Category:COVID-19 "n:Category:COVID-19") from Wikinews
- [**Quotations**](https://en.wikiquote.org/wiki/Coronavirus_disease_2019 "q:Coronavirus disease 2019") from Wikiquote
- [](https://en.wikipedia.org/wiki/File:Wikiversity_logo_2017.svg)[**Resources**](https://en.wikiversity.org/wiki/COVID-19 "v:COVID-19") from Wikiversity
- [**Data**](https://www.wikidata.org/wiki/Q84263196 "d:Q84263196") from Wikidata
| [Authority control databases](https://en.wikipedia.org/wiki/Help:Authority_control "Help:Authority control") [](https://www.wikidata.org/wiki/Q84263196#identifiers "Edit this at Wikidata") | |
|---|---|
| International | [GND](https://d-nb.info/gnd/1206347392) |
| National | [United States](https://id.loc.gov/authorities/sh2020000570) [France](https://catalogue.bnf.fr/ark:/12148/cb17874453m) [BnF data](https://data.bnf.fr/ark:/12148/cb17874453m) [Japan](https://id.ndl.go.jp/auth/ndlna/001347199) [Czech Republic](https://aleph.nkp.cz/F/?func=find-c&local_base=aut&ccl_term=ica=ph1075649&CON_LNG=ENG) [2](https://aleph.nkp.cz/F/?func=find-c&local_base=aut&ccl_term=ica=ph1075649&CON_LNG=ENG) [Spain](https://datos.bne.es/resource/XX6068533) [Latvia](https://kopkatalogs.lv/F?func=direct&local_base=lnc10&doc_number=000290795&P_CON_LNG=ENG) [Chile](http://www.bncatalogo.cl/F?func=direct&local_base=red10&doc_number=000927635) [Israel](https://www.nli.org.il/en/authorities/987008595071705171) |
| Other | [Yale LUX](https://lux.collections.yale.edu/view/concept/f769dffc-677a-473a-96c7-bfdd47c4266a) |
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COVID-19
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| Readable Markdown | This article is about the disease itself. For the virus that caused the disease, see [SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2"). For the global pandemic caused by the disease, see [COVID-19 pandemic](https://en.wikipedia.org/wiki/COVID-19_pandemic "COVID-19 pandemic"). For other diseases caused by coronaviruses, see [Coronavirus diseases](https://en.wikipedia.org/wiki/Coronavirus_diseases "Coronavirus diseases").
| Coronavirus disease 2019 (COVID-19) | |
|---|---|
| Other names | COVID, (the) coronavirus |
| [](https://en.wikipedia.org/wiki/File:Fphar-11-00937-g001.jpg) | |
| Transmission and life-cycle of [SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2"), which causes COVID-19 | |
| Pronunciation | [\[1\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-1) |
| [Specialty](https://en.wikipedia.org/wiki/Medical_specialty "Medical specialty") | [Infectious disease](https://en.wikipedia.org/wiki/Infectious_disease_\(medical_specialty\) "Infectious disease (medical specialty)") |
| [Symptoms](https://en.wikipedia.org/wiki/Signs_and_symptoms "Signs and symptoms") | [Fever, cough, fatigue, shortness of breath, vomiting, loss of taste or smell; some cases asymptomatic](https://en.wikipedia.org/wiki/Symptoms_of_COVID-19 "Symptoms of COVID-19")[\[2\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC2020Sym-2)[\[3\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO2020QA-3) |
| [Complications](https://en.wikipedia.org/wiki/Complication_\(medicine\) "Complication (medicine)") | [Pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia"), [sepsis](https://en.wikipedia.org/wiki/Sepsis "Sepsis"), [ARDS](https://en.wikipedia.org/wiki/Acute_respiratory_distress_syndrome "Acute respiratory distress syndrome"), [kidney failure](https://en.wikipedia.org/wiki/Kidney_failure "Kidney failure"), [respiratory failure](https://en.wikipedia.org/wiki/Respiratory_failure "Respiratory failure"), [pulmonary fibrosis](https://en.wikipedia.org/wiki/Pulmonary_fibrosis "Pulmonary fibrosis"), [CKS](https://en.wikipedia.org/wiki/Cytokine_release_syndrome "Cytokine release syndrome"), [MIS-C](https://en.wikipedia.org/wiki/Pediatric_multisystem_inflammatory_syndrome "Pediatric multisystem inflammatory syndrome"), [long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID"), [brain damage](https://en.wikipedia.org/wiki/Brain_damage "Brain damage") |
| Usual onset | 2–14 days (typically 5) after infection |
| Duration | 5 days to [chronic](https://en.wikipedia.org/wiki/Long_COVID "Long COVID") |
| [Causes](https://en.wikipedia.org/wiki/Cause_\(medicine\) "Cause (medicine)") | [SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2") |
| [Diagnostic method](https://en.wikipedia.org/wiki/Medical_diagnosis "Medical diagnosis") | [RT‑PCR testing](https://en.wikipedia.org/wiki/Reverse_transcription_polymerase_chain_reaction "Reverse transcription polymerase chain reaction"), [CT scan](https://en.wikipedia.org/wiki/CT_scan "CT scan"), [rapid antigen test](https://en.wikipedia.org/wiki/Rapid_antigen_test "Rapid antigen test") |
| Prevention | [Vaccination](https://en.wikipedia.org/wiki/COVID-19_vaccine "COVID-19 vaccine"), face coverings, [quarantine](https://en.wikipedia.org/wiki/Quarantine "Quarantine"), [social distancing](https://en.wikipedia.org/wiki/Social_distancing "Social distancing"), ventilation, hand washing |
| Treatment | [Symptomatic and supportive](https://en.wikipedia.org/wiki/Management_of_COVID-19 "Management of COVID-19") |
| Frequency | 779,056,637[\[4\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Template:COVID-19_data-4) confirmed cases (true case count is expected to be much higher[\[5\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-5)) |
| Deaths | 7,111,504[\[4\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Template:COVID-19_data-4) (reported) 18\.2–33.5 million[\[6\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-6) (estimated) |
**Coronavirus disease 2019** (**COVID-19**) is a [contagious disease](https://en.wikipedia.org/wiki/Contagious_disease "Contagious disease") caused by the [coronavirus](https://en.wikipedia.org/wiki/Coronavirus "Coronavirus") [SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2"). Starting in January 2020, the disease spread worldwide, resulting in the [COVID-19 pandemic](https://en.wikipedia.org/wiki/COVID-19_pandemic "COVID-19 pandemic"). In March 2020, the [World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization "World Health Organization") declared COVID-19 a [global health emergency](https://en.wikipedia.org/wiki/Public_health_emergency_of_international_concern "Public health emergency of international concern"); they declared the end of the emergency in May 2023.[\[7\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-7)
The [symptoms of COVID‑19](https://en.wikipedia.org/wiki/Symptoms_of_COVID%E2%80%9119 "Symptoms of COVID‑19") can vary but often include fever,[\[8\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-8) fatigue, cough, [breathing difficulties](https://en.wikipedia.org/wiki/Breathing_difficulties "Breathing difficulties"), [loss of smell](https://en.wikipedia.org/wiki/Anosmia "Anosmia"), and [loss of taste](https://en.wikipedia.org/wiki/Ageusia "Ageusia").[\[9\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-9)[\[10\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-10)[\[11\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-11) Symptoms may begin one to 14 days [after exposure](https://en.wikipedia.org/wiki/Incubation_period "Incubation period") to the virus. At least a third of people who are infected [do not develop noticeable symptoms](https://en.wikipedia.org/wiki/Asymptomatic "Asymptomatic").[\[12\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-12)[\[13\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-13) Of those who develop symptoms noticeable enough to be classified as patients, most (81%) develop mild to moderate symptoms (up to mild [pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia")), while 14% develop severe symptoms ([dyspnea](https://en.wikipedia.org/wiki/Dyspnea "Dyspnea"), [hypoxia](https://en.wikipedia.org/wiki/Hypoxia_\(medical\) "Hypoxia (medical)"), or more than 50% lung involvement on imaging), and 5% develop critical symptoms ([respiratory failure](https://en.wikipedia.org/wiki/Respiratory_failure "Respiratory failure"), [shock](https://en.wikipedia.org/wiki/Shock_\(circulatory\) "Shock (circulatory)"), or [multiorgan dysfunction](https://en.wikipedia.org/wiki/Organ_dysfunction "Organ dysfunction")).[\[14\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC_Interim_Guidance-14) Older people have a higher risk of developing severe symptoms and dying. Some people experience persistent symptoms ([long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID")), for months or years after infection, including [fatigue](https://en.wikipedia.org/wiki/Fatigue "Fatigue"), cognitive issues and [shortness of breath](https://en.wikipedia.org/wiki/Shortness_of_breath "Shortness of breath"). Damage to organs has been observed in a subset.[\[15\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-davis-15)
[COVID‑19 transmission](https://en.wikipedia.org/wiki/Transmission_of_COVID-19 "Transmission of COVID-19") occurs when infectious particles are breathed in or come into contact with the eyes, nose, or mouth. The risk is highest when people are in close proximity, but small [airborne](https://en.wikipedia.org/wiki/Airborne_transmission "Airborne transmission") particles containing the virus can remain suspended in the air and travel over longer distances, particularly indoors. Transmission can also occur when people touch their eyes, nose, or mouth after touching surfaces or objects that have been contaminated by the virus. People remain contagious for up to 20 days and can spread the virus even if they do not develop symptoms.[\[16\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-16)
There are two common [tests to detect COVID](https://en.wikipedia.org/wiki/COVID-19_testing "COVID-19 testing"). Antigen tests (also called [rapid lateral flow tests](https://en.wikipedia.org/wiki/COVID-19_rapid_antigen_test "COVID-19 rapid antigen test")) can be used at home. A positive test indicates an active infection. However, negative tests are not accurate, especially early or late in the infection. Health care providers can perform a more accurate [PCR test](https://en.wikipedia.org/wiki/PCR_test "PCR test"), which is typically analysed in a laboratory.[\[17\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-17)[\[18\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-18)
Several [COVID-19 vaccines](https://en.wikipedia.org/wiki/COVID-19_vaccine "COVID-19 vaccine") have been approved and distributed in various countries, many of which have initiated [mass vaccination campaigns](https://en.wikipedia.org/wiki/Deployment_of_COVID-19_vaccines "Deployment of COVID-19 vaccines"). Other [preventive measures](https://en.wikipedia.org/wiki/Pandemic_prevention "Pandemic prevention") include physical or [social distancing](https://en.wikipedia.org/wiki/Social_distancing "Social distancing"), [quarantining](https://en.wikipedia.org/wiki/Quarantine "Quarantine"), ventilation of indoor spaces, [use of face masks or coverings](https://en.wikipedia.org/wiki/Face_masks_during_the_COVID-19_pandemic "Face masks during the COVID-19 pandemic") in public, covering coughs and sneezes, [hand washing](https://en.wikipedia.org/wiki/Hand_washing "Hand washing"), and keeping unwashed hands away from the face. While [drugs have been developed](https://en.wikipedia.org/wiki/COVID-19_drug_development "COVID-19 drug development") to inhibit the virus, the primary [treatment](https://en.wikipedia.org/wiki/Treatment_and_management_of_COVID-19 "Treatment and management of COVID-19") is still [symptomatic](https://en.wikipedia.org/wiki/Symptomatic_treatment "Symptomatic treatment"), managing the disease through [supportive care](https://en.wikipedia.org/wiki/Symptomatic_treatment "Symptomatic treatment"), [isolation](https://en.wikipedia.org/wiki/Isolation_\(health_care\) "Isolation (health care)"), and [experimental measures](https://en.wikipedia.org/wiki/Medical_research "Medical research").
The first known case was [identified in Wuhan](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Hubei "COVID-19 pandemic in Hubei"), China, in December 2019.[\[19\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WSJ-20210226-19) Most scientists believe that the SARS-CoV-2 virus entered into human populations through natural [zoonosis](https://en.wikipedia.org/wiki/Zoonosis "Zoonosis"), similar to the [SARS-CoV-1](https://en.wikipedia.org/wiki/SARS-CoV-1 "SARS-CoV-1") and [MERS-CoV](https://en.wikipedia.org/wiki/MERS-CoV "MERS-CoV") outbreaks, and consistent with other pandemics in human history.[\[20\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pekar-20)[\[21\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-jiang_wang-21) Social and environmental factors including [climate change](https://en.wikipedia.org/wiki/Climate_change "Climate change"), [natural ecosystem destruction](https://en.wikipedia.org/wiki/Environmental_degradation "Environmental degradation") and [wildlife trade](https://en.wikipedia.org/wiki/Wildlife_trade_and_zoonoses "Wildlife trade and zoonoses") increased the likelihood of such zoonotic spillover.[\[22\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-IPCC-2022a-22)[\[23\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-IPCC-2022b-23)[\[24\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-University-of-Cambridge-2021-24)[\[25\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-European-Commission-25)
Nomenclature
During the initial outbreak in [Wuhan](https://en.wikipedia.org/wiki/Wuhan "Wuhan"), the virus was commonly called "coronavirus" and "Wuhan coronavirus",[\[26\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-26)[\[27\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-27)[\[28\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-28) and the disease was referred to by the same terms and sometimes as "Wuhan pneumonia".[\[29\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-29)[\[30\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-30) In the past, many diseases have been named after geographical locations, such as the [Spanish flu](https://en.wikipedia.org/wiki/Spanish_flu "Spanish flu"),[\[31\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-31) [Middle East respiratory syndrome](https://en.wikipedia.org/wiki/Middle_East_respiratory_syndrome "Middle East respiratory syndrome"), and [Zika virus](https://en.wikipedia.org/wiki/Zika_virus "Zika virus").[\[32\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Nature_Stop-32) In January 2020, the [World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization "World Health Organization") (WHO) recommended 2019-nCoV[\[33\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-33) and 2019-nCoV acute respiratory disease[\[34\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-34) as interim names for the virus and disease per 2015 guidance and international guidelines against using geographical locations or groups of people in disease and virus names to prevent [social stigma](https://en.wikipedia.org/wiki/Social_stigma "Social stigma").[\[35\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-35)[\[36\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-veconomist-36)[\[37\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-37) The official names COVID‑19 and SARS-CoV-2 were issued by the WHO on 11 February 2020 with COVID-19 being shorthand for "coronavirus disease 2019".[\[38\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO-naming-38)[\[39\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-39) The WHO additionally uses "the COVID‑19 virus" and "the virus responsible for COVID‑19" in public communications.[\[38\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO-naming-38)[\[40\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-40)
Signs and symptoms
[](https://en.wikipedia.org/wiki/File:Symptoms_of_coronavirus_disease_2019_4.0.svg)
[Symptoms](https://en.wikipedia.org/wiki/Signs_and_symptoms "Signs and symptoms") of COVID-19
The [symptoms of COVID-19](https://en.wikipedia.org/wiki/Symptoms_of_COVID-19 "Symptoms of COVID-19") are variable depending on the [type of variant](https://en.wikipedia.org/wiki/COVID_variant "COVID variant") contracted, ranging from mild [symptoms](https://en.wikipedia.org/wiki/Symptom "Symptom") to a potentially fatal illness.[\[41\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_CDC2020Sym-41)[\[42\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Grant_et_al_2020-42) Common symptoms include [coughing](https://en.wikipedia.org/wiki/Cough "Cough"), [fever](https://en.wikipedia.org/wiki/Fever "Fever"), [loss of smell](https://en.wikipedia.org/wiki/Anosmia "Anosmia") and [taste](https://en.wikipedia.org/wiki/Ageusia "Ageusia"), with less common ones including [headaches](https://en.wikipedia.org/wiki/Headache "Headache"), [nasal congestion](https://en.wikipedia.org/wiki/Nasal_congestion "Nasal congestion") and [runny nose](https://en.wikipedia.org/wiki/Rhinorrhea "Rhinorrhea"), [muscle pain](https://en.wikipedia.org/wiki/Muscle_pain "Muscle pain"), [sore throat](https://en.wikipedia.org/wiki/Sore_throat "Sore throat"), [diarrhea](https://en.wikipedia.org/wiki/Diarrhea "Diarrhea"), [eye irritation](https://en.wikipedia.org/wiki/Eye_irritation "Eye irritation"),[\[43\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-43) and toes swelling or turning purple,[\[44\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-44) and in moderate to severe cases, [breathing difficulties](https://en.wikipedia.org/wiki/Breathing_difficulties "Breathing difficulties").[\[45\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_ECDC-45) People with the COVID-19 infection may have different symptoms, and their symptoms may change over time.
Three common clusters of symptoms have been identified: a respiratory symptom cluster with cough, [sputum](https://en.wikipedia.org/wiki/Sputum "Sputum"), [shortness of breath](https://en.wikipedia.org/wiki/Shortness_of_breath "Shortness of breath"), and fever; a musculoskeletal symptom cluster with [muscle](https://en.wikipedia.org/wiki/Skeletal_muscle "Skeletal muscle") and joint pain, headache, and fatigue; and a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhea.[\[45\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_ECDC-45) In people without prior ear, nose, or throat disorders, [loss of taste](https://en.wikipedia.org/wiki/Hypogeusia "Hypogeusia") combined with [loss of smell](https://en.wikipedia.org/wiki/Hyposmia "Hyposmia") is associated with COVID-19 and is reported in as many as 88% of symptomatic cases.[\[46\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Paderno_2020-46)[\[47\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Chabot_2021-47)[\[48\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_pmid32483687-48)
Of those who show symptoms, 81% develop only mild to moderate symptoms (up to mild [pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia")), while 14% develop severe symptoms ([dyspnea](https://en.wikipedia.org/wiki/Dyspnea "Dyspnea"), [hypoxia](https://en.wikipedia.org/wiki/Hypoxia_\(medical\) "Hypoxia (medical)"), or more than 50% lung involvement on imaging) that require hospitalization, and 5% of patients develop critical symptoms ([respiratory failure](https://en.wikipedia.org/wiki/Respiratory_failure "Respiratory failure"), septic [shock](https://en.wikipedia.org/wiki/Shock_\(circulatory\) "Shock (circulatory)"), or [multiorgan dysfunction](https://en.wikipedia.org/wiki/Organ_dysfunction "Organ dysfunction")) requiring ICU admission. As of 2024–2025, the majority of infections are characterized as mild or asymptomatic; however, risk remains stratified by age and underlying health conditions, with severe outcomes—including respiratory failure and multi-organ dysfunction—occurring in a significantly smaller percentage of the general vaccinated population than in early 2020.[\[49\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-49)[\[50\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-50)[\[51\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_CDC_Interim_Guidance-51)[\[52\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-52)
[](https://en.wikipedia.org/wiki/File:Asymptomatic_COVID_by_age.jpg)
Proportion of asymptomatic SARS-CoV-2 infection by age. About 44% of those infected with SARS-CoV-2 remained asymptomatic throughout the infection.[\[53\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Wang2023-53)
At least a third of the people who are infected with the virus do not develop noticeable symptoms at any point in time.[\[53\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Wang2023-53)[\[54\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-54)[\[55\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Asymptomatic-55) These [asymptomatic](https://en.wikipedia.org/wiki/Asymptomatic "Asymptomatic") carriers tend not to get tested and can still spread the disease.[\[55\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Asymptomatic-55)[\[56\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-56)[\[57\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-57)[\[58\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Furukawa_2020-58) Other infected people will develop symptoms later (called "pre-symptomatic") or have very mild symptoms and can also spread the virus.[\[58\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_Furukawa_2020-58)
As is common with infections, there is a delay, or [incubation period](https://en.wikipedia.org/wiki/Incubation_period "Incubation period"), between the moment a person first becomes infected and the appearance of the first symptoms. The [median](https://en.wikipedia.org/wiki/Median "Median") delay for COVID-19 is four to five days[\[59\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_pmid32329974-59) possibly being infectious on 1–4 of those days.[\[60\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-60) Most symptomatic people experience symptoms within two to seven days after exposure, and almost all will experience at least one symptom within 12 days.[\[59\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_pmid32329974-59)[\[61\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-61)
Most people recover from the [acute](https://en.wikipedia.org/wiki/Acute_\(medicine\) "Acute (medicine)") phase of the disease. However, some people continue to experience a range of effects, such as [fatigue](https://en.wikipedia.org/wiki/Fatigue "Fatigue"), for prolonged periods after an initial COVID-19 infection.[\[62\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_cdc24-62) This is the result of a condition called [long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID"), which can be described as a range of persistent symptoms that continue for months or years.[\[62\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_cdc24-62) Long-term damage to organs has been observed after the onset of COVID-19. Multi-year studies are underway to further investigate the protracted effects of long COVID.[\[62\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_cdc24-62) Reducing the risk of long COVID includes staying up to date on the most recent COVID-19 vaccine, practicing good hygiene, maintaining clean indoor air, and physical distancing from people infected with a respiratory virus.[\[62\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Symptoms_of_COVID-19_cdc24-62)
The [Omicron variant](https://en.wikipedia.org/wiki/SARS-CoV-2_Omicron_variant "SARS-CoV-2 Omicron variant") became dominant in the U.S. in December 2021. Symptoms with the Omicron variant are less severe than they are with other variants.[\[63\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-63)
Complications
[](https://en.wikipedia.org/wiki/File:Fimmu-11-01648-g001.jpg)
Mechanisms of SARS-CoV-2 [cytokine storm](https://en.wikipedia.org/wiki/Cytokine_storm "Cytokine storm") and complications
Complications may include [pneumonia](https://en.wikipedia.org/wiki/Pneumonia "Pneumonia"), [acute respiratory distress syndrome](https://en.wikipedia.org/wiki/Acute_respiratory_distress_syndrome "Acute respiratory distress syndrome") (ARDS), [multi-organ failure](https://en.wikipedia.org/wiki/Multiple_organ_dysfunction_syndrome "Multiple organ dysfunction syndrome"), [septic shock](https://en.wikipedia.org/wiki/Septic_shock "Septic shock"), and death.[\[64\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Hui14Jan2020-64)[\[65\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-65)[\[66\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-StatPearls-66)[\[67\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Heymann_Shindo_2020_pp._542%E2%80%93545222-67) Cardiovascular complications may include heart failure, [arrhythmias](https://en.wikipedia.org/wiki/Arrhythmia "Arrhythmia") (including [atrial fibrillation](https://en.wikipedia.org/wiki/Atrial_fibrillation "Atrial fibrillation")), [heart inflammation](https://en.wikipedia.org/wiki/Myocarditis "Myocarditis"), [thrombosis](https://en.wikipedia.org/wiki/Thrombosis "Thrombosis"), particularly [venous thromboembolism](https://en.wikipedia.org/wiki/Venous_thromboembolism "Venous thromboembolism"),[\[68\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-68)[\[69\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-69)[\[70\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Long-2020-70)[\[71\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-71)[\[72\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-72)[\[73\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-73) and endothelial cell injury and dysfunction.[\[74\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-74) Approximately 20–30% of people who present with COVID‑19 have [elevated liver enzymes](https://en.wikipedia.org/wiki/Elevated_transaminases "Elevated transaminases"), reflecting liver injury.[\[75\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-75)[\[76\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Sanders202022-76)
Neurologic manifestations include [seizure](https://en.wikipedia.org/wiki/Seizure "Seizure"), stroke, [encephalitis](https://en.wikipedia.org/wiki/Encephalitis "Encephalitis"), and [Guillain–Barré syndrome](https://en.wikipedia.org/wiki/Guillain%E2%80%93Barr%C3%A9_syndrome "Guillain–Barré syndrome") (which includes [loss of motor functions](https://en.wikipedia.org/wiki/Hemiparesis "Hemiparesis")).[\[77\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Carod-Artal-2020-77)[\[78\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-78) Following the infection, children may develop [paediatric multisystem inflammatory syndrome](https://en.wikipedia.org/wiki/Paediatric_multisystem_inflammatory_syndrome "Paediatric multisystem inflammatory syndrome"), which has symptoms similar to [Kawasaki disease](https://en.wikipedia.org/wiki/Kawasaki_disease "Kawasaki disease"), which can be fatal.[\[79\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-79)[\[80\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-80) In very rare cases, acute [encephalopathy](https://en.wikipedia.org/wiki/Encephalopathy "Encephalopathy") can occur, and it can be considered in those who have been diagnosed with COVID‑19 and have an altered mental status.[\[81\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-81)
According to the US [Centers for Disease Control and Prevention](https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention "Centers for Disease Control and Prevention"), pregnant women are at increased risk of becoming seriously ill from COVID‑19.[\[82\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cordoba-Vives-2020-82) This is because pregnant women with COVID‑19 appear to be more likely to develop respiratory and obstetric complications that can lead to [miscarriage](https://en.wikipedia.org/wiki/Miscarriage "Miscarriage"), [premature delivery](https://en.wikipedia.org/wiki/Premature_delivery "Premature delivery") and [intrauterine growth restriction](https://en.wikipedia.org/wiki/Intrauterine_growth_restriction "Intrauterine growth restriction").[\[82\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cordoba-Vives-2020-82)
Fungal infections such as [aspergillosis](https://en.wikipedia.org/wiki/Aspergillosis "Aspergillosis"), [candidiasis](https://en.wikipedia.org/wiki/Candidiasis "Candidiasis"), [cryptococcosis](https://en.wikipedia.org/wiki/Cryptococcosis "Cryptococcosis") and [mucormycosis](https://en.wikipedia.org/wiki/Mucormycosis "Mucormycosis") have been recorded in people recovering from COVID‑19.[\[83\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-83)[\[84\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-84)
Cause
COVID‑19 is caused by infection with a [strain](https://en.wikipedia.org/wiki/Strain_\(biology\)#Microbiology_and_virology "Strain (biology)") of [coronavirus](https://en.wikipedia.org/wiki/Coronavirus "Coronavirus") known as "severe acute respiratory syndrome coronavirus 2" ([SARS-CoV-2](https://en.wikipedia.org/wiki/SARS-CoV-2 "SARS-CoV-2")).[\[85\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-85)
Transmission
[](https://en.wikipedia.org/wiki/File:Transmission_of_COVID-19.jpg)
[Transmission](https://en.wikipedia.org/wiki/Transmission_\(medicine\) "Transmission (medicine)") of COVID‑19
COVID-19 is mainly transmitted from person to person through inhaling air contaminated by [droplets](https://en.wikipedia.org/wiki/Drop_\(liquid\) "Drop (liquid)")/[aerosols](https://en.wikipedia.org/wiki/Aerosol "Aerosol") and small [airborne](https://en.wikipedia.org/wiki/Airborne_transmission "Airborne transmission") particles containing the virus. Infected people exhale those particles as they breathe, talk, cough, sneeze, or sing.[\[86\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Wang_2021-86)[\[87\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Greenhalgh_2021-87)[\[88\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_AR2021-88)[\[89\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-89) Transmission is most likely at closer range but can also occur over longer distances, particularly indoors.[\[86\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Wang_2021-86)[\[90\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Miller_2021-90)
The virus spreads through virus-laden fluid particles, or droplets, which are created in the respiratory tract, and they are expelled by the mouth and the nose. There are three types of transmission: "droplet" and "contact", which are associated with large droplets, and "airborne", which is associated with small droplets.[\[91\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_:1-91) If the droplets are above a certain critical size, they settle faster than they [evaporate](https://en.wikipedia.org/wiki/Evaporate "Evaporate"), and therefore they [contaminate](https://en.wikipedia.org/wiki/Contaminate "Contaminate") surfaces surrounding them.[\[91\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_:1-91) Droplets that are below a certain critical size, generally thought to be \<100μm diameter, evaporate faster than they settle; due to that fact, they form respiratory aerosol particles that remain airborne for a long period of time over extensive distances.[\[91\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_:1-91)[\[86\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Wang_2021-86)
[Infectivity](https://en.wikipedia.org/wiki/Infectivity "Infectivity") can begin four to five days before the onset of symptoms.[\[92\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_HeCorrection-92) Infected people can spread the disease even if they are pre-symptomatic or [asymptomatic](https://en.wikipedia.org/wiki/Asymptomatic "Asymptomatic").[\[93\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_CDNASoNG-93) Most commonly, the peak viral load in [upper respiratory tract](https://en.wikipedia.org/wiki/Upper_respiratory_tract "Upper respiratory tract") samples occurs close to the time of symptom onset and declines after the first week after symptoms begin.[\[93\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_CDNASoNG-93) Current evidence suggests a duration of viral shedding and the period of infectiousness of up to ten days following symptom onset for people with mild to moderate COVID-19, and up to 20 days for persons with severe COVID-19, including immunocompromised people.[\[94\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_CDCClinicalQuestions-94)[\[93\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_CDNASoNG-93)
Infectious particles range in size from [aerosols](https://en.wikipedia.org/wiki/Aerosol "Aerosol") that remain suspended in the air for long periods of time to larger [droplets](https://en.wikipedia.org/wiki/Respiratory_droplet "Respiratory droplet") that remain airborne briefly or fall to the ground.[\[95\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_CDCScientificBriefTransmission-95)[\[96\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_who_transmitted-96)[\[97\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_WHO-ECDC-CDC-UK-Ca-Aus-Annals-97)[\[98\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Tang_2021-98) Additionally, COVID-19 research has redefined the traditional understanding of how respiratory viruses are transmitted.[\[98\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Tang_2021-98)[\[99\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Morawska_2021-99) The largest droplets of respiratory fluid do not travel far, but can be inhaled or land on mucous membranes on the eyes, nose, or mouth to infect.[\[97\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_WHO-ECDC-CDC-UK-Ca-Aus-Annals-97) Aerosols are highest in concentration when people are in close proximity, which leads to easier viral transmission when people are physically close,[\[97\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_WHO-ECDC-CDC-UK-Ca-Aus-Annals-97)[\[98\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Tang_2021-98)[\[99\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_Morawska_2021-99) but [airborne transmission](https://en.wikipedia.org/wiki/Airborne_transmission "Airborne transmission") can occur at longer distances, mainly in locations that are poorly ventilated;[\[97\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_WHO-ECDC-CDC-UK-Ca-Aus-Annals-97) in those conditions small particles can remain suspended in the air for minutes to hours.[\[97\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Transmission_of_COVID-19_WHO-ECDC-CDC-UK-Ca-Aus-Annals-97)[\[100\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-100)
Virology
[](https://en.wikipedia.org/wiki/File:Coronavirus_virion_structure.svg)
Illustration of [SARSr-CoV](https://en.wikipedia.org/wiki/SARSr-CoV "SARSr-CoV") [virion](https://en.wikipedia.org/wiki/Virus "Virus")
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a [novel](https://en.wikipedia.org/wiki/Novel_virus "Novel virus") severe acute respiratory syndrome coronavirus. It was first isolated from three people with pneumonia connected to the [cluster](https://en.wikipedia.org/wiki/Disease_cluster "Disease cluster") of acute respiratory illness cases in Wuhan.[\[101\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-ECDC_risk_assessment-101) All structural features of the novel SARS-CoV-2 virus particle occur in related [coronaviruses](https://en.wikipedia.org/wiki/Coronavirus "Coronavirus") in nature,[\[102\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NM-20200317-102) particularly in *[Rhinolophus sinicus](https://en.wikipedia.org/wiki/Rhinolophus_sinicus "Rhinolophus sinicus")* (Chinese horseshoe bats).[\[103\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-zhou20-103)
Outside the human body, the virus is destroyed by household soap which bursts its [protective bubble](https://en.wikipedia.org/wiki/Viral_envelope "Viral envelope").[\[104\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NatGeoSoap-104) Hospital disinfectants, alcohols, heat, [povidone-iodine](https://en.wikipedia.org/wiki/Povidone-iodine "Povidone-iodine"), and [ultraviolet](https://en.wikipedia.org/wiki/Ultraviolet "Ultraviolet")\-C (UV-C) irradiation are also effective disinfection methods for surfaces.[\[105\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-105)
SARS-CoV-2 is closely related to the original [SARS-CoV](https://en.wikipedia.org/wiki/SARS-CoV "SARS-CoV").[\[106\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Zhu24Jan2020-106) It is thought to have an animal ([zoonotic](https://en.wikipedia.org/wiki/Zoonosis "Zoonosis")) origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus *[Betacoronavirus](https://en.wikipedia.org/wiki/Betacoronavirus "Betacoronavirus")*, in subgenus *[Sarbecovirus](https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome%E2%80%93related_coronavirus "Severe acute respiratory syndrome–related coronavirus")* (lineage B) together with two bat-derived strains. It is 96% identical at the whole [genome](https://en.wikipedia.org/wiki/Genome "Genome") level to other bat coronavirus samples (BatCov [RaTG13](https://en.wikipedia.org/wiki/RaTG13 "RaTG13")).[\[107\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHOReport24Feb2020-107)[\[108\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-108)[\[109\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-RathoreSingh-109) The structural proteins of SARS-CoV-2 include [membrane glycoprotein](https://en.wikipedia.org/wiki/Coronavirus_membrane_protein "Coronavirus membrane protein") (M), [envelope protein](https://en.wikipedia.org/wiki/Coronavirus_envelope_protein "Coronavirus envelope protein") (E), [nucleocapsid protein](https://en.wikipedia.org/wiki/Coronavirus_nucleocapsid_protein "Coronavirus nucleocapsid protein") (N), and the [spike protein](https://en.wikipedia.org/wiki/Coronavirus_spike_protein "Coronavirus spike protein") (S). The M protein of SARS-CoV-2 is about 98% similar to the M protein of bat SARS-CoV, maintains around 98% homology with pangolin SARS-CoV, and has 90% homology with the M protein of SARS-CoV; whereas, the similarity is only around 38% with the M protein of [MERS-CoV](https://en.wikipedia.org/wiki/MERS-CoV "MERS-CoV").[\[110\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-110)
SARS-CoV-2 variants
The many thousands of SARS-CoV-2 variants are grouped into either [clades](https://en.wikipedia.org/wiki/Clade "Clade") or [lineages](https://en.wikipedia.org/wiki/Lineage_\(evolution\) "Lineage (evolution)").[\[111\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-111)[\[112\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Rambaut-2020-112) The WHO, in collaboration with partners, expert networks, national authorities, institutions and researchers, have established nomenclature systems for naming and tracking SARS-CoV-2 genetic lineages by [GISAID](https://en.wikipedia.org/wiki/GISAID "GISAID"), [Nextstrain](https://en.wikipedia.org/wiki/Nextstrain "Nextstrain") and [Pango](https://en.wikipedia.org/wiki/Phylogenetic_Assignment_of_Named_Global_Outbreak_Lineages "Phylogenetic Assignment of Named Global Outbreak Lineages"). The expert group convened by the WHO recommended the labelling of variants using letters of the [Greek alphabet](https://en.wikipedia.org/wiki/Greek_alphabet "Greek alphabet"), for example, [Alpha](https://en.wikipedia.org/wiki/SARS-CoV-2_Alpha_variant "SARS-CoV-2 Alpha variant"), [Beta](https://en.wikipedia.org/wiki/SARS-CoV-2_Beta_variant "SARS-CoV-2 Beta variant"), [Delta](https://en.wikipedia.org/wiki/SARS-CoV-2_Delta_variant "SARS-CoV-2 Delta variant"), and [Gamma](https://en.wikipedia.org/wiki/SARS-CoV-2_Gamma_variant "SARS-CoV-2 Gamma variant"), giving the justification that they "will be easier and more practical to discussed by non-scientific audiences".[\[113\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-113) Nextstrain divides the variants into five clades (19A, 19B, 20A, 20B, and 20C), while GISAID divides them into seven (L, O, V, S, G, GH, and GR).[\[114\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Alm2020Aug-114) The Pango tool groups variants into lineages, with many circulating lineages being classed under the B.1 lineage.[\[112\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Rambaut-2020-112)[\[115\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-115)
Several notable variants of SARS-CoV-2 emerged throughout 2020.[\[116\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Lauring_Hodcroft_2021_pp._529%E2%80%93531-116)[\[117\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Abdool_Karim_de_Oliveira_pp._1866%E2%80%931868-117) [Cluster 5](https://en.wikipedia.org/wiki/Cluster_5 "Cluster 5") emerged among [minks](https://en.wikipedia.org/wiki/Mink "Mink") and mink farmers in [Denmark](https://en.wikipedia.org/wiki/Denmark "Denmark").[\[118\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-118) After [strict quarantines](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Denmark "COVID-19 pandemic in Denmark") and the [slaughter of all the country's mink](https://en.wikipedia.org/wiki/2020_Danish_mink_cull "2020 Danish mink cull"), the cluster was assessed to no longer be circulating among humans in Denmark as of 1 February 2021.[\[119\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-119)
As of December 2021, there are five dominant variants of SARS-CoV-2 spreading among global populations: the [Alpha variant](https://en.wikipedia.org/wiki/SARS-CoV-2_Alpha_variant "SARS-CoV-2 Alpha variant") (B.1.1.7, formerly called the UK variant), first found in London and Kent, the [Beta variant](https://en.wikipedia.org/wiki/SARS-CoV-2_Beta_variant "SARS-CoV-2 Beta variant") (B.1.351, formerly called the South Africa variant), the [Gamma variant](https://en.wikipedia.org/wiki/SARS-CoV-2_Gamma_variant "SARS-CoV-2 Gamma variant") (P.1, formerly called the Brazil variant), the [Delta variant](https://en.wikipedia.org/wiki/SARS-CoV-2_Delta_variant "SARS-CoV-2 Delta variant") (B.1.617.2, formerly called the India variant),[\[120\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-120) and the [Omicron variant](https://en.wikipedia.org/wiki/SARS-CoV-2_Omicron_variant "SARS-CoV-2 Omicron variant") (B.1.1.529), which had spread to 57 countries as of 7 December.[\[121\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-121)[\[122\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-122)
On 19 December 2023, the WHO declared that another distinctive variant, JN.1, had emerged as a "variant of interest". Though the WHO expected an increase in cases globally, particularly for countries entering winter, the overall global health risk was considered low.[\[123\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-123)[\[124\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-124)
Pathophysiology
[](https://en.wikipedia.org/wiki/File:Fpubh-08-00383-g003.jpg)
COVID‑19 [pathogenesis](https://en.wikipedia.org/wiki/Pathogenesis "Pathogenesis")
The SARS-CoV-2 virus can infect a wide range of cells and systems of the body. COVID‑19 is most known for affecting the upper respiratory tract (sinuses, nose, and throat) and the lower respiratory tract (windpipe and lungs).[\[125\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid33132005-125) The lungs are the organs most affected by COVID‑19 because the virus accesses host cells via the [receptor](https://en.wikipedia.org/wiki/Receptor_\(biochemistry\) "Receptor (biochemistry)") for the enzyme [angiotensin-converting enzyme 2](https://en.wikipedia.org/wiki/Angiotensin-converting_enzyme_2 "Angiotensin-converting enzyme 2") (ACE2), which is most abundant on the surface of [type II alveolar cells](https://en.wikipedia.org/wiki/Type_II_cell "Type II cell") of the lungs.[\[126\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-126) The virus uses a special surface glycoprotein called a "[spike](https://en.wikipedia.org/wiki/Coronavirus_spike_protein "Coronavirus spike protein")" to connect to the ACE2 receptor and enter the host cell.[\[127\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Nature_Microbiology-127)
Respiratory tract
Following viral entry, COVID‑19 infects the ciliated epithelium of the nasopharynx and upper airways.[\[128\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-128) Autopsies of people who died of COVID‑19 have found [diffuse alveolar damage](https://en.wikipedia.org/wiki/Diffuse_alveolar_damage "Diffuse alveolar damage"), and lymphocyte-containing inflammatory infiltrates within the lung.[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
From the [CT scans](https://en.wikipedia.org/wiki/CT_scan "CT scan") of COVID-19 infected lungs, white patches were observed containing fluid known as [ground-glass opacity](https://en.wikipedia.org/wiki/Ground-glass_opacity "Ground-glass opacity") (GGO) or simply ground glass.[\[130\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-130) This tended to correlate with the clear jelly liquid found in lung autopsies of people who died of COVID-19. One possibility addressed in medical research is that [hyuralonic acid](https://en.wikipedia.org/wiki/Hyaluronic_acid "Hyaluronic acid") (HA) could be the leading factor for this observation of the clear jelly liquid found in the lungs, in what could be hyuralonic storm, in conjunction with [cytokine storm](https://en.wikipedia.org/wiki/Cytokine_storm "Cytokine storm").[\[131\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-131)
Nervous system
One common symptom, loss of smell, results from [infection of the support cells of the olfactory epithelium](https://en.wikipedia.org/wiki/Impact_of_COVID-19_on_neurological,_psychological_and_other_mental_health_outcomes "Impact of COVID-19 on neurological, psychological and other mental health outcomes"), with subsequent damage to the [olfactory neurons](https://en.wikipedia.org/wiki/Olfactory_receptor_neuron "Olfactory receptor neuron").[\[132\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Meunier-2020-132) The involvement of both the central and peripheral nervous system in COVID‑19 has been reported in many medical publications.[\[133\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Guerrero2020-133) It is clear that many people with [COVID-19 exhibit neurological or mental health issues](https://en.wikipedia.org/wiki/Impact_of_COVID-19_on_neurological,_psychological_and_other_mental_health_outcomes "Impact of COVID-19 on neurological, psychological and other mental health outcomes"). The virus is not detected in the [central nervous system](https://en.wikipedia.org/wiki/Central_nervous_system "Central nervous system") (CNS) of the majority of people with COVID-19 who also have [neurological issues](https://en.wikipedia.org/wiki/Impact_of_the_COVID-19_pandemic_on_neurological,_psychological_and_other_mental_health_outcomes "Impact of the COVID-19 pandemic on neurological, psychological and other mental health outcomes"). However, SARS-CoV-2 has been detected at low levels in the brains of those who have died from COVID‑19, but these results need to be confirmed.[\[134\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Pezzini2020-134) While virus has been detected in [cerebrospinal fluid](https://en.wikipedia.org/wiki/Cerebrospinal_fluid "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.[\[135\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-135)[\[136\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-136)[\[137\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-137) The virus may also enter the bloodstream from the lungs and cross the blood–brain barrier to gain access to the CNS, possibly within an infected white blood cell.[\[134\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Pezzini2020-134)
[](https://en.wikipedia.org/wiki/File:Ijms-21-05932-g003.webp)
[Tropism](https://en.wikipedia.org/wiki/Host_tropism "Host tropism") and [multiple organ injuries](https://en.wikipedia.org/wiki/Multiple_organ_dysfunction_syndrome "Multiple organ dysfunction syndrome") in SARS-CoV-2 infection
Research conducted when Alpha was the dominant variant has suggested COVID-19 may cause brain damage.[\[138\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-138) Later research showed that all variants studied (including Omicron) killed brain cells, but the exact cells killed varied by variant.[\[139\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-139) It is unknown if such damage is temporary or permanent.[\[140\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-140)[\[141\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-141) Observed individuals infected with COVID-19 (most with mild cases) experienced an additional 0.2% to 2% of brain tissue lost in regions of the brain connected to the sense of smell compared with uninfected individuals, and the overall effect on the brain was equivalent on average to at least one extra year of normal ageing; infected individuals also scored lower on several cognitive tests. All effects were more pronounced among older ages.[\[142\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-142)
Gastrointestinal tract
The virus also affects gastrointestinal organs as ACE2 is abundantly expressed in the [glandular](https://en.wikipedia.org/wiki/Gland "Gland") cells of [gastric](https://en.wikipedia.org/wiki/Stomach "Stomach"), [duodenal](https://en.wikipedia.org/wiki/Duodenum "Duodenum") and [rectal](https://en.wikipedia.org/wiki/Rectum "Rectum") [epithelium](https://en.wikipedia.org/wiki/Epithelium "Epithelium")[\[143\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Gu-2020-143) as well as [endothelial](https://en.wikipedia.org/wiki/Endothelium "Endothelium") cells and [enterocytes](https://en.wikipedia.org/wiki/Enterocyte "Enterocyte") of the [small intestine](https://en.wikipedia.org/wiki/Small_intestine "Small intestine").[\[144\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid32343593-144)
Cardiovascular system
The virus can cause [acute myocardial injury](https://en.wikipedia.org/wiki/Myocardial_infarction "Myocardial infarction") and chronic damage to the [cardiovascular system](https://en.wikipedia.org/wiki/Circulatory_system "Circulatory system").[\[145\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-145)[\[146\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Zheng-2020-146) An acute cardiac injury was found in 12% of infected people admitted to the hospital in Wuhan, China,[\[147\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Huang24Jan2020-147) and is more frequent in severe disease.[\[148\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-148) 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.[\[146\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Zheng-2020-146) ACE2 receptors are highly expressed in the heart and are involved in heart function.[\[146\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Zheng-2020-146)[\[149\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-149)
A high incidence of [thrombosis](https://en.wikipedia.org/wiki/Thrombosis "Thrombosis") and [venous thromboembolism](https://en.wikipedia.org/wiki/Venous_thromboembolism "Venous thromboembolism") occurs in people transferred to [intensive care units](https://en.wikipedia.org/wiki/Intensive_care_unit "Intensive care unit") with COVID‑19 infections, and may be related to poor prognosis.[\[150\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-150) Blood vessel dysfunction and clot formation (as suggested by high [D-dimer](https://en.wikipedia.org/wiki/D-dimer "D-dimer") levels caused by blood clots) may have a significant role in mortality, incidents of clots leading to [pulmonary embolisms](https://en.wikipedia.org/wiki/Pulmonary_embolism "Pulmonary embolism"), and [ischaemic events](https://en.wikipedia.org/wiki/Stroke "Stroke") (strokes) within the brain found as complications leading to death in people infected with COVID‑19.[\[151\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Science-151) Infection may initiate a chain of [vasoconstrictive responses](https://en.wikipedia.org/wiki/Vasoconstriction "Vasoconstriction") within the body, including pulmonary vasoconstriction – a possible mechanism in which oxygenation decreases during pneumonia.[\[151\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Science-151) Furthermore, damage of [arterioles](https://en.wikipedia.org/wiki/Arterioles "Arterioles") and [capillaries](https://en.wikipedia.org/wiki/Capillaries "Capillaries") was found in brain tissue samples of people who died from COVID‑19.[\[152\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-152)[\[153\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-153)
COVID‑19 may also cause substantial structural changes to [blood cells](https://en.wikipedia.org/wiki/Blood_cell "Blood cell"), sometimes persisting for months after hospital discharge.[\[154\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-154) [A low level of blood lymphocytess](https://en.wikipedia.org/wiki/Lymphopenia "Lymphopenia") may result from the virus acting through ACE2-related entry into lymphocytes.[\[155\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-155)
Kidneys
Another common cause of death is complications related to the [kidneys](https://en.wikipedia.org/wiki/Kidney "Kidney").[\[151\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Science-151) Early reports show that up to 30% of people hospitalised with COVID-19 both in China and in New York have experienced some injury to their kidneys, including some persons with no previous kidney problems.[\[156\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-156)
Immunopathology
[](https://en.wikipedia.org/wiki/File:Fimmu-11-579250-g003.jpg)
Key components of the [adaptive immune response](https://en.wikipedia.org/wiki/Adaptive_immune_system "Adaptive immune system") to SARS-CoV-2
Although SARS-CoV-2 has a tropism for ACE2-expressing epithelial cells of the respiratory tract, people with severe COVID‑19 have symptoms of systemic hyperinflammation. Clinical laboratory findings of elevated [IL‑2](https://en.wikipedia.org/wiki/Interleukin_2 "Interleukin 2"), [IL‑6](https://en.wikipedia.org/wiki/Interleukin_6 "Interleukin 6"), [IL‑7](https://en.wikipedia.org/wiki/Interleukin_7 "Interleukin 7"), as well as the following suggest an underlying immunopathology:[\[147\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Huang24Jan2020-147)
- [Granulocyte-macrophage colony-stimulating factor](https://en.wikipedia.org/wiki/Granulocyte-macrophage_colony-stimulating_factor "Granulocyte-macrophage colony-stimulating factor") (GM‑CSF)
- [Interferon gamma-induced protein 10](https://en.wikipedia.org/wiki/CXCL10 "CXCL10") (IP‑10)
- [Monocyte chemoattractant protein 1](https://en.wikipedia.org/wiki/Monocyte_chemoattractant_protein-1 "Monocyte chemoattractant protein-1") (MCP1)
- [Macrophage inflammatory protein 1‑alpha](https://en.wikipedia.org/wiki/CCL3 "CCL3") (MIP‑1‑alpha)
- [Tumour necrosis factor](https://en.wikipedia.org/wiki/Tumour_necrosis_factor "Tumour necrosis factor") (TNF‑α) indicative of [cytokine release syndrome](https://en.wikipedia.org/wiki/Cytokine_release_syndrome "Cytokine release syndrome") (CRS)
[Interferon alpha](https://en.wikipedia.org/wiki/Interferon-alpha "Interferon-alpha") plays a complex, Janus-faced role in the pathogenesis of COVID-19. Although it promotes the elimination of virus-infected cells, it also upregulates the expression of ACE-2, thereby facilitating the SARS-Cov2 virus to enter cells and to replicate.[\[157\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-157)[\[158\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-158) A competition of negative feedback loops (via protective effects of interferon alpha) and positive feedback loops (via upregulation of ACE-2) is assumed to determine the fate of people with COVID-19.[\[159\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-159)\[*[needs update](https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers#Chronological_items "Wikipedia:Manual of Style/Dates and numbers")*\]
Additionally, people with COVID‑19 and [acute respiratory distress syndrome](https://en.wikipedia.org/wiki/Acute_respiratory_distress_syndrome "Acute respiratory distress syndrome") (ARDS) have classical [serum](https://en.wikipedia.org/wiki/Serum_\(blood\) "Serum (blood)") [biomarkers](https://en.wikipedia.org/wiki/Biomarker_\(medicine\) "Biomarker (medicine)") of CRS, including elevated [C-reactive protein](https://en.wikipedia.org/wiki/C-reactive_protein "C-reactive protein") (CRP), [lactate dehydrogenase](https://en.wikipedia.org/wiki/Lactate_dehydrogenase "Lactate dehydrogenase") (LDH), [D-dimer](https://en.wikipedia.org/wiki/D-dimer "D-dimer"), and [ferritin](https://en.wikipedia.org/wiki/Ferritin "Ferritin").[\[160\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-160)
Systemic inflammation results in [vasodilation](https://en.wikipedia.org/wiki/Vasodilation "Vasodilation"), allowing inflammatory lymphocytic and monocytic infiltration of the lung and the heart. In particular, pathogenic GM-CSF-secreting [T cells](https://en.wikipedia.org/wiki/T_cell "T cell") were shown to correlate with the recruitment of inflammatory IL-6-secreting [monocytes](https://en.wikipedia.org/wiki/Monocyte "Monocyte") and severe lung pathology in people with COVID‑19.[\[161\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-161) Lymphocytic infiltrates have also been reported at autopsy.[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
Viral and host factors
Virus proteins
[](https://en.wikipedia.org/wiki/File:Fpubh-08-00383-g004.jpg)
The association between SARS-CoV-2 and the [Renin-Angiotensin-Aldosterone System](https://en.wikipedia.org/wiki/Renin%E2%80%93angiotensin_system "Renin–angiotensin system") (RAAS)
Multiple viral and host factors affect the pathogenesis of the virus. The [S-protein](https://en.wikipedia.org/wiki/S_protein "S protein"), otherwise known as the spike protein, is the viral component that attaches to the host receptor via the [ACE2](https://en.wikipedia.org/wiki/Angiotensin-converting_enzyme_2 "Angiotensin-converting enzyme 2") receptors. It includes two subunits: S1 and S2.
- S1 determines the virus-host range and cellular tropism via the receptor-binding domain.
- S2 mediates the membrane fusion of the virus to its potential cell host via the H1 and HR2, which are [heptad repeat](https://en.wikipedia.org/wiki/Heptad_repeat "Heptad repeat") regions.
Studies have shown that S1 domain induced [IgG](https://en.wikipedia.org/wiki/IgG "IgG") and [IgA](https://en.wikipedia.org/wiki/IgA "IgA") antibody levels at a much higher capacity. It is the focus spike proteins expression that are involved in many effective COVID‑19 vaccines.[\[162\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid33340022-162)
The M protein is the viral protein responsible for the transmembrane transport of nutrients. It is the cause of the bud release and the formation of the viral envelope.[\[163\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Boopathi-2020-163) The N and E protein are accessory proteins that interfere with the host's immune response.[\[163\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Boopathi-2020-163)
Host factors
Human [angiotensin converting enzyme 2](https://en.wikipedia.org/wiki/Angiotensin_converting_enzyme_2 "Angiotensin converting enzyme 2") (hACE2) is the host factor that SARS-CoV-2 virus targets causing COVID‑19. Theoretically, the usage of [angiotensin receptor blockers](https://en.wikipedia.org/wiki/Angiotensin_II_receptor_blocker "Angiotensin II receptor blocker") (ARB) and [ACE inhibitors](https://en.wikipedia.org/wiki/ACE_inhibitor "ACE inhibitor") upregulating ACE2 expression might increase [morbidity](https://en.wikipedia.org/wiki/Morbidity "Morbidity") with COVID‑19, though animal data suggest some potential protective effect of ARB; however no clinical studies have proven susceptibility or outcomes. Until further data is available, guidelines and recommendations for people with hypertension remain.[\[164\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-164)
The effect of the virus on ACE2 cell surfaces leads to leukocytic infiltration, increased blood vessel permeability, alveolar wall permeability, as well as decreased secretion of lung surfactants. These effects cause the majority of the respiratory symptoms. However, the aggravation of local inflammation causes a cytokine storm eventually leading to a [systemic inflammatory response syndrome](https://en.wikipedia.org/wiki/Systemic_inflammatory_response_syndrome "Systemic inflammatory response syndrome").[\[165\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-165)
Among healthy adults not exposed to SARS-CoV-2, about 35% have [CD4\+ T cells](https://en.wikipedia.org/wiki/CD4%2B_T_cell "CD4+ T cell") that recognise the SARS-CoV-2 [S protein](https://en.wikipedia.org/wiki/Peplomer "Peplomer") (particularly the S2 subunit) and about 50% react to other proteins of the virus, suggesting [cross-reactivity](https://en.wikipedia.org/wiki/Cross-reactivity "Cross-reactivity") from previous [common colds](https://en.wikipedia.org/wiki/Common_cold "Common cold") caused by other coronaviruses.[\[166\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-166)
It is unknown whether different persons use similar antibody genes in response to COVID‑19.[\[167\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-167)
Host cytokine response
[](https://en.wikipedia.org/wiki/File:Ijms-21-05932-g004.webp)
Mild versus severe [immune response](https://en.wikipedia.org/wiki/Immune_system "Immune system") during [virus infection](https://en.wikipedia.org/wiki/Viral_disease "Viral disease")
The severity of the inflammation can be attributed to the severity of what is known as the [cytokine storm](https://en.wikipedia.org/wiki/Cytokine_storm "Cytokine storm").[\[168\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid32474885-168) Levels of [interleukin 1B](https://en.wikipedia.org/wiki/Interleukin_1_beta "Interleukin 1 beta"), [interferon-gamma](https://en.wikipedia.org/wiki/Interferon_gamma "Interferon gamma"), interferon-inducible protein 10, and monocyte chemoattractant protein 1 were all associated with COVID‑19 disease severity. Treatment has been proposed to combat the cytokine storm as it remains to be one of the leading causes of [morbidity](https://en.wikipedia.org/wiki/Morbidity "Morbidity") and mortality in COVID‑19 disease.[\[169\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-169)
A cytokine storm is due to an acute hyperinflammatory response that is responsible for clinical illness in an array of diseases but in COVID‑19, it is related to worse prognosis and increased fatality. The storm causes acute respiratory distress syndrome, blood clotting events such as strokes, [myocardial infarction](https://en.wikipedia.org/wiki/Myocardial_infarction "Myocardial infarction"), [encephalitis](https://en.wikipedia.org/wiki/Encephalitis "Encephalitis"), [acute kidney injury](https://en.wikipedia.org/wiki/Acute_kidney_injury "Acute kidney injury"), and [vasculitis](https://en.wikipedia.org/wiki/Vasculitis "Vasculitis"). The production of [IL-1](https://en.wikipedia.org/wiki/Interleukin_1 "Interleukin 1"), [IL-2](https://en.wikipedia.org/wiki/Interleukin_2 "Interleukin 2"), [IL-6](https://en.wikipedia.org/wiki/Interleukin_6 "Interleukin 6"), [TNF-alpha](https://en.wikipedia.org/wiki/Tumor_necrosis_factor "Tumor necrosis factor"), and [interferon-gamma](https://en.wikipedia.org/wiki/Interferon_gamma "Interferon gamma"), all crucial components of normal immune responses, inadvertently become the causes of a cytokine storm. The cells of the [central nervous system](https://en.wikipedia.org/wiki/Central_nervous_system "Central nervous system"), the [microglia](https://en.wikipedia.org/wiki/Microglia "Microglia"), [neurons](https://en.wikipedia.org/wiki/Neuron "Neuron"), and [astrocytes](https://en.wikipedia.org/wiki/Astrocyte "Astrocyte"), are also involved in the release of [pro-inflammatory cytokines](https://en.wikipedia.org/wiki/Pro-inflammatory_cytokine "Pro-inflammatory cytokine") affecting the nervous system, and effects of cytokine storms toward the CNS are not uncommon.[\[170\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-170)
Pregnancy response
There are many unknowns for pregnant women during the COVID-19 pandemic. Given that they are prone to have complications and severe disease infection with other types of coronaviruses, they have been identified as a vulnerable group and advised to take supplementary preventive measures.[\[171\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wastnedge_2021-171)
Physiological responses to pregnancy can include:
- Immunological: The immunological response to COVID-19, like other viruses, depends on a working immune system. It adapts during pregnancy to allow the development of the foetus whose genetic load is only partially shared with their mother, leading to a different immunological reaction to infections during the course of pregnancy.[\[171\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wastnedge_2021-171)
- Respiratory: Many factors can make pregnant women more vulnerable to hard respiratory infections. One of them is the total reduction of the lungs' capacity and inability to clear secretions.[\[171\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wastnedge_2021-171)
- Coagulation: During pregnancy, there are higher levels of circulating coagulation factors, and the pathogenesis of SARS-CoV-2 infection can be implicated. The thromboembolic events with associated mortality are a risk for pregnant women.[\[171\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wastnedge_2021-171)
However, from the evidence base, it is difficult to conclude whether pregnant women are at increased risk of grave consequences of this virus.[\[171\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wastnedge_2021-171)
In addition to the above, other clinical studies have proved that SARS-CoV-2 can affect the period of pregnancy in different ways. On the one hand, there is little evidence of its impact up to 12 weeks gestation. On the other hand, COVID-19 infection may cause increased rates of unfavourable outcomes in the course of the pregnancy. Some examples of these could be foetal growth restriction, preterm birth, and perinatal mortality, which refers to the foetal death past 22 or 28 completed weeks of pregnancy as well as the death among live-born children up to seven completed days of life.[\[171\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wastnedge_2021-171) For preterm birth, a 2023 review indicates that there appears to be a correlation with COVID-19.[\[172\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-172)
Unvaccinated women in later stages of pregnancy with COVID-19 are more likely than other people to need very intensive care. Babies born to mothers with COVID-19 are more likely to have breathing problems. Pregnant women are strongly encouraged to get [vaccinated](https://en.wikipedia.org/wiki/COVID-19_vaccine "COVID-19 vaccine").[\[173\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-173)
Diagnosis
COVID‑19 can provisionally be diagnosed on the basis of symptoms and confirmed using [reverse transcription polymerase chain reaction](https://en.wikipedia.org/wiki/Reverse_transcription_polymerase_chain_reaction "Reverse transcription polymerase chain reaction") (RT-PCR) or other [nucleic acid testing](https://en.wikipedia.org/wiki/Nucleic_acid_test "Nucleic acid test") of infected secretions.[\[174\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid32621814-174)[\[175\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-jTxKm-175) Along with laboratory testing, chest CT scans may be helpful to diagnose COVID‑19 in individuals with a high clinical suspicion of infection.[\[176\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Salehi-2020-176) Detection of a past infection is possible with [serological tests](https://en.wikipedia.org/wiki/Serology "Serology"), which detect [antibodies](https://en.wikipedia.org/wiki/Antibody "Antibody") produced by the body in response to the infection.[\[174\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid32621814-174)
Viral testing
[](https://en.wikipedia.org/wiki/File:Infektionsschutzzentrum_im_Rautenstrauch-Joest-Museum,_K%C3%B6ln-6313_\(cropped\).jpg)
Demonstration of a [nasopharyngeal swab](https://en.wikipedia.org/wiki/Nasopharyngeal_swab "Nasopharyngeal swab") for [COVID‑19 testing](https://en.wikipedia.org/wiki/COVID%E2%80%9119_testing "COVID‑19 testing")
The standard methods of testing for presence of SARS-CoV-2 are [nucleic acid tests](https://en.wikipedia.org/wiki/Nucleic_acid_test "Nucleic acid test"),[\[174\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid32621814-174)[\[177\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-20200130cdc-177) which detects the presence of viral RNA fragments.[\[178\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO_InterimGuidance-178) As these tests detect RNA but not infectious virus, its "ability to determine duration of infectivity of patients is limited".[\[179\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-2k0iS-179) The test is typically done on respiratory samples obtained by a [nasopharyngeal swab](https://en.wikipedia.org/wiki/Nasopharyngeal_swab "Nasopharyngeal swab"); however, a nasal swab or sputum sample may also be used.[\[180\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC2020Testing-180)[\[181\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-20200129cdc-181) Results are generally available within hours.[\[174\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid32621814-174) The WHO has published several testing protocols for the disease.[\[182\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-182)
Several laboratories and companies have developed serological tests, which detect antibodies produced by the body in response to infection. Some have been evaluated by [Public Health England](https://en.wikipedia.org/wiki/Public_Health_England "Public Health England") and approved for use in the UK.[\[183\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-independent9515466-183)
The [University of Oxford](https://en.wikipedia.org/wiki/University_of_Oxford "University of Oxford")'s CEBM has pointed to mounting evidence[\[184\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-yFMEP-184)[\[185\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-2exX5-185) that "a good proportion of 'new' mild cases and people re-testing positives after quarantine or discharge from hospital are not infectious, but are simply clearing harmless virus particles which their immune system has efficiently dealt with" and have called for "an international effort to standardize and periodically calibrate testing"[\[186\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-PQGAv-186) In September 2020, the UK government issued "guidance for procedures to be implemented in laboratories to provide assurance of positive SARS-CoV-2 RNA results during periods of low prevalence, when there is a reduction in the predictive value of positive test results".[\[187\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-9Kblp-187)
Imaging
[](https://en.wikipedia.org/wiki/File:COVID19CTPneumonia.jpg)
A [CT](https://en.wikipedia.org/wiki/Computed_tomography "Computed tomography") scan of a person with COVID-19 shows lesions (bright regions) in the lungs
[](https://en.wikipedia.org/wiki/File:COVID19CT1.webp)
CT scan of rapid progression stage of COVID-19
[](https://en.wikipedia.org/wiki/File:COVID-19_Pneumonie_-_82m_Roe_Thorax_ap_-_001.jpg)
Chest X-ray showing COVID‑19 pneumonia
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.[\[176\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Salehi-2020-176)[\[188\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-acr.org-188) Bilateral multilobar [ground-glass opacities](https://en.wikipedia.org/wiki/Ground-glass_opacity "Ground-glass opacity") with a peripheral, asymmetric, and posterior distribution are common in early infection.[\[176\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Salehi-2020-176)[\[189\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-189) Subpleural dominance, [crazy paving](https://en.wikipedia.org/wiki/Crazy_paving_\(medicine\) "Crazy paving (medicine)") (lobular septal thickening with variable alveolar filling), and [consolidation](https://en.wikipedia.org/wiki/Pulmonary_consolidation "Pulmonary consolidation") may appear as the disease progresses.[\[176\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Salehi-2020-176)[\[190\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-190) Characteristic imaging features on chest [radiographs](https://en.wikipedia.org/wiki/Radiograph "Radiograph") and [computed tomography](https://en.wikipedia.org/wiki/Computed_tomography "Computed tomography") (CT) of people who are symptomatic include asymmetric peripheral ground-glass opacities without [pleural effusions](https://en.wikipedia.org/wiki/Pleural_effusion "Pleural effusion").[\[191\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AJR-191)
Many groups have created [COVID‑19 datasets](https://en.wikipedia.org/wiki/COVID%E2%80%9119_datasets "COVID‑19 datasets") that include imagery such as the [Italian Radiological Society](https://en.wikipedia.org/wiki/Italian_Society_of_Medical_and_Interventional_Radiology "Italian Society of Medical and Interventional Radiology") which has compiled an international online database of imaging findings for confirmed cases.[\[192\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cx70C-192) Due to overlap with other infections such as [adenovirus](https://en.wikipedia.org/wiki/Adenovirus "Adenovirus"), imaging without confirmation by rRT-PCR is of limited [specificity](https://en.wikipedia.org/wiki/Specificity_\(statistics\) "Specificity (statistics)") in identifying COVID‑19.[\[191\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AJR-191) A large study in China compared chest CT results to PCR and demonstrated that though imaging is less specific for the infection, it is faster and more [sensitive](https://en.wikipedia.org/wiki/Sensitivity_\(statistics\) "Sensitivity (statistics)").[\[175\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-jTxKm-175)
Coding
In late 2019, the WHO assigned emergency [ICD-10](https://en.wikipedia.org/wiki/ICD-10 "ICD-10") disease codes 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.[\[193\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-ICD10_2019_U07p2-193)
Pathology
The main pathological findings at autopsy are:
- [Macroscopy](https://en.wikipedia.org/wiki/Macroscopic_scale "Macroscopic scale"): [pericarditis](https://en.wikipedia.org/wiki/Pericarditis "Pericarditis"), [lung consolidation](https://en.wikipedia.org/wiki/Lung_consolidation "Lung consolidation") and [pulmonary oedema](https://en.wikipedia.org/wiki/Pulmonary_edema "Pulmonary edema")[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
- Lung findings:
- Minor serous [exudation](https://en.wikipedia.org/wiki/Exudate "Exudate"), minor [fibrin](https://en.wikipedia.org/wiki/Fibrin "Fibrin") exudation[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
- Pulmonary oedema, [pneumocyte](https://en.wikipedia.org/wiki/Pneumocyte "Pneumocyte") [hyperplasia](https://en.wikipedia.org/wiki/Hyperplasia "Hyperplasia"), large atypical [pneumocytes](https://en.wikipedia.org/wiki/Pneumocyte "Pneumocyte"), interstitial [inflammation](https://en.wikipedia.org/wiki/Inflammation "Inflammation") with [lymphocytic](https://en.wikipedia.org/wiki/Lymphocytic "Lymphocytic") [infiltration](https://en.wikipedia.org/wiki/Infiltration_\(medical\) "Infiltration (medical)") and [multinucleated giant cell](https://en.wikipedia.org/wiki/Giant_cell "Giant cell") formation[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
- [Diffuse alveolar damage](https://en.wikipedia.org/wiki/Diffuse_alveolar_damage "Diffuse alveolar damage") (DAD) with diffuse [alveolar](https://en.wikipedia.org/wiki/Pulmonary_alveolus "Pulmonary alveolus") [exudates](https://en.wikipedia.org/wiki/Exudates "Exudates"). DAD is the cause of [acute respiratory distress syndrome](https://en.wikipedia.org/wiki/Acute_respiratory_distress_syndrome "Acute respiratory distress syndrome") (ARDS) and severe [hypoxaemia](https://en.wikipedia.org/wiki/Hypoxemia "Hypoxemia").[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
- [Organisation](https://en.wikipedia.org/wiki/Healing "Healing") of [exudates](https://en.wikipedia.org/wiki/Exudate "Exudate") in [alveolar cavities](https://en.wikipedia.org/wiki/Pulmonary_alveolus "Pulmonary alveolus") and [pulmonary interstitial fibrosis](https://en.wikipedia.org/wiki/Pulmonary_fibrosis "Pulmonary fibrosis")[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
- [Plasmocytosis](https://en.wikipedia.org/wiki/Plasma_cell "Plasma cell") in [bronchoalveolar lavage](https://en.wikipedia.org/wiki/Bronchoalveolar_lavage "Bronchoalveolar lavage") (BAL)[\[194\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-194)
- Blood and vessels: [disseminated intravascular coagulation](https://en.wikipedia.org/wiki/Disseminated_intravascular_coagulation "Disseminated intravascular coagulation") (DIC);[\[195\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-195) [leukoerythroblastic](https://en.wikipedia.org/wiki/Leukoerythroblastic "Leukoerythroblastic") reaction,[\[196\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-196) [endotheliitis](https://en.wikipedia.org/wiki/Endotheliitis "Endotheliitis"),[\[197\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-SatturwarFowkes2021-197) [hemophagocytosis](https://en.wikipedia.org/wiki/Hemophagocytosis "Hemophagocytosis")[\[197\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-SatturwarFowkes2021-197)
- Heart: [cardiac muscle cell](https://en.wikipedia.org/wiki/Cardiac_muscle_cell "Cardiac muscle cell") necrosis[\[197\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-SatturwarFowkes2021-197)
- Liver: microvesicular [steatosis](https://en.wikipedia.org/wiki/Steatosis "Steatosis")[\[129\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Cureus-129)
- Nose: [shedding of olfactory epithelium](https://en.wikipedia.org/wiki/Impact_of_COVID-19_on_neurological,_psychological_and_other_mental_health_outcomes "Impact of COVID-19 on neurological, psychological and other mental health outcomes")[\[132\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Meunier-2020-132)
- Brain: [infarction](https://en.wikipedia.org/wiki/Cerebral_infarction "Cerebral infarction")[\[197\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-SatturwarFowkes2021-197)
- Kidneys: acute tubular damage.[\[197\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-SatturwarFowkes2021-197)
- Spleen: [white pulp](https://en.wikipedia.org/wiki/White_pulp "White pulp") depletion.[\[197\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-SatturwarFowkes2021-197)
Prevention
[](https://en.wikipedia.org/wiki/File:20200609_Effect_of_pandemic_containment_measures.gif)
Without pandemic containment measures – such as social distancing, vaccination, and face masks – pathogens can spread exponentially.[\[198\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Science_20200515-198) This graphic shows how early adoption of containment measures tends to protect wider swaths of the population.
Preventive measures to reduce the chances of infection include getting vaccinated, staying at home, wearing a mask in public, avoiding crowded places, keeping distance from others, ventilating indoor spaces, managing potential exposure durations,[\[199\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-199) 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.[\[200\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC042020-200)[\[201\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-201)
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](https://en.wikipedia.org/wiki/COVID-19#Face_masks_and_respiratory_hygiene) 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.[\[202\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC2020IfSick-202)[\[203\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-203)
The first [COVID‑19 vaccine](https://en.wikipedia.org/wiki/COVID%E2%80%9119_vaccine "COVID‑19 vaccine") was granted regulatory approval on 2 December 2020 by the UK medicines regulator [MHRA](https://en.wikipedia.org/wiki/Medicines_and_Healthcare_products_Regulatory_Agency "Medicines and Healthcare products Regulatory Agency").[\[204\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-ukgov12-2-204) It was evaluated for [emergency use authorisation](https://en.wikipedia.org/wiki/Emergency_use_authorisation "Emergency use authorisation") (EUA) status by the US [FDA](https://en.wikipedia.org/wiki/Food_and_Drugs_Administration "Food and Drugs Administration"), and in several other countries.[\[205\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-mueller-205) Initially, the US [National Institutes of Health](https://en.wikipedia.org/wiki/National_Institutes_of_Health "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 the setting of a clinical trial.[\[206\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NIHGuidelines2020-206)[\[76\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Sanders202022-76) Without a vaccine, other prophylactic measures, or effective treatments, a key part of managing COVID‑19 is trying to decrease and delay the epidemic peak, known as "flattening the [curve](https://en.wikipedia.org/wiki/Epidemic_curve "Epidemic curve")".[\[207\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Lancet2020Flatten-207) This is done by slowing the infection rate to decrease the risk of health services being overwhelmed, allowing for better treatment of active cases, and delaying additional cases until effective treatments or a vaccine become available.[\[207\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Lancet2020Flatten-207)[\[208\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wiles-208)
Vaccine
[](https://en.wikipedia.org/wiki/File:Fphar-11-00937-g004-L.jpg)
Different vaccine candidate types in development for SARS-CoV-2
[](https://en.wikipedia.org/wiki/File:2021-_COVID-19_death_rates_by_vaccination_status_-_US.svg)
Death rates for unvaccinated Americans substantially exceeded those who were vaccinated, with bivalent boosters further reducing the death rate.[\[209\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVIDmortality_2021_2023-209)
Major vaccines include the [Pfizer–BioNTech mRNA vaccine](https://en.wikipedia.org/wiki/Pfizer%E2%80%93BioNTech_COVID-19_vaccine "Pfizer–BioNTech COVID-19 vaccine"), [Moderna mRNA vaccine](https://en.wikipedia.org/wiki/Moderna_COVID-19_vaccine "Moderna COVID-19 vaccine"), and the [Novavax protein subunit vaccine](https://en.wikipedia.org/wiki/Novavax_COVID-19_vaccine "Novavax COVID-19 vaccine").[\[210\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_VaccineKnowledgeCOVID-210) With the emergence of new [SARS-CoV-2 variants](https://en.wikipedia.org/wiki/Variants_of_SARS-CoV-2 "Variants of SARS-CoV-2"), the original vaccines—particularly [Pfizer](https://en.wikipedia.org/wiki/Pfizer "Pfizer")–[BioNTech](https://en.wikipedia.org/wiki/BioNTech "BioNTech") and [Moderna](https://en.wikipedia.org/wiki/Moderna "Moderna") vaccines—have been updated. These "variant-adapted" vaccines are offered as [booster doses](https://en.wikipedia.org/wiki/Booster_dose "Booster dose").[\[210\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_VaccineKnowledgeCOVID-210) The immunity from the vaccines also wanes over time, requiring people to get boosters to maintain protection.[\[211\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_Rogers_2022-211)
Common side effects of COVID‑19 vaccines include soreness, fatigue, headache, [myalgia](https://en.wikipedia.org/wiki/Myalgia "Myalgia") (muscle pain), and [arthralgia](https://en.wikipedia.org/wiki/Arthralgia "Arthralgia") (joint pain), which resolve without medical treatment within a few days.[\[212\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_COVID-19_vaccine_WHO-212) COVID‑19 vaccination is safe for people who are pregnant or are breastfeeding.[\[213\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_breastf-213)
The COVID‑19 vaccines are widely credited for their role in reducing the spread of COVID‑19 and reducing the severity and death caused by COVID‑19.[\[211\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_Rogers_2022-211)[\[214\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-214) Many countries implemented phased distribution plans that prioritized those at highest risk of complications, such as the elderly, and those at high risk of exposure, such as [healthcare workers](https://en.wikipedia.org/wiki/Health_professional "Health professional").[\[215\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_Beaumont-215)[\[216\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_Wang1-216) By December 2020, more than 10 billion vaccine doses had been preordered,[\[217\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_mullard-217) with about half of the doses purchased by [high-income countries](https://en.wikipedia.org/wiki/World_Bank_high-income_economy "World Bank high-income economy") comprising 14% of the world's population.[\[218\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_So-218) As of August 2024, over 13 billion doses of COVID‑19 vaccines have been administered worldwide.[\[219\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-COVID-19_vaccine_Richie_2021-219)
Face masks and respiratory hygiene
[](https://en.wikipedia.org/wiki/File:2009Julija-210.jpg)
Masks with an exhalation valve. The valves are a weak point that can transmit the viruses outwards.
In community and healthcare settings, the use of face masks is intended as [source control](https://en.wikipedia.org/wiki/Source_control_\(respiratory_disease\) "Source control (respiratory disease)") to limit [transmission](https://en.wikipedia.org/wiki/Transmission_of_COVID-19 "Transmission of COVID-19") of the virus and for personal protection to prevent infection.[\[220\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_AR2021-220) Properly worn masks both limit the [respiratory droplets](https://en.wikipedia.org/wiki/Respiratory_droplet "Respiratory droplet") and [aerosols](https://en.wikipedia.org/wiki/Airborne_transmission "Airborne transmission") spread by infected individuals and help protect healthy individuals from infection.[\[221\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_Matuschek-221)[\[222\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_interplay-222)
Reviews of various kinds of scientific studies have concluded that masking is effective in protecting the individual against COVID-19.[\[221\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_Matuschek-221)[\[223\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_Talic-223)[\[224\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_cdc-sci-224) Various [case-control](https://en.wikipedia.org/wiki/Case%E2%80%93control_study "Case–control study") and population-based studies have also shown that increased levels of masking in a community reduces the spread of SARS-CoV-2,[\[223\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_Talic-223)[\[224\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_cdc-sci-224) though there is a paucity of evidence from [randomized controlled trials](https://en.wikipedia.org/wiki/Randomized_controlled_trial "Randomized controlled trial") (RCTs).[\[225\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_cochrane-225)[\[226\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_royalsoc-226) Masks vary in how well they work. Fitted [N95s](https://en.wikipedia.org/wiki/N95_respirator "N95 respirator") outperform surgical masks,[\[227\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_Ju-227)[\[228\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_norespirator-228) while cloth masks provide marginal protection.[\[229\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_Ataei-229)[\[230\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Face_masks_during_the_COVID-19_pandemic_cloth_v_surgical-230) During the public health emergency, governments widely recommended and mandated mask-wearing, and prominent national and intergovernmental health agencies and their leaders recommended the use of masks to reduce transmission, including the [WHO](https://en.wikipedia.org/wiki/WHO "WHO"), [American](https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention "Centers for Disease Control and Prevention"), [European](https://en.wikipedia.org/wiki/ECDC "ECDC"), and [Chinese](https://en.wikipedia.org/wiki/Chinese_Center_for_Disease_Control_and_Prevention "Chinese Center for Disease Control and Prevention") Centers for Disease Control and Prevention.
Indoor ventilation and avoiding crowded indoor spaces
The CDC states that avoiding crowded indoor spaces reduces the risk of COVID-19 infection.[\[231\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC-2020b-231) When indoors, increasing the rate of air change, decreasing recirculation of air and increasing the use of outdoor air can reduce transmission.[\[231\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC-2020b-231)[\[232\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-ecdc_transmission2-232) The WHO recommends [ventilation](https://en.wikipedia.org/wiki/Ventilation_\(architecture\) "Ventilation (architecture)") and [air filtration](https://en.wikipedia.org/wiki/Air_filtration "Air filtration") in public spaces to help clear out infectious aerosols.[\[233\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDCasof07092020-233)[\[234\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-KoFZO-234)[\[235\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Lancetdroplet05272020-235)
Exhaled respiratory particles can build-up within enclosed spaces with inadequate [ventilation](https://en.wikipedia.org/wiki/Ventilation_\(architecture\) "Ventilation (architecture)"). The risk of COVID‑19 infection increases especially in spaces where people engage in physical exertion or raise their voice (e.g., exercising, shouting, singing) as this increases exhalation of respiratory droplets. Prolonged exposure to these conditions, typically more than 15 minutes, leads to higher risk of infection.[\[231\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC-2020b-231)
[Displacement ventilation](https://en.wikipedia.org/wiki/Displacement_ventilation "Displacement ventilation") with large natural inlets can move stale air directly to the exhaust in [laminar flow](https://en.wikipedia.org/wiki/Laminar_flow "Laminar flow") while significantly reducing the concentration of droplets and particles. [Passive ventilation](https://en.wikipedia.org/wiki/Passive_ventilation "Passive ventilation") reduces energy consumption and maintenance costs but may lack [controllability](https://en.wikipedia.org/wiki/Demand_controlled_ventilation "Demand controlled ventilation") and [heat recovery](https://en.wikipedia.org/wiki/Heat_recovery_ventilation "Heat recovery ventilation"). Displacement ventilation can also be achieved mechanically with higher energy and maintenance costs. The use of large ducts and openings helps to prevent mixing in closed environments. Recirculation and mixing should be avoided because recirculation prevents dilution of harmful particles and redistributes possibly contaminated air, and mixing increases the concentration and range of infectious particles and keeps larger particles in the air.[\[236\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-236)
Hand-washing and hygiene
[](https://en.wikipedia.org/wiki/File:In_Rwanda_build_where_everyone_can_wash_hand_in_prevention_of_covid-19.jpg)
Students in [Rwanda](https://en.wikipedia.org/wiki/Rwanda "Rwanda") hand washing and wearing face masks during the [COVID‑19 pandemic in the country](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Rwanda "COVID-19 pandemic in Rwanda")
Thorough hand hygiene after any cough or sneeze is required.[\[237\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-nhs.uk-2020-237) The WHO 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.[\[238\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO-2020b-238) When soap and water are not available, the CDC recommends using an alcohol-based [hand sanitiser](https://en.wikipedia.org/wiki/Hand_sanitiser "Hand sanitiser") with at least 60% alcohol.[\[239\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-239) 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](https://en.wikipedia.org/wiki/Ethanol "Ethanol") or [isopropanol](https://en.wikipedia.org/wiki/Isopropanol "Isopropanol"). [Hydrogen peroxide](https://en.wikipedia.org/wiki/Hydrogen_peroxide "Hydrogen peroxide") is used to help eliminate [bacterial spores](https://en.wikipedia.org/wiki/Bacterial_spore "Bacterial spore") in the alcohol; it is "not an active substance for hand [antisepsis](https://en.wikipedia.org/wiki/Antisepsis "Antisepsis")". [Glycerol](https://en.wikipedia.org/wiki/Glycerol "Glycerol") is added as a [humectant](https://en.wikipedia.org/wiki/Humectant "Humectant").[\[240\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-240)
Social distancing (also known as physical distancing) includes [infection control](https://en.wikipedia.org/wiki/Infection_control "Infection control") actions intended to slow the spread of the disease by minimising close contact between individuals. Methods include quarantines; travel restrictions; and the closing of schools, workplaces, stadiums, theatres, or shopping centres. Individuals may apply social distancing methods by staying at home, limiting travel, avoiding crowded areas, using no-contact greetings, and physically distancing themselves from others.[\[241\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-241)
In 2020, outbreaks occurred in prisons due to crowding and an inability to enforce adequate social distancing.[\[242\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Hawks2020-242)[\[243\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-243) In the United States, the prisoner population is ageing 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.[\[242\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Hawks2020-242)
Surface cleaning
After being expelled from the body, coronaviruses can survive on surfaces for hours to days. If a person touches the dirty surface, they may deposit the virus at the eyes, nose, or mouth where it can enter the body and cause infection.[\[244\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDCTrans-244) Evidence indicates that contact with infected surfaces is not the main driver of COVID‑19,[\[245\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-245)[\[246\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-246)[\[247\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-cdc.gov-247) leading to recommendations for optimised disinfection procedures to avoid issues such as the increase of [antimicrobial resistance](https://en.wikipedia.org/wiki/Antimicrobial_resistance "Antimicrobial resistance") through the use of inappropriate cleaning products and processes.[\[248\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-disinfection-foodindus-248)[\[249\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-249) [Deep cleaning](https://en.wikipedia.org/wiki/Deep_clean_\(COVID-19\) "Deep clean (COVID-19)") and other surface sanitation has been criticised as [hygiene theatre](https://en.wikipedia.org/wiki/Hygiene_theater "Hygiene theater"), giving a false sense of security against something primarily spread through the air.[\[250\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-250)[\[251\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-251)
The amount of time that the virus can survive depends significantly on the type of surface, the temperature, and the humidity.[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252) Coronaviruses die very quickly when exposed to the [UV light](https://en.wikipedia.org/wiki/UV_light "UV light") in [sunlight](https://en.wikipedia.org/wiki/Sunlight "Sunlight").[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252) Like other enveloped viruses, SARS-CoV-2 survives longest when the temperature is at [room temperature](https://en.wikipedia.org/wiki/Room_temperature "Room temperature") or lower, and when the [relative humidity](https://en.wikipedia.org/wiki/Relative_humidity "Relative humidity") is low (\<50%).[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252)
On many surfaces, including glass, some types of plastic, stainless steel, and skin, the virus can remain infective for several days indoors at room temperature, or even about a week under ideal conditions.[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252)[\[253\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-253) On some surfaces, including cotton fabric and copper, the virus usually dies after a few hours.[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252) The virus dies faster on porous surfaces than on non-porous surfaces due to capillary action within pores and faster aerosol droplet evaporation.[\[254\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-254)[\[247\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-cdc.gov-247)[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252) However, of the many surfaces tested, two with the longest survival times are N95 respirator masks and surgical masks, both of which are considered porous surfaces.[\[252\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Bueckert-2020-252)
The CDC says that in most situations, cleaning surfaces with soap or detergent, not disinfecting, is enough to reduce risk of transmission.[\[247\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-cdc.gov-247)[\[255\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-255) The CDC recommends that if a COVID‑19 case is suspected or confirmed at a facility such as an office or day care, all areas such as offices, bathrooms, common areas, shared electronic equipment like tablets, touch screens, keyboards, remote controls, and ATMs used by the ill persons should be disinfected.[\[256\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-sxygw-256) Surfaces may be decontaminated with the following:
- 62–71% [ethanol](https://en.wikipedia.org/wiki/Ethanol "Ethanol")
- 50–100% [isopropanol](https://en.wikipedia.org/wiki/Isopropanol "Isopropanol")
- 0\.1% [sodium hypochlorite](https://en.wikipedia.org/wiki/Sodium_hypochlorite "Sodium hypochlorite")
- 0\.5% [hydrogen peroxide](https://en.wikipedia.org/wiki/Hydrogen_peroxide "Hydrogen peroxide")
- 0\.2–7.5% [povidone-iodine](https://en.wikipedia.org/wiki/Povidone-iodine "Povidone-iodine")
- 50–200 ppm [hypochlorous acid](https://en.wikipedia.org/wiki/Hypochlorous_acid "Hypochlorous acid")
Other solutions, such as [benzalkonium chloride](https://en.wikipedia.org/wiki/Benzalkonium_chloride "Benzalkonium chloride") and [chlorhexidine gluconate](https://en.wikipedia.org/wiki/Chlorhexidine_gluconate "Chlorhexidine gluconate"), are less effective. [Ultraviolet germicidal irradiation](https://en.wikipedia.org/wiki/Ultraviolet_germicidal_irradiation "Ultraviolet germicidal irradiation") may also be used,[\[233\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDCasof07092020-233) although popular devices require 5–10 min exposure and may deteriorate some materials over time.[\[257\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-257)
Self-isolation
[Self-isolation](https://en.wikipedia.org/wiki/Self-isolation "Self-isolation") at home has been recommended for those diagnosed with COVID‑19 and those who suspect they have been infected. Health agencies have issued detailed instructions for proper self-isolation.[\[258\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid33012884-258) Many governments have mandated or recommended self-quarantine for entire populations. The strongest self-quarantine instructions have been issued to those in high-risk groups.[\[259\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-lZR3i-259) Those who may have been exposed to someone with COVID‑19 and those who have recently travelled to a country or region with the widespread transmission have been advised to self-quarantine for 14 days from the time of last possible exposure.[\[260\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-260)
A 2021 Cochrane rapid review found that based upon low-certainty evidence, international travel-related control measures such as restricting cross-border travel may help to contain the spread of COVID‑19.[\[261\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Burns-2021-261) Additionally, symptom/exposure-based screening measures at borders may miss many positive cases.[\[261\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Burns-2021-261) While test-based border screening measures may be more effective, it could also miss many positive cases if only conducted upon arrival without follow-up. The review concluded that a minimum 10-day quarantine may be beneficial in preventing the spread of COVID‑19 and may be more effective if combined with an additional control measure like border screening.[\[261\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Burns-2021-261)
Treatment
The [treatment and management of COVID-19](https://en.wikipedia.org/wiki/Treatment_and_management_of_COVID-19 "Treatment and management of COVID-19") combines both [supportive care](https://en.wikipedia.org/wiki/Supportive_care "Supportive care"), which includes treatment to [relieve symptoms](https://en.wikipedia.org/wiki/Symptomatic_treatment "Symptomatic treatment"), [fluid therapy](https://en.wikipedia.org/wiki/Fluid_replacement "Fluid replacement"), [oxygen support](https://en.wikipedia.org/wiki/Oxygen_support "Oxygen support") as needed,[\[262\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_NatureDale_Fisher_&_David_Heymann-262)[\[263\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_KuiFang2020-263)[\[264\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_Wang_Du_Zhu_Cao_2020_p.-264) and a growing list of approved medications. Highly effective vaccines have reduced mortality related to SARS-CoV-2; for those awaiting vaccination, as well as for the estimated millions of immunocompromised persons who are unlikely to respond robustly to vaccination, treatment remains important.[\[265\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-265) Some people may experience persistent symptoms or disability after recovery from the infection, known as [long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID"), but there is still limited information on the best management and rehabilitation for this condition.[\[266\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_NIHGuidelines2020-266)
Most cases of COVID-19 are mild. In these, supportive care includes medication such as [paracetamol](https://en.wikipedia.org/wiki/Paracetamol "Paracetamol") or [NSAIDs](https://en.wikipedia.org/wiki/NSAID "NSAID") to relieve symptoms (fever, body aches, cough), proper intake of fluids, rest, and [nasal breathing](https://en.wikipedia.org/wiki/Obligate_nasal_breathing "Obligate nasal breathing").[\[267\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-267)[\[268\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_AutoDW-63-268)[\[269\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-269)[\[270\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-270) Good personal hygiene and a [healthy diet](https://en.wikipedia.org/wiki/Healthy_diet "Healthy diet") are also recommended.[\[271\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-271) As of April 2020 the U.S. [Centers for Disease Control and Prevention](https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention "Centers for Disease Control and Prevention") (CDC) recommended that those who suspect they are carrying the virus isolate themselves at home and wear a face mask.[\[272\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_CDC2020IfSick-272) As of November 2020 use of the [glucocorticoid](https://en.wikipedia.org/wiki/Glucocorticoid "Glucocorticoid") [dexamethasone](https://en.wikipedia.org/wiki/Dexamethasone "Dexamethasone") had been strongly recommended in those severe cases treated in hospital with low oxygen levels, to reduce the risk of death.[\[273\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_:3-273)[\[274\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_:0-274)[\[275\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_:1-275) [Noninvasive ventilation](https://en.wikipedia.org/wiki/Noninvasive_ventilation "Noninvasive ventilation") and, ultimately, admission to an [intensive care unit](https://en.wikipedia.org/wiki/Intensive_care_unit "Intensive care unit") for [mechanical ventilation](https://en.wikipedia.org/wiki/Mechanical_ventilation "Mechanical ventilation") may be required to support breathing.[\[266\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_NIHGuidelines2020-266) [Extracorporeal membrane oxygenation](https://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygenation "Extracorporeal membrane oxygenation") (ECMO) has been used to address respiratory failure, but its benefits are still under consideration.[\[276\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_Guan_Ni_Hu_Liang_p.-276)[\[277\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_Henry_2020_p.-277) Some of the cases of severe disease course are caused by systemic hyper-inflammation, the so-called *[cytokine storm](https://en.wikipedia.org/wiki/Cytokine_storm "Cytokine storm")*.[\[278\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-278)
Although several medications have been approved in different countries as of April 2022, not all countries have these medications. Patients with mild to moderate symptoms who are in the risk groups can take [nirmatrelvir/ritonavir](https://en.wikipedia.org/wiki/Nirmatrelvir/ritonavir "Nirmatrelvir/ritonavir") (marketed as Paxlovid) or [remdesivir](https://en.wikipedia.org/wiki/Remdesivir "Remdesivir"), either of which reduces the risk of serious illness or hospitalization.[\[279\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-279)[\[280\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-280) In the US, the [Biden Administration COVID-19 action plan](https://en.wikipedia.org/wiki/Biden_Administration_COVID-19_action_plan "Biden Administration COVID-19 action plan") includes the Test to Treat initiative, where people can go to a pharmacy, take a COVID test, and immediately receive free Paxlovid if they test positive.[\[281\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-281) In November 2021, the UK approved the use of [molnupiravir](https://en.wikipedia.org/wiki/Molnupiravir "Molnupiravir") as a COVID treatment for vulnerable patients recently diagnosed with the disease.[\[282\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-282)
Several [experimental treatments](https://en.wikipedia.org/wiki/Clinical_research "Clinical research") are being actively studied in [clinical trials](https://en.wikipedia.org/wiki/Clinical_trial "Clinical trial").[\[283\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_BMJ-283) Others were thought to be promising early in the pandemic, such as [hydroxychloroquine](https://en.wikipedia.org/wiki/Hydroxychloroquine "Hydroxychloroquine") and [lopinavir/ritonavir](https://en.wikipedia.org/wiki/Lopinavir/ritonavir "Lopinavir/ritonavir"), but later research found them to be ineffective or even harmful,[\[283\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_BMJ-283)[\[284\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_Kim_Read_Fauci_p=2149-284)[\[285\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_NIHGuidelinesTherapeuticManagement-285) like [fluvoxamine](https://en.wikipedia.org/wiki/Fluvoxamine "Fluvoxamine"), a cheap and widely available [antidepressant](https://en.wikipedia.org/wiki/Antidepressant "Antidepressant");[\[286\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-286) As of December 2020, there was not enough high-quality evidence to recommend so-called early treatment.[\[284\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_Kim_Read_Fauci_p=2149-284)[\[285\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_NIHGuidelinesTherapeuticManagement-285) In December 2020, two [monoclonal antibody](https://en.wikipedia.org/wiki/Monoclonal_antibody "Monoclonal antibody")\-based therapies were available in the United States, for early use in cases thought to be at high risk of progression to severe disease.[\[285\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_NIHGuidelinesTherapeuticManagement-285) The antiviral [remdesivir](https://en.wikipedia.org/wiki/Remdesivir "Remdesivir") has been available in the U.S., Canada, Australia, and several other countries, with varying restrictions; it is not recommended for people needing mechanical ventilation and has been discouraged altogether by the [World Health Organization](https://en.wikipedia.org/wiki/World_Health_Organization "World Health Organization") (WHO),[\[287\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_Hsu_p=m4457-287) due to limited evidence of its efficacy.[\[283\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Treatment_and_management_of_COVID-19_BMJ-283)
Prognosis and risk factors
[](https://en.wikipedia.org/wiki/File:Covid-19_SP_-_UTI_V._Nova_Cachoeirinha.jpg)
Medical professionals treating a COVID-19 patient in critical condition in an [intensive care unit](https://en.wikipedia.org/wiki/Intensive_care_unit "Intensive care unit") in May 2020.
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](https://en.wikipedia.org/wiki/Common_cold "Common cold"). In 3–4% of cases (7.4% for those over age 65) symptoms are severe enough to cause hospitalisation.[\[288\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid33087398-288) 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.[\[107\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHOReport24Feb2020-107) The Italian [Istituto Superiore di Sanità](https://en.wikipedia.org/wiki/Istituto_Superiore_di_Sanit%C3%A0 "Istituto Superiore di Sanità") reported that the median time between the onset of symptoms and death was twelve days, with seven being hospitalised. However, people transferred to an ICU had a median time of ten days between hospitalisation and death.[\[289\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-ISSCharacteristics-289) Abnormal sodium levels during hospitalisation with COVID-19 are associated with poor prognoses: high sodium with a greater risk of death, and low sodium with an increased chance of needing ventilator support.[\[290\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-290)[\[291\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-291) Prolonged [prothrombin](https://en.wikipedia.org/wiki/Prothrombin "Prothrombin") time and elevated [C-reactive protein](https://en.wikipedia.org/wiki/C-reactive_protein "C-reactive protein") levels on admission to the hospital are associated with severe course of COVID‑19 and with a transfer to ICU.[\[292\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-292)[\[293\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-293)
Some early studies suggest 10% to 20% of people with COVID‑19 will experience [symptoms lasting longer than a month](https://en.wikipedia.org/wiki/Long_COVID "Long COVID").[\[294\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NIHRreportSep20-294)[\[295\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-HvIJa-295) A majority of those who were admitted to hospital with severe disease report long-term problems including fatigue and shortness of breath.[\[296\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-UniWashingtonSep20-296) On 30 October 2020, WHO chief [Tedros Adhanom](https://en.wikipedia.org/wiki/Tedros_Adhanom "Tedros Adhanom") warned that "to a significant number of people, the COVID virus poses a range of serious long-term effects". He has described the vast spectrum of COVID‑19 symptoms that fluctuate over time as "really concerning". They range from fatigue, a cough and shortness of breath, to inflammation and injury of major organs – including the lungs and heart, and also neurological and psychologic effects. Symptoms often overlap and can affect any system in the body. Infected people have reported cyclical bouts of fatigue, headaches, months of complete exhaustion, mood swings, and other symptoms. Tedros therefore concluded that a strategy of achieving [herd immunity](https://en.wikipedia.org/wiki/Herd_immunity "Herd immunity") by infection, rather than vaccination, is "morally unconscionable and unfeasible".[\[297\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-OaTsI-297)
In terms of hospital readmissions about 9% of 106,000 individuals had to return for hospital treatment within two months of discharge. The average to readmit was eight days since first hospital visit. There are several risk factors that have been identified as being a cause of multiple admissions to a hospital facility. Among these are advanced age (above 65 years of age) and presence of a chronic condition such as diabetes, COPD, heart failure or chronic kidney disease.[\[298\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-rArHO-298)[\[299\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CtbMg-299)
According to [scientific reviews](https://en.wikipedia.org/wiki/Scientific_review "Scientific review") smokers are more likely to require intensive care or die compared to non-smokers.[\[300\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-300)[\[301\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-engin-review-301) Acting on the same ACE2 pulmonary receptors affected by smoking, air pollution has been correlated with the disease.[\[301\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-engin-review-301) Short-term[\[302\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-302) and chronic[\[303\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-303) exposure to air pollution seems to enhance morbidity and mortality from COVID‑19.[\[304\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-304)[\[305\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-305)[\[306\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-306) Pre-existing heart and lung diseases[\[307\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-307) and also [obesity](https://en.wikipedia.org/wiki/Obesity "Obesity"), especially in conjunction with [fatty liver disease](https://en.wikipedia.org/wiki/Fatty_liver_disease "Fatty liver disease"), contributes to an increased health risk of COVID‑19.[\[301\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-engin-review-301)[\[308\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-308)[\[309\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-309)[\[310\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-310)
It is also assumed that those that are immunocompromised are at higher risk of getting severely sick from SARS-CoV-2.[\[311\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-311) One research study that looked into the COVID‑19 infections in hospitalised kidney transplant recipients found a mortality rate of 11%.[\[312\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-312)
Men with untreated [hypogonadism](https://en.wikipedia.org/wiki/Hypogonadism "Hypogonadism") were 2.4 times more likely than men with eugonadism to be hospitalised if they contracted COVID-19; Hypogonad men treated with [testosterone](https://en.wikipedia.org/wiki/Testosterone "Testosterone") were less likely to be hospitalised for COVID-19 than men who were not treated for hypogonadism.[\[313\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-jama-313)
Genetic risk factors
[Genetics](https://en.wikipedia.org/wiki/Genetics "Genetics") plays an important role in the ability to fight off Covid.[\[314\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid33888907-314) For instance, those that do not produce detectable [type I interferons](https://en.wikipedia.org/wiki/Type_I_interferon "Type I interferon") or produce [auto-antibodies](https://en.wikipedia.org/wiki/Autoantibody "Autoantibody") against these may get much sicker from COVID‑19.[\[315\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-315)[\[316\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-316) [Genetic screening](https://en.wikipedia.org/wiki/Genetic_screening "Genetic screening") is able to detect [interferon](https://en.wikipedia.org/wiki/Interferon "Interferon") effector genes.[\[317\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-317) Some genetic variants are risk factors in specific populations. For instance, an [allele](https://en.wikipedia.org/wiki/Allele "Allele") of the [DOCK2](https://en.wikipedia.org/wiki/DOCK2 "DOCK2") gene (dedicator of cytokinesis 2 gene) is a common risk factor in Asian populations but much less common in Europe. The mutation leads to lower expression of DOCK2 especially in younger people with severe COVID-19 infections.[\[318\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-318) In fact, many other genes and genetic variants have been found that determine the outcome of SARS-CoV-2 infections.[\[319\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-319)
Blood group
A series of studies have examined a potential [relationship between blood group and COVID-19](https://en.wikipedia.org/wiki/Relationship_between_blood_group_and_COVID-19 "Relationship between blood group and COVID-19"). Initial research conducted by scientists in [Wuhan](https://en.wikipedia.org/wiki/Wuhan "Wuhan"), [China](https://en.wikipedia.org/wiki/China "China"), on thousands of infected patients suggested that individuals with [blood group](https://en.wikipedia.org/wiki/Blood_type "Blood type") A were more likely to experience severe symptoms of COVID-19 infection compared to those with blood group O.[\[320\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-320)[\[321\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-321) Other blood types fell between these two in terms of relative risk.
A second study, published in the *[New England Journal of Medicine](https://en.wikipedia.org/wiki/New_England_Journal_of_Medicine "New England Journal of Medicine")*, did not establish a [causal relationship](https://en.wikipedia.org/wiki/Causal_relationship "Causal relationship") between blood type and the severity of COVID-19, but it did support the earlier findings from Chinese researchers.[\[322\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Relationship_between_blood_group_and_COVID-19_hamshahrionline.ir-322) However, later studies conducted in other countries did not confirm a significant or meaningful link between blood type and disease severity, calling into question the universality of the initial findings.
Children
While very young children have experienced lower rates of infection, older children have a rate of infection that is similar to the population as a whole.[\[323\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-323)[\[324\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-324) Children are likely to have milder symptoms and are at lower risk of severe disease than adults.[\[325\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Reardon-325) The CDC reports that in the US roughly a third of hospitalised children were admitted to the ICU,[\[326\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-326) while a European multinational study of hospitalised children from June 2020, found that about 8% of children admitted to a hospital needed intensive care.[\[327\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-327) Four of the 582 children (0.7%) in the European study died, but the actual mortality rate may be "substantially lower" since milder cases that did not seek medical help were not included in the study.[\[328\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-328)[\[329\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CDC_2020children-329)
Long-term effects
Around 10% to 30% of non-hospitalised people with COVID-19 go on to develop [long COVID](https://en.wikipedia.org/wiki/Long_COVID "Long COVID"). For those that do need hospitalisation, the incidence of long-term effects is over 50%.[\[15\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-davis-15) Long COVID is an often severe multisystem disease with a large set of symptoms. Common symptoms are [fatigue](https://en.wikipedia.org/wiki/Fatigue "Fatigue"), [post-exertional malaise](https://en.wikipedia.org/wiki/Post-exertional_malaise "Post-exertional malaise"), [cognitive issues](https://en.wikipedia.org/wiki/Cognitive_impairment "Cognitive impairment"), [shortness of breath](https://en.wikipedia.org/wiki/Shortness_of_breath "Shortness of breath") and pain. There are likely various, possibly coinciding, causes.[\[15\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-davis-15) Organ damage from the acute infection can explain a part of the symptoms, but long COVID is also observed in people where organ damage seems to be absent.[\[330\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid35594336-330)
By a variety of mechanisms, the lungs are the organs most affected in COVID‑19.[\[331\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Torres-331) In people requiring hospital admission, up to 98% of CT scans performed show lung abnormalities after 28 days of illness even if they had clinically improved.[\[332\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-332) People with advanced age, severe disease, prolonged ICU stays, or who smoke are more likely to have long-lasting effects, including pulmonary fibrosis.[\[333\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Rai-333) Overall, approximately one-third of those investigated after four weeks will have findings of [pulmonary fibrosis](https://en.wikipedia.org/wiki/Pulmonary_fibrosis "Pulmonary fibrosis") or reduced lung function as measured by [DLCO](https://en.wikipedia.org/wiki/DLCO "DLCO"), even in asymptomatic people, but with the suggestion of continuing improvement with the passing of more time.[\[331\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Torres-331) After severe disease, lung function can take anywhere from three months to a year or more to return to previous levels.[\[334\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-334)
The risks of [cognitive deficit](https://en.wikipedia.org/wiki/Cognitive_deficit "Cognitive deficit"), [dementia](https://en.wikipedia.org/wiki/Dementia "Dementia"), psychotic disorders, and [epilepsy](https://en.wikipedia.org/wiki/Epilepsy "Epilepsy") or seizures persists at an increased level two years after infection.[\[335\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-335)
Immunity
[](https://en.wikipedia.org/wiki/File:Diagnostics-10-00453-g001.webp)
Human [antibody response](https://en.wikipedia.org/wiki/Antibody_response "Antibody response") to SARS-CoV-2 infection
The [immune response](https://en.wikipedia.org/wiki/Immune_response "Immune response") by humans to SARS-CoV-2 virus occurs as a combination of the [cell-mediated immunity](https://en.wikipedia.org/wiki/Cell-mediated_immunity "Cell-mediated immunity") and antibody production,[\[336\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-336) just as with most other infections.[\[337\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-337) B cells interact with T cells and begin dividing before selection into the plasma cell, partly on the basis of their affinity for antigen.[\[338\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-338) Since SARS-CoV-2 has been in the human population only since December 2019, it remains unknown if the [immunity](https://en.wikipedia.org/wiki/Immunity_\(medical\) "Immunity (medical)") is long-lasting in people who recover from the disease.[\[339\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CohenJI2020Dec-339) The presence of neutralising antibodies in blood strongly correlates with protection from infection, but the level of neutralising antibody declines with time. Those with asymptomatic or mild disease had undetectable levels of neutralising antibody two months after infection. In another study, the level of neutralising antibodies fell four-fold one to four months after the onset of symptoms. However, the lack of antibodies in the blood does not mean antibodies will not be rapidly produced upon reexposure to SARS-CoV-2. Memory B cells specific for the spike and nucleocapsid proteins of SARS-CoV-2 last for at least six months after the appearance of symptoms.[\[339\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CohenJI2020Dec-339)
As of August 2021, reinfection with COVID‑19 was possible but uncommon. The first case of reinfection was documented in August 2020.[\[340\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wang-2021-340) A systematic review found 17 cases of confirmed reinfection in medical literature as of May 2021.[\[340\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wang-2021-340) With the Omicron variant, as of 2022, reinfections have become common, albeit it is unclear how common.[\[341\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-abc-reinfections-341) [COVID-19 reinfections](https://en.wikipedia.org/wiki/SARS-CoV-2#Reinfection "SARS-CoV-2") are thought to likely be less severe than primary infections, especially if one was previously infected by the same variant.[\[341\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-abc-reinfections-341)\[*[additional citation(s) needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed "Wikipedia:Citation needed")*\]
Mortality
Several measures are commonly used to quantify mortality.[\[342\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-342) 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.[\[343\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:0-343)
The [mortality rate](https://en.wikipedia.org/wiki/Mortality_rate "Mortality rate") reflects the number of deaths within a specific demographic group divided by the population of that demographic group. Consequently, the mortality rate reflects the prevalence as well as the severity of the disease within a given population. Mortality rates are highly correlated to age, with relatively low rates for young people and relatively high rates among the elderly.[\[344\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-JAMAPedsCOVID19-344)[\[345\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Lu_Zhang_Du_Zhang_p.-345)[\[346\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pediatrics_tong-346) In fact, one relevant factor of mortality rates is the age structure of the countries' populations. For example, the case fatality rate for COVID‑19 is lower in India than in the US since India's younger population represents a larger percentage than in the US.[\[347\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Dehingia-2021-347)
Case fatality rate
The [case fatality rate](https://en.wikipedia.org/wiki/Case_fatality_rate "Case fatality rate") (CFR) 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 1\.02% (6,881,955/676,609,955) as of 10 March 2023.[\[348\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-JHU_ticker-348) The number varies by region.[\[349\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-349)[\[343\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:0-343)
- [](https://en.wikipedia.org/wiki/File:Cumulative_confirmed_COVID-19_cases.svg "Total confirmed cases over time")
Total confirmed cases over time
- [![Total confirmed cases of COVID‑19 per million people\[350\]](https://upload.wikimedia.org/wikipedia/commons/thumb/7/75/World_map_of_total_confirmed_COVID-19_cases_per_million_people.svg/330px-World_map_of_total_confirmed_COVID-19_cases_per_million_people.svg.png)](https://en.wikipedia.org/wiki/File:World_map_of_total_confirmed_COVID-19_cases_per_million_people.svg "Total confirmed cases of COVID‑19 per million people[350]")
Total confirmed cases of COVID‑19 per million people[\[350\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-350)
- [](https://en.wikipedia.org/wiki/File:Daily_and_total_confirmed_COVID-19_deaths,_World.svg "Total confirmed deaths over time")
Total confirmed deaths over time
- [![Total confirmed deaths due to COVID‑19 per million people\[351\]](https://upload.wikimedia.org/wikipedia/commons/thumb/3/3a/World_map_of_total_confirmed_COVID-19_deaths_per_million_people_by_country.svg/330px-World_map_of_total_confirmed_COVID-19_deaths_per_million_people_by_country.svg.png)](https://en.wikipedia.org/wiki/File:World_map_of_total_confirmed_COVID-19_deaths_per_million_people_by_country.svg "Total confirmed deaths due to COVID‑19 per million people[351]")
Total confirmed deaths due to COVID‑19 per million people[\[351\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-351)
Infection fatality rate
A key metric in gauging the severity of COVID‑19 is the [infection fatality rate](https://en.wikipedia.org/wiki/Infection_fatality_rate "Infection fatality rate") (IFR), also referred to as the *infection fatality ratio* or *infection fatality risk*.[\[352\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-352)[\[353\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-353)[\[354\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-354) This metric is calculated by dividing the total number of deaths from the disease by the total number of infected individuals; hence, in contrast to the [CFR](https://en.wikipedia.org/wiki/Case_fatality_rate "Case fatality rate"), the IFR incorporates asymptomatic and undiagnosed infections as well as reported cases.[\[355\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-urlGeneralized_trapezoidal_ogive_curves_for_fatality_rate_modeling-355)
Estimates
[](https://en.wikipedia.org/wiki/File:Graph_of_Covid-19_Infection_Fatality_Ratio_by_age.png)
The red line shows the estimate of infection fatality rate (IFR), in percentage terms, as a function of age. The shaded region depicts the 95% confidence interval for that estimate. Markers denotes specific observations used in the meta-analysis.[\[356\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-EJE_levinetal-356)
[](https://en.wikipedia.org/wiki/File:Log_Graph_of_Covid-19_Infection_Fatality_Ratio_by_age.png)
The same relationship plotted on a log scale
A December 2020 systematic review and meta-analysis estimated that population IFR during the first wave of the pandemic was about 0.5% to 1% in many locations (including France, Netherlands, New Zealand, and Portugal), 1% to 2% in other locations (Australia, England, Lithuania, and Spain), and exceeded 2% in Italy.[\[356\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-EJE_levinetal-356) That study also found that most of these differences in IFR reflected corresponding differences in the age composition of the population and age-specific infection rates; in particular, the metaregression estimate of IFR is very low for children and younger adults (e.g., 0.002% at age 10 and 0.01% at age 25) but increases progressively to 0.4% at age 55, 1.4% at age 65, 4.6% at age 75, and 15% at age 85.[\[356\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-EJE_levinetal-356) These results were also highlighted in a December 2020 report issued by the WHO.[\[357\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-357)
| Age group | IFR |
|---|---|
| 0–34 | 0\.004% |
| 35–44 | 0\.068% |
| 45–54 | 0\.23% |
| 55–64 | 0\.75% |
| 65–74 | 2\.5% |
| 75–84 | 8\.5% |
| 85 + | 28\.3% |
An analysis of those IFR rates indicates that COVID‑19 is hazardous not only for the elderly but also for middle-aged adults, for whom the infection fatality rate of COVID-19 is two orders of magnitude greater than the annualised risk of a fatal automobile accident and far more dangerous than seasonal [influenza](https://en.wikipedia.org/wiki/Influenza "Influenza").[\[356\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-EJE_levinetal-356)
Earlier estimates of IFR
At an early stage of the pandemic, the World Health Organization reported estimates of IFR between 0.3% and 1%.[\[358\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-358)[\[359\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-359) On 2 July, The WHO's chief scientist reported that the average IFR estimate presented at a two-day WHO expert forum was about 0.6%.[\[360\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NYT-20200704dm-360)[\[361\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-361) In August, the WHO found that studies incorporating data from broad serology testing in Europe showed IFR estimates converging at approximately 0.5–1%.[\[362\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-362) Firm lower limits of IFRs have been established in a number of locations such as New York City and Bergamo in Italy since the IFR cannot be less than the population fatality rate. (After sufficient time however, people can get reinfected).[\[363\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-363) As of 10 July, in New York City, with a population of 8.4 million, 23,377 individuals (18,758 confirmed and 4,619 probable) have died with COVID‑19 (0.3% of the population).[\[364\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-364) Antibody testing in New York City suggested an IFR of ≈0.9%,[\[365\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-365) and ≈1.4%.[\[366\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-366) In [Bergamo province](https://en.wikipedia.org/wiki/Province_of_Bergamo "Province of Bergamo"), 0.6% of the population has died.[\[367\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-367) In September 2020, the U.S. Centers for Disease Control and Prevention (CDC) reported preliminary estimates of age-specific IFRs for public health planning purposes.[\[368\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:1-368)
Sex differences
| Percentage of infected people who are hospitalised | | | | | | | | | |
|---|---|---|---|---|---|---|---|---|---|
| 0–19 | 20–29 | 30–39 | 40–49 | 50–59 | 60–69 | 70–79 | 80+ | Total | |
| Female | 0\.1 (0.07–0.2) | 0\.5 (0.3–0.8) | 0\.9 (0.5–1.5) | 1\.3 (0.7–2.1) | 2\.6 (1.5–4.2) | 5\.1 (2.9–8.3) | 7\.8 (4.4–12.8) | 19\.3 (10.9–31.6) | 2\.6 (1.5–4.3) |
| Male | 0\.2 (0.08–0.2) | 0\.6 (0.3–0.9) | 1\.2 (0.7–1.9) | 1\.6 (0.9–2.6) | 3\.2 (1.8–5.2) | 6\.7 (3.7–10.9) | 11\.0 (6.2–17.9) | 37\.6 (21.1–61.3) | 3\.3 (1.8–5.3) |
| Total | 0\.1 (0.08–0.2) | 0\.5 (0.3–0.8) | 1\.1 (0.6–1.7) | 1\.4 (0.8–2.3) | 2\.9 (1.6–4.7) | 5\.8 (3.3–9.5) | 9\.3 (5.2–15.1) | 26\.2 (14.8–42.7) | 2\.9 (1.7–4.8) |
| Percentage of hospitalised people who go to Intensive Care Unit | | | | | | | | | |
| 0–19 | 20–29 | 30–39 | 40–49 | 50–59 | 60–69 | 70–79 | 80+ | Total | |
| Female | 16\.7 (14.3–19.3) | 8\.7 (7.5–9.9) | 11\.9 (10.9–13.0) | 16\.6 (15.6–17.7) | 20\.7 (19.8–21.6) | 23\.1 (22.2–24.0) | 18\.7 (18.0–19.5) | 4\.2 (4.0–4.5) | 14\.3 (13.9–14.7) |
| Male | 26\.9 (23.1–31.1) | 14\.0 (12.2–16.0) | 19\.2 (17.6–20.9) | 26\.9 (25.4–28.4) | 33\.4 (32.0–34.8) | 37\.3 (36.0–38.6) | 30\.2 (29.1–31.3) | 6\.8 (6.5–7.2) | 23\.1 (22.6–23.6) |
| Total | 22\.2 (19.1–25.7) | 11\.6 (10.1–13.2) | 15\.9 (14.5–17.3) | 22\.2 (21.0–23.5) | 27\.6 (26.5–28.7) | 30\.8 (29.8–31.8) | 24\.9 (24.1–25.8) | 5\.6 (5.3–5.9) | 19\.0 (18.7–19.44) |
| Percent of hospitalised people who die | | | | | | | | | |
| 0–19 | 20–29 | 30–39 | 40–49 | 50–59 | 60–69 | 70–79 | 80+ | Total | |
| Female | 0\.5 (0.2–1.0) | 0\.9 (0.5–1.3) | 1\.5 (1.2–1.9) | 2\.6 (2.3–3.0) | 5\.2 (4.8–5.6) | 10\.1 (9.5–10.6) | 16\.7 (16.0–17.4) | 25\.2 (24.4–26.0) | 14\.4 (14.0–14.8) |
| Male | 0\.7 (0.3–1.5) | 1\.3 (0.8–1.9) | 2\.2 (1.7–2.7) | 3\.8 (3.3–4.4) | 7\.6 (7.0–8.2) | 14\.8 (14.1–15.6) | 24\.6 (23.7–25.6) | 37\.1 (36.1–38.2) | 21\.2 (20.8–21.7) |
| Total | 0\.6 (0.2–1.3) | 1\.1 (0.7–1.6) | 1\.9 (1.5–2.3) | 3\.3 (2.9–3.8) | 6\.5 (6.0–7.0) | 12\.6 (12.0–13.2) | 21\.0 (20.3–21.7) | 31\.6 (30.9–32.4) | 18\.1 (17.8–18.4) |
| Percent of infected people who die – infection fatality rate (IFR) | | | | | | | | | |
| 0–19 | 20–29 | 30–39 | 40–49 | 50–59 | 60–69 | 70–79 | 80+ | Total | |
| Female | 0\.001 (\<0.001–0.002) | 0\.004 (0.002–0.007) | 0\.01 (0.007–0.02) | 0\.03 (0.02–0.06) | 0\.1 (0.08–0.2) | 0\.5 (0.3–0.8) | 1\.3 (0.7–2.1) | 4\.9 (2.7–8.0) | 0\.4 (0.2–0.6) |
| Male | 0\.001 (\<0.001–0.003) | 0\.007 (0.003–0.01) | 0\.03 (0.02–0.05) | 0\.06 (0.03–0.1) | 0\.2 (0.1–0.4) | 1\.0 (0.6–1.6) | 2\.7 (1.5–1.4) | 14\.0 (7.9–22.7) | 0\.7 (0.4–1.1) |
| Total | 0\.001 (\<0.001–0.002) | 0\.005 (0.003–0.01) | 0\.02 (0.01–0.03) | 0\.05 (0.03–0.08) | 0\.2 (0.1–0.3) | 0\.7 (0.4–1.2) | 1\.9 (1.1–3.2) | 8\.3 (4.7–13.5) | 0\.5 (0.3–0.9) |
| Numbers in parentheses are 95% [credible intervals](https://en.wikipedia.org/wiki/Credible_interval "Credible interval") for the estimates. | | | | | | | | | |
COVID‑19 [case fatality rates](https://en.wikipedia.org/wiki/Case_fatality_rate "Case fatality rate") are higher among men than women in most countries. However, in a few countries like India, Nepal, Vietnam, and Slovenia the fatality cases are higher in women than men.[\[347\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Dehingia-2021-347) Globally, men are more likely to be admitted to the [ICU](https://en.wikipedia.org/wiki/Intensive_care_unit "Intensive care unit") and more likely to die.[\[370\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-370)[\[371\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-371) One meta-analysis found that globally, men were more likely to get COVID‑19 than women; there were approximately 55 men and 45 women per 100 infections ([CI](https://en.wikipedia.org/wiki/Confidence_interval "Confidence interval"): 51.43–56.58).[\[372\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-372)
The [Chinese Center for Disease Control and Prevention](https://en.wikipedia.org/wiki/Chinese_Center_for_Disease_Control_and_Prevention "Chinese Center for Disease Control and Prevention") reported the death rate was 2.8% for men and 1.7% for women.[\[373\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Epidemiology17Feb2020-373) Later reviews in June 2020 indicated that there is no significant difference in susceptibility or in CFR between genders.[\[374\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-374)[\[375\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-375) One review acknowledges the different mortality rates in Chinese men, suggesting that it may be attributable to lifestyle choices such as smoking and drinking alcohol rather than genetic factors.[\[376\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-376) Smoking, which in some countries like China is mainly a male activity, is a habit that contributes to increasing significantly the case fatality rates among men.[\[347\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Dehingia-2021-347) Sex-based immunological differences, lesser 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.[\[377\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-nyt-italy-377) In Europe as of February 2020, 57% of the infected people were men and 72% of those died with COVID‑19 were men.[\[378\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-378) As of April 2020, the US government is not tracking sex-related data of COVID‑19 infections.[\[379\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-nytimesus-379) Research has shown that viral illnesses like Ebola, HIV, influenza and SARS affect men and women differently.[\[379\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-nytimesus-379)
Ethnic differences
In the US, a greater proportion of deaths due to COVID‑19 have occurred among African Americans and other minority groups.[\[380\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AVD-380) Structural factors that prevent them from practising social distancing include their concentration in crowded substandard housing and in "essential" occupations such as retail grocery workers, public transit employees, health-care workers and custodial staff. Greater prevalence of lacking [health insurance](https://en.wikipedia.org/wiki/Health_insurance "Health insurance") and care of underlying conditions such as [diabetes](https://en.wikipedia.org/wiki/Diabetes "Diabetes"),[\[381\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Shauly-Aharonov-2021-381) hypertension, and [heart disease](https://en.wikipedia.org/wiki/Heart_disease "Heart disease") also increase their risk of death.[\[382\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-382) Similar issues affect [Native American](https://en.wikipedia.org/wiki/Indigenous_peoples_of_the_Americas "Indigenous peoples of the Americas") and [Latino](https://en.wikipedia.org/wiki/Latino_\(demonym\) "Latino (demonym)") communities.[\[380\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AVD-380) On the one hand, in the Dominican Republic there is a clear example of both gender and ethnic inequality. In this Latin American territory, there is great inequality and precariousness that especially affects Dominican women, with greater emphasis on those of Haitian descent.[\[383\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Batthyany-2020-383) According to a US health policy non-profit, 34% of American Indian and Alaska Native People (AIAN) non-elderly adults are at risk of serious illness compared to 21% of white non-elderly adults.[\[384\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:2-384) The source attributes it to disproportionately high rates of many health conditions that may put them at higher risk as well as living conditions like lack of access to clean water.[\[384\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:2-384)
Leaders have called for efforts to research and address the disparities.[\[385\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-385) In the UK, a greater proportion of deaths due to COVID‑19 have occurred in those of a [Black](https://en.wikipedia.org/wiki/Black_British_people "Black British people"), [Asian](https://en.wikipedia.org/wiki/British_Asian "British Asian"), and other ethnic minority background.[\[386\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-386)[\[387\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-387)[\[388\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-388) More severe impacts upon patients including the relative incidence of the necessity of hospitalisation requirements, and vulnerability to the disease has been associated via DNA analysis to be expressed in genetic variants at chromosomal region 3, features that are associated with European [Neanderthal](https://en.wikipedia.org/wiki/Neanderthal "Neanderthal") heritage. That structure imposes greater risks that those affected will develop a more severe form of the disease.[\[389\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Neanderthal-389) The findings are from Professor Svante Pääbo and researchers he leads at the [Max Planck Institute for Evolutionary Anthropology](https://en.wikipedia.org/wiki/Max_Planck_Institute_for_Evolutionary_Anthropology "Max Planck Institute for Evolutionary Anthropology") and the [Karolinska Institutet](https://en.wikipedia.org/wiki/Karolinska_Institutet "Karolinska Institutet").[\[389\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Neanderthal-389) This admixture of modern human and Neanderthal genes is estimated to have occurred roughly between 50,000 and 60,000 years ago in Southern Europe.[\[389\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Neanderthal-389)
Comorbidities
[Biological](https://en.wikipedia.org/wiki/Biology "Biology") factors (immune response) and the general behaviour (habits) can strongly determine the consequences of COVID‑19.[\[347\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Dehingia-2021-347) Most of those who die of COVID‑19 have [pre-existing (underlying) conditions](https://en.wikipedia.org/wiki/Pre-existing_condition "Pre-existing condition"), including hypertension, [diabetes mellitus](https://en.wikipedia.org/wiki/Diabetes_mellitus "Diabetes mellitus"),[\[381\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Shauly-Aharonov-2021-381) and [cardiovascular disease](https://en.wikipedia.org/wiki/Cardiovascular_disease "Cardiovascular disease").[\[390\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO-2020a-390) According to March data from the United States, 89% of those hospitalised had preexisting conditions.[\[391\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-391) The Italian Istituto Superiore di Sanità reported that out of 8.8% of deaths where [medical charts](https://en.wikipedia.org/wiki/Medical_record "Medical record") were available, 96.1% of people had at least one [comorbidity](https://en.wikipedia.org/wiki/Comorbidity "Comorbidity") with the average person having 3.4 diseases.[\[289\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-ISSCharacteristics-289) According to this report the most common comorbidities are hypertension (66% of deaths), [type 2 diabetes](https://en.wikipedia.org/wiki/Type_2_diabetes "Type 2 diabetes") (29.8% of deaths), [ischaemic heart disease](https://en.wikipedia.org/wiki/Ischemic_heart_disease "Ischemic heart disease") (27.6% of deaths), [atrial fibrillation](https://en.wikipedia.org/wiki/Atrial_fibrillation "Atrial fibrillation") (23.1% of deaths) and [chronic renal failure](https://en.wikipedia.org/wiki/Chronic_renal_failure "Chronic renal failure") (20.2% of deaths).
Most critical respiratory comorbidities according to the US Centers for Disease Control and Prevention (CDC), are: moderate or severe [asthma](https://en.wikipedia.org/wiki/Asthma "Asthma"), pre-existing [COPD](https://en.wikipedia.org/wiki/Chronic_obstructive_pulmonary_disease "Chronic obstructive pulmonary disease"), [pulmonary fibrosis](https://en.wikipedia.org/wiki/Pulmonary_fibrosis "Pulmonary fibrosis"), and [cystic fibrosis](https://en.wikipedia.org/wiki/Cystic_fibrosis "Cystic fibrosis").[\[392\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:3-392) Evidence stemming from [meta-analysis](https://en.wikipedia.org/wiki/Meta-analysis "Meta-analysis") of several smaller research papers also suggests that smoking can be associated with worse outcomes.[\[393\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-393)[\[394\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-394) When someone with existing respiratory problems is infected with COVID‑19, they might be at greater risk for severe symptoms.[\[392\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:3-392) COVID‑19 also poses a greater risk to people who [misuse opioids](https://en.wikipedia.org/wiki/Opioid_use_disorder "Opioid use disorder") and [amphetamines](https://en.wikipedia.org/wiki/Stimulant_use_disorder "Stimulant use disorder"), insofar as their drug use may have caused lung damage.[\[395\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-395)
In August 2020, the CDC issued a caution that [tuberculosis](https://en.wikipedia.org/wiki/Tuberculosis "Tuberculosis") (TB) infections could increase the risk of severe illness or death. The WHO recommended that people with respiratory symptoms be screened for both diseases, as testing positive for COVID‑19 could not rule out co-infections. Some projections have estimated that reduced TB detection due to the pandemic could result in 6.3 million additional TB cases and 1.4 million TB-related deaths by 2025.[\[396\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-396)
History
| | |
|---|---|
|  | This section needs to be **updated**. The reason given is: **excessive detail about the very early pandemic while missing an overview of the later pandemic**. Please help update this article to reflect recent events or newly available information. *(July 2023)* |
The virus is thought to be of natural animal origin, most likely through [spillover infection](https://en.wikipedia.org/wiki/Spillover_infection "Spillover infection").[\[102\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NM-20200317-102)[\[397\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-PMC7969828-397)[\[398\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-398) A joint-study conducted in early 2021 by the People's Republic of China and the World Health Organization indicated that the virus descended from a coronavirus that infects wild bats, and likely spread to humans through an intermediary wildlife host.[\[399\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-399) There are several theories about where the [index case](https://en.wikipedia.org/wiki/Index_case "Index case") originated and [investigations into the origin of the pandemic](https://en.wikipedia.org/wiki/Investigations_into_the_origin_of_COVID-19 "Investigations into the origin of COVID-19") are ongoing.[\[400\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-patientZero-400) According to articles published in July 2022 in *[Science](https://en.wikipedia.org/wiki/Science_\(journal\) "Science (journal)")*, virus transmission into humans occurred through two spillover events in November 2019 and was likely due to live wildlife trade on the [Huanan wet market](https://en.wikipedia.org/wiki/Huanan_Seafood_Wholesale_Market "Huanan Seafood Wholesale Market") in the city of [Wuhan](https://en.wikipedia.org/wiki/Wuhan "Wuhan") (Hubei, China).[\[401\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-401)[\[402\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-402)[\[403\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-403) Doubts about the conclusions have mostly centered on the precise site of spillover.[\[404\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-404) Earlier [phylogenetics](https://en.wikipedia.org/wiki/Phylogenetics "Phylogenetics") estimated that SARS-CoV-2 arose in October or November 2019.[\[102\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NM-20200317-102)[\[405\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-evolutionary-405)[\[406\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-dorp_evo-406) A phylogenetic algorithm analysis suggested that the virus may have been circulating in [Guangdong](https://en.wikipedia.org/wiki/Guangdong "Guangdong") before Wuhan.[\[407\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-407)
Most scientists believe the virus spilled into human populations through natural [zoonosis](https://en.wikipedia.org/wiki/Zoonosis "Zoonosis"), similar to the [SARS-CoV-1](https://en.wikipedia.org/wiki/SARS-CoV-1 "SARS-CoV-1") and [MERS-CoV](https://en.wikipedia.org/wiki/MERS-CoV "MERS-CoV") outbreaks, and consistent with other pandemics in human history.[\[20\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pekar-20)[\[21\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-jiang_wang-21) According to the [Intergovernmental Panel on Climate Change](https://en.wikipedia.org/wiki/Intergovernmental_Panel_on_Climate_Change "Intergovernmental Panel on Climate Change") several social and environmental factors including [climate change](https://en.wikipedia.org/wiki/Climate_change "Climate change"), [natural ecosystem destruction](https://en.wikipedia.org/wiki/Environmental_degradation "Environmental degradation") and [wildlife trade](https://en.wikipedia.org/wiki/Wildlife_trade_and_zoonoses "Wildlife trade and zoonoses") increased the likelihood of such zoonotic spillover.[\[22\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-IPCC-2022a-22)[\[23\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-IPCC-2022b-23) One study made with the support of the [European Union](https://en.wikipedia.org/wiki/European_Union "European Union") found climate change increased the likelihood of the pandemic by influencing distribution of bat species.[\[24\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-University-of-Cambridge-2021-24)[\[25\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-European-Commission-25)
Available evidence suggests that the SARS-CoV-2 virus was originally harboured by bats, and spread to humans multiple times from infected wild animals at the [Huanan Seafood Market](https://en.wikipedia.org/wiki/Huanan_Seafood_Market "Huanan Seafood Market") in [Wuhan](https://en.wikipedia.org/wiki/Wuhan "Wuhan") in December 2019.[\[20\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pekar-20)[\[21\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-jiang_wang-21) A minority of scientists and some members of the [U.S intelligence community](https://en.wikipedia.org/wiki/United_States_Intelligence_Community "United States Intelligence Community") believe the virus may have been [unintentionally leaked](https://en.wikipedia.org/wiki/COVID-19_lab_leak_theory "COVID-19 lab leak theory") from a laboratory such as the [Wuhan Institute of Virology](https://en.wikipedia.org/wiki/Wuhan_Institute_of_Virology "Wuhan Institute of Virology").[\[408\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NYT_DoE_Feb2023-408)[\[409\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Hill_Feb_2023_DoE-409) The US intelligence community has mixed views on the issue,[\[410\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CNN_Feb2023_LeBlanc-410)[\[411\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Guardian_Feb2023-411) but overall agrees with the scientific consensus that the virus was not developed as a [biological weapon](https://en.wikipedia.org/wiki/Biological_agent "Biological agent") and is unlikely to have been [genetically engineered](https://en.wikipedia.org/wiki/Genetic_engineering "Genetic engineering").[\[412\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-412)[\[413\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-413)[\[414\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-414)[\[415\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-415) There is no evidence SARS-CoV-2 existed in any laboratory prior to the pandemic.[\[416\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-critical-416)[\[417\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Gorski-417)[\[418\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-HolmesConversationDead-418)
The first confirmed human infections were in Wuhan. A study of the first 41 cases of confirmed COVID‑19, published in January 2020 in *The Lancet*, reported the earliest date of onset of symptoms as 1 December 2019.[\[419\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WuMarch2020-419)[\[420\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Wang24Jan2020-420)[\[421\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AutoDW-67-421) Official publications from the WHO reported the earliest onset of symptoms as 8 December 2019.[\[422\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-422) Human-to-human transmission was confirmed by the WHO and Chinese authorities by 20 January 2020.[\[423\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-423)[\[424\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-424) According to official Chinese sources, these were mostly linked to the [Huanan Seafood Wholesale Market](https://en.wikipedia.org/wiki/Huanan_Seafood_Wholesale_Market "Huanan Seafood Wholesale Market"), which also sold live animals.[\[425\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-characteristicsZH-425) In May 2020, [George Gao](https://en.wikipedia.org/wiki/George_F._Gao "George F. Gao"), the director of the CDC, said animal samples collected from the seafood market had tested negative for the virus, indicating that the market was the site of an early [superspreading event](https://en.wikipedia.org/wiki/Superspreader "Superspreader"), but that it was not the site of the initial outbreak.[\[426\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-426) Traces of the virus have been found in wastewater samples that were collected in [Milan](https://en.wikipedia.org/wiki/Milan "Milan") and [Turin](https://en.wikipedia.org/wiki/Turin "Turin"), Italy, on 18 December 2019.[\[427\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-427)
By December 2019, the spread of infection was almost entirely driven by human-to-human transmission.[\[373\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Epidemiology17Feb2020-373)[\[428\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-428) The number of COVID-19 cases in Hubei gradually increased, reaching 60 by 20 December,[\[429\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-429) and at least 266 by 31 December.[\[430\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-430) On 24 December, [Wuhan Central Hospital](https://en.wikipedia.org/wiki/Wuhan_Central_Hospital "Wuhan Central Hospital") sent a [bronchoalveolar lavage fluid](https://en.wikipedia.org/wiki/Bronchoalveolar_lavage_fluid "Bronchoalveolar lavage fluid") (BAL) sample from an unresolved clinical case to sequencing company Vision Medicals. On 27 and 28 December, Vision Medicals informed the Wuhan Central Hospital and the Chinese CDC of the results of the test, showing a new coronavirus.[\[431\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-431) A pneumonia cluster of unknown cause was observed on 26 December and treated by the doctor [Zhang Jixian](https://en.wikipedia.org/wiki/Zhang_Jixian "Zhang Jixian") in Hubei Provincial Hospital, who informed the Wuhan Jianghan CDC on 27 December.[\[432\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-432) On 30 December, a test report addressed to Wuhan Central Hospital, from company CapitalBio Medlab, stated an erroneous positive result for [SARS](https://en.wikipedia.org/wiki/SARS "SARS"), causing a group of doctors at Wuhan Central Hospital to alert their colleagues and relevant hospital authorities of the result. The Wuhan Municipal Health Commission issued a notice to various medical institutions on "the treatment of pneumonia of unknown cause" that same evening.[\[433\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-433) Eight of these doctors, including [Li Wenliang](https://en.wikipedia.org/wiki/Li_Wenliang "Li Wenliang") (punished on 3 January),[\[434\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-434) were later admonished by the police for spreading false rumours and another, [Ai Fen](https://en.wikipedia.org/wiki/Ai_Fen "Ai Fen"), was reprimanded by her superiors for raising the alarm.[\[435\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-435)
The Wuhan Municipal Health Commission made the first public announcement of a pneumonia outbreak of unknown cause on 31 December, confirming 27 cases[\[436\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AutoDW-69-436)[\[437\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-437)[\[438\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-AutoDW-68-438) – enough to trigger an investigation.[\[439\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-bbc50984025-439)
During the early stages of the outbreak, the number of cases doubled approximately every seven and a half days.[\[440\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Qun29Jan2020-440) In early and mid-January 2020, the virus spread to other [Chinese provinces](https://en.wikipedia.org/wiki/Provinces_of_China "Provinces of China"), helped by the [Chinese New Year migration](https://en.wikipedia.org/wiki/Chunyun "Chunyun") and Wuhan being a transport hub and major rail interchange.[\[107\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHOReport24Feb2020-107) On 20 January, China reported nearly 140 new cases in one day, including two people in Beijing and one in [Shenzhen](https://en.wikipedia.org/wiki/Shenzhen "Shenzhen").[\[441\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-france2420200120-441) Later official data shows 6,174 people had already developed symptoms by then,[\[373\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Epidemiology17Feb2020-373) and more may have been infected.[\[442\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-flattery-442) A report in *The Lancet* on 24 January indicated human transmission, strongly recommended personal protective equipment for health workers, and said testing for the virus was essential due to its "pandemic potential".[\[147\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Huang24Jan2020-147)[\[443\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Horton_18_March-443) On 30 January, the WHO declared COVID-19 a [Public Health Emergency of International Concern](https://en.wikipedia.org/wiki/Public_Health_Emergency_of_International_Concern "Public Health Emergency of International Concern").[\[442\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-flattery-442) By this time, the outbreak spread by a factor of 100 to 200 times.[\[444\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-444)
Italy had its first confirmed cases on 31 January 2020, two tourists from China.[\[445\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Corriere_20Jan-445) Italy overtook China as the country with the most deaths on 19 March 2020.[\[446\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-sky11960412-446) By 26 March the United States had overtaken China and Italy with the highest number of confirmed cases in the world.[\[447\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-NYT-20200326-447) Research on coronavirus genomes indicates the majority of COVID-19 cases in [New York](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_New_York_\(state\) "COVID-19 pandemic in New York (state)") came from European travellers, rather than directly from China or any other Asian country.[\[448\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-20200408nytimes-448) Retesting of prior samples found a person in France who had the virus on 27 December 2019,[\[449\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-France-retest-449)[\[450\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Deslandes-2020-450) and a person in the United States who died from the disease on 6 February 2020.[\[451\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-PBS-2wks-451)
RT-PCR testing of untreated wastewater samples from Brazil and Italy have suggested detection of SARS-CoV-2 as early as November and December 2019, respectively, but the methods of such sewage studies have not been optimised, many have not been peer-reviewed, details are often missing, and there is a risk of false positives due to contamination or if only one gene target is detected.[\[452\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-452) A September 2020 review journal article said, "The possibility that the COVID‑19 infection had already spread to Europe at the end of last year is now indicated by abundant, even if partially circumstantial, evidence", including pneumonia case numbers and radiology in France and Italy in November and December.[\[453\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-platto-453)
As of 1 October 2021, *[Reuters](https://en.wikipedia.org/wiki/Reuters "Reuters")* reported that it had estimated the worldwide total number of deaths due to COVID‑19 to have exceeded five million.[\[454\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-454)
The Public Health Emergency of International Concern for COVID-19 ended on 5 May 2023. By this time, everyday life in most countries had returned to how it was before the pandemic.[\[455\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-455)[\[456\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-456)
Misinformation
After the initial outbreak of COVID‑19, [misinformation](https://en.wikipedia.org/wiki/Misinformation "Misinformation") and [disinformation](https://en.wikipedia.org/wiki/Disinformation "Disinformation") regarding the origin, scale, prevention, treatment, and other aspects of the disease rapidly spread online.[\[457\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-bbc_misinfo-457)[\[458\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-GUAR-458)[\[459\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-RunningList-459)
In September 2020, the US Centers for Disease Control and Prevention (CDC) published preliminary estimates of the risk of death by age groups in the United States, but those estimates were widely misreported and misunderstood.[\[368\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-:1-368)[\[460\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-460)
Other species
Humans appear to be capable of spreading the virus to some other animals,[\[461\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Gryseels_2021_MammalReview-461)[\[462\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-TanLam2022_NatComm-462) a type of disease transmission referred to as [zooanthroponosis](https://en.wikipedia.org/wiki/Anthroponotic_disease "Anthroponotic disease").[\[463\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Pappas_MDPI_2022-463)[\[464\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-MunirAshraf_2020-464)
Some pets, especially cats and [ferrets](https://en.wikipedia.org/wiki/Ferret "Ferret"), can catch this virus from infected humans.[\[465\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Kampf-2020-465)[\[466\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-466) Symptoms in cats include [respiratory](https://en.wikipedia.org/wiki/Respiratory_symptom "Respiratory symptom") (such as a cough) and digestive symptoms.[\[465\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Kampf-2020-465) Cats can spread the virus to other cats, and may be able to spread the virus to humans, but cat-to-human transmission of SARS-CoV-2 has not been proven.[\[465\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Kampf-2020-465)[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467) Compared to cats, dogs are less susceptible to this infection.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467) Behaviours which increase the risk of transmission include kissing, licking, and petting the animal.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467)
The virus does not appear to be able to infect [pigs](https://en.wikipedia.org/wiki/Pig "Pig"), [ducks](https://en.wikipedia.org/wiki/Domestic_duck "Domestic duck"), or chickens at all.[\[465\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Kampf-2020-465) [Mice](https://en.wikipedia.org/wiki/Mouse "Mouse"), rats, and rabbits, if they can be infected at all, are unlikely to be involved in spreading the virus.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467)
Tigers and lions in zoos have become infected as a result of contact with infected humans.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467) As expected, monkeys and [great ape](https://en.wikipedia.org/wiki/Great_ape "Great ape") species such as [orangutans](https://en.wikipedia.org/wiki/Orangutan "Orangutan") can also be infected with the COVID‑19 virus.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467)
[Minks](https://en.wikipedia.org/wiki/Mink "Mink"), which are in the [same family](https://en.wikipedia.org/wiki/Weasel_family "Weasel family") as ferrets, have been infected.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467) Minks may be asymptomatic, and can also spread the virus to humans.[\[467\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Tazerji-2020-467) Multiple countries have identified infected animals in [mink farms](https://en.wikipedia.org/wiki/Mink_farm "Mink farm").[\[468\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Gorman-2021-468) [Denmark](https://en.wikipedia.org/wiki/Denmark "Denmark"), a major producer of mink pelts, ordered the slaughter of all minks over fears of viral mutations,[\[468\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Gorman-2021-468) following an outbreak referred to as [Cluster 5](https://en.wikipedia.org/wiki/Cluster_5 "Cluster 5"). A vaccine for mink and other animals is being researched.[\[468\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Gorman-2021-468)
Research
International research on vaccines and medicines in COVID‑19 is underway by government organisations, academic groups, and industry researchers.[\[469\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-dhama-469)[\[470\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-zhang2020-470) The CDC has classified it to require a [BSL3](https://en.wikipedia.org/wiki/BSL3 "BSL3") grade laboratory.[\[471\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-inlbg-471) There has been a great deal of COVID‑19 research, involving accelerated research processes and publishing shortcuts to meet the global demand.[\[472\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Aristovnik_et_al._2020-472)
As of December 2020, hundreds of [clinical trials](https://en.wikipedia.org/wiki/Clinical_trial "Clinical trial") have been undertaken, with research happening on every continent except [Antarctica](https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Antarctica "COVID-19 pandemic in Antarctica").[\[473\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-473) As of November 2020, more than 200 possible treatments have been studied in humans.[\[474\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-474)
Transmission and prevention research
[Modelling](https://en.wikipedia.org/wiki/Modeling_and_simulation "Modeling and simulation") research has been conducted with several objectives, including predictions of the dynamics of transmission,[\[475\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-475) diagnosis and prognosis of infection,[\[476\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-476) estimation of the impact of interventions,[\[477\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-477)[\[478\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-478) or allocation of resources.[\[479\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-479) Modelling studies are mostly based on [compartmental models in epidemiology](https://en.wikipedia.org/wiki/Compartmental_models_in_epidemiology "Compartmental models in epidemiology"),[\[480\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-480) estimating the number of infected people over time under given conditions. Several other types of models have been developed and used during the COVID‑19 pandemic including [computational fluid dynamics](https://en.wikipedia.org/wiki/Computational_fluid_dynamics "Computational fluid dynamics") models to study the flow physics of COVID‑19,[\[481\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-481) retrofits of crowd movement models to study occupant exposure,[\[482\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-482) mobility-data based models to investigate transmission,[\[483\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-483) or the use of [macroeconomic](https://en.wikipedia.org/wiki/Macroeconomic "Macroeconomic") models to assess the economic impact of the pandemic.[\[484\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-484)
[](https://en.wikipedia.org/wiki/File:Fmolb-07-585899-g001.jpg)
Seven possible drug targets in viral replication process and drugs
Repurposed [antiviral drugs](https://en.wikipedia.org/wiki/Antiviral_drug "Antiviral drug") make up most of the research into COVID‑19 treatments.[\[485\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-milken-485)[\[486\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-koch-486) Other candidates in trials include [vasodilators](https://en.wikipedia.org/wiki/Vasodilator "Vasodilator"), [corticosteroids](https://en.wikipedia.org/wiki/Corticosteroid "Corticosteroid"), immune therapies, [lipoic acid](https://en.wikipedia.org/wiki/Lipoic_acid "Lipoic acid"), [bevacizumab](https://en.wikipedia.org/wiki/Bevacizumab "Bevacizumab"), and [recombinant](https://en.wikipedia.org/wiki/Recombinant_DNA "Recombinant DNA") angiotensin-converting enzyme 2.[\[486\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-koch-486)
In March 2020, the World Health Organization (WHO) initiated the [Solidarity trial](https://en.wikipedia.org/wiki/Solidarity_trial "Solidarity trial") to assess the treatment effects of some promising drugs:[\[487\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-kai-487)[\[488\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-488)
- An [experimental drug](https://en.wikipedia.org/wiki/Experimental_drug "Experimental drug") called [remdesivir](https://en.wikipedia.org/wiki/Remdesivir "Remdesivir")
- [Anti-malarial](https://en.wikipedia.org/wiki/Antimalarial_medication "Antimalarial medication") drugs [chloroquine](https://en.wikipedia.org/wiki/Chloroquine "Chloroquine") and [hydroxychloroquine](https://en.wikipedia.org/wiki/Hydroxychloroquine "Hydroxychloroquine")
- Two [anti-HIV drugs](https://en.wikipedia.org/wiki/Anti-HIV_medications "Anti-HIV medications"), [lopinavir/ritonavir](https://en.wikipedia.org/wiki/Lopinavir/ritonavir "Lopinavir/ritonavir") and [interferon-beta](https://en.wikipedia.org/wiki/Interferon-beta "Interferon-beta")
More than 300 active clinical trials are underway as of April 2020.[\[76\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Sanders202022-76)
Research on the antimalarial drugs hydroxychloroquine and chloroquine showed that they were ineffective at best,[\[489\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-20200526nytimes-489)[\[490\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-490) and that they may reduce the antiviral activity of remdesivir.[\[491\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-491) By May 2020, France, Italy, and Belgium had banned the use of hydroxychloroquine as a COVID‑19 treatment.[\[492\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-492)
In June, initial results from the randomised [RECOVERY Trial](https://en.wikipedia.org/wiki/RECOVERY_Trial "RECOVERY Trial") in the United Kingdom showed that dexamethasone reduced mortality by one third for people who are critically ill on ventilators and one fifth for those receiving supplemental oxygen.[\[493\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-493) Because this is a well-tested and widely available treatment, it was welcomed by the WHO, which is in the process of updating treatment guidelines to include dexamethasone and other steroids.[\[494\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-494)[\[495\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-495) Based on those preliminary results, dexamethasone treatment has been recommended by the NIH for peoples with COVID‑19 who are mechanically ventilated or who require supplemental oxygen but not in people with COVID‑19 who do not require supplemental oxygen.[\[496\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-496)
In September 2020, the WHO released updated guidance on using corticosteroids for COVID‑19.[\[497\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO_guidance-497)[\[498\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-498) The WHO recommends systemic corticosteroids rather than no systemic corticosteroids for the treatment of people with severe and critical COVID‑19 (strong recommendation, based on moderate certainty evidence).[\[497\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO_guidance-497) The WHO suggests not to use corticosteroids in the treatment of people with non-severe COVID‑19 (conditional recommendation, based on low certainty evidence).[\[497\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-WHO_guidance-497) The updated guidance was based on a meta-analysis of clinical trials of people critically ill with COVID‑19.[\[499\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-499)[\[500\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-500)
In September 2020, the [European Medicines Agency](https://en.wikipedia.org/wiki/European_Medicines_Agency "European Medicines Agency") (EMA) endorsed the use of dexamethasone in adults and adolescents from 12 years of age and weighing at least 40 kilograms (88 lb) who require supplemental oxygen therapy.[\[501\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-EMA_PR-501)[\[502\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-502) Dexamethasone can be taken [by mouth](https://en.wikipedia.org/wiki/Oral_administration "Oral administration") or given as an injection or [infusion (drip) into a vein](https://en.wikipedia.org/wiki/Intravenous "Intravenous").[\[501\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-EMA_PR-501)
In November 2020, the US [Food and Drug Administration](https://en.wikipedia.org/wiki/Food_and_Drug_Administration "Food and Drug Administration") (FDA) issued an emergency use authorisation for the investigational monoclonal antibody therapy [bamlanivimab](https://en.wikipedia.org/wiki/Bamlanivimab "Bamlanivimab") for the treatment of mild-to-moderate COVID‑19.[\[503\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-FDA_bamlanivimab_EUA-503) Bamlanivimab is authorised for people with positive results of direct SARS-CoV-2 viral testing who are twelve years of age and older weighing at least 40 kilograms (88 lb), and who are at high risk for progressing to severe COVID‑19 or hospitalisation.[\[503\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-FDA_bamlanivimab_EUA-503) This includes those who are 65 years of age or older, or who have chronic medical conditions.[\[503\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-FDA_bamlanivimab_EUA-503)
In February 2021, the FDA issued an emergency use authorisation (EUA) for bamlanivimab and [etesevimab](https://en.wikipedia.org/wiki/Etesevimab "Etesevimab") administered together for the treatment of mild to moderate COVID‑19 in people twelve years of age or older weighing at least 40 kilograms (88 lb) who test positive for SARS‑CoV‑2 and who are at high risk for progressing to severe COVID‑19. The authorised use includes treatment for those who are 65 years of age or older or who have certain chronic medical conditions.[\[504\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-FDA_PR_20210209-504)
In April 2021, the FDA revoked the emergency use authorisation (EUA) that allowed for the investigational monoclonal antibody therapy bamlanivimab, when administered alone, to be used for the treatment of mild-to-moderate COVID‑19 in adults and certain paediatric patients.[\[505\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-FDA_PR_20210416-505)
Cytokine storm
[](https://en.wikipedia.org/wiki/File:Fimmu-11-01648-g003.jpg)
Various therapeutic strategies for targeting cytokine storm
A [cytokine storm](https://en.wikipedia.org/wiki/Cytokine_storm "Cytokine storm") can be a complication in the later stages of severe COVID‑19. A cytokine storm is a potentially deadly immune reaction where a large amount of pro-inflammatory cytokines and [chemokines](https://en.wikipedia.org/wiki/Chemokine "Chemokine") are released too quickly. A cytokine storm can lead to ARDS and multiple organ failure.[\[506\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-506) Data collected from Jin Yin-tan Hospital in Wuhan, China indicates that people who had more severe responses to COVID‑19 had greater amounts of pro-inflammatory cytokines and chemokines in their system than people who had milder responses. These high levels of pro-inflammatory cytokines and chemokines indicate presence of a cytokine storm.[\[507\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-507)
[Tocilizumab](https://en.wikipedia.org/wiki/Tocilizumab "Tocilizumab") has been included in treatment guidelines by China's [National Health Commission](https://en.wikipedia.org/wiki/National_Health_Commission "National Health Commission") after a small study was completed.[\[508\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-tocil-1-508)[\[509\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-tocil-2-509) It is undergoing a [Phase II](https://en.wikipedia.org/wiki/Phase_IIb "Phase IIb") non-randomised trial at the national level in Italy after showing positive results in people with severe disease.[\[510\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-510)[\[511\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-511) Combined with a serum [ferritin](https://en.wikipedia.org/wiki/Ferrite_\(magnet\) "Ferrite (magnet)") blood test to identify a cytokine storm (also called cytokine storm syndrome, not to be confused with [cytokine release syndrome](https://en.wikipedia.org/wiki/Cytokine_release_syndrome "Cytokine release syndrome")), it is meant to counter such developments, which are thought to be the cause of death in some affected people.[\[512\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-tocil-5,6,8-512) The [interleukin-6 receptor](https://en.wikipedia.org/wiki/Interleukin-6_receptor "Interleukin-6 receptor") (IL-6R) [antagonist](https://en.wikipedia.org/wiki/Receptor_antagonist "Receptor antagonist") was approved by the FDA to undergo a Phase III clinical trial assessing its effectiveness on COVID‑19 based on retrospective case studies for the treatment of steroid-refractory cytokine release syndrome induced by a different cause, [CAR T cell](https://en.wikipedia.org/wiki/Chimeric_antigen_receptor_T_cell "Chimeric antigen receptor T cell") [therapy](https://en.wikipedia.org/wiki/Gene_therapy "Gene therapy"), in 2017.[\[513\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-CancerNetworkTocilizumabTrial-513) 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](https://en.wikipedia.org/wiki/Blood%E2%80%93brain_barrier "Blood–brain barrier"), and exacerbating [neurotoxicity](https://en.wikipedia.org/wiki/Neurotoxicity "Neurotoxicity") while having no effect on the incidence of CRS.[\[514\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-514)
[Lenzilumab](https://en.wikipedia.org/wiki/Lenzilumab "Lenzilumab"), an anti-GM-CSF [monoclonal antibody](https://en.wikipedia.org/wiki/Monoclonal_antibody "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.[\[515\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-515)
Passive antibodies
[](https://en.wikipedia.org/wiki/File:Ppat.1008735.g002.png)
Overview of the application and use of [convalescent plasma](https://en.wikipedia.org/wiki/Convalescent_plasma "Convalescent plasma") therapy
Transferring purified and concentrated [antibodies](https://en.wikipedia.org/wiki/Immunoglobulin_therapy "Immunoglobulin therapy") produced by the immune systems of those who have recovered from COVID‑19 to people who need them is being investigated as a non-vaccine method of [passive immunisation](https://en.wikipedia.org/wiki/Passive_immunity "Passive immunity").[\[516\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid-32167489-516)[\[517\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Iannizzi-2023-517) [Viral neutralisation](https://en.wikipedia.org/wiki/Neutralisation_\(immunology\) "Neutralisation (immunology)") is the anticipated [mechanism of action](https://en.wikipedia.org/wiki/Mechanism_of_action "Mechanism of action") by which passive antibody therapy can mediate defence against SARS-CoV-2. The spike protein of SARS-CoV-2 is the primary target for neutralising antibodies.[\[518\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Ho-2020-518) As of 8 August 2020, eight neutralising antibodies targeting the spike protein of SARS-CoV-2 have entered clinical studies.[\[519\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-519) It has been proposed that selection of broad-neutralising antibodies against SARS-CoV-2 and SARS-CoV might be useful for treating not only COVID‑19 but also future SARS-related CoV infections.[\[518\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Ho-2020-518) Other mechanisms, however, such as [antibody-dependant cellular cytotoxicity](https://en.wikipedia.org/wiki/Antibody-dependent_cellular_cytotoxicity "Antibody-dependent cellular cytotoxicity") or [phagocytosis](https://en.wikipedia.org/wiki/Phagocytosis "Phagocytosis"), may be possible.[\[516\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid-32167489-516) Other forms of passive antibody therapy, for example, using manufactured monoclonal antibodies, are in development.[\[516\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid-32167489-516)
The use of passive antibodies to treat people with active COVID‑19 is also being studied. This involves the production of [convalescent serum](https://en.wikipedia.org/wiki/Convalescent_serum "Convalescent serum"), which consists of the liquid portion of the blood from people who recovered from the infection and contains antibodies specific to this virus, which is then administered to active patients.[\[516\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid-32167489-516) This strategy was tried for SARS with inconclusive results.[\[516\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-pmid-32167489-516) An updated Cochrane review in May 2023 found high certainty evidence that, for the treatment of people with moderate to severe COVID‑19, convalescent plasma did not reduce mortality or bring about symptom improvement.[\[517\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Iannizzi-2023-517) There continues to be uncertainty about the safety of convalescent plasma administration to people with COVID‑19 and differing outcomes measured in different studies limits their use in determining efficacy.[\[517\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-Iannizzi-2023-517)
Bioethics
Since the outbreak of the COVID‑19 pandemic, scholars have explored the [bioethics](https://en.wikipedia.org/wiki/Bioethics "Bioethics"), [normative economics](https://en.wikipedia.org/wiki/Normative_economics "Normative economics"), and [political theories](https://en.wikipedia.org/wiki/Political_philosophy "Political philosophy") of [healthcare policies](https://en.wikipedia.org/wiki/Healthcare_policy "Healthcare policy") related to the public health crisis.[\[520\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-520) Academics have pointed to the moral distress of healthcare workers, ethics of distributing scarce healthcare resources such as ventilators,[\[521\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-521) and the global justice of vaccine diplomacies.[\[522\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-522)[\[523\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-523) The socio-economic inequalities between genders,[\[524\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-524) races,[\[525\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-525) groups with disabilities,[\[526\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-526) communities,[\[527\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-527) regions, countries,[\[528\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-528) and continents have also drawn attention in academia and the general public.[\[529\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-529)[\[530\]](https://en.wikipedia.org/wiki/COVID-19#cite_note-530)
See also
- [Coronavirus diseases](https://en.wikipedia.org/wiki/Coronavirus_diseases "Coronavirus diseases"), a group of closely related syndromes
- [Disease X](https://en.wikipedia.org/wiki/Disease_X "Disease X"), a WHO term
- [Law of declining virulence](https://en.wikipedia.org/wiki/Law_of_declining_virulence "Law of declining virulence") – Disproved hypothesis of epidemiologist Theobald Smith
- [Theory of virulence](https://en.wikipedia.org/wiki/Theory_of_virulence "Theory of virulence") – Theory by biologist Paul W. Ewald
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Sabatello M, Burke TB, McDonald KE, Appelbaum PS (October 2020). ["Disability, Ethics, and Health Care in the COVID-19 Pandemic"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7483109). *American Journal of Public Health*. **110** (10): 1523–1527\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.2105/AJPH.2020.305837](https://doi.org/10.2105%2FAJPH.2020.305837). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [7483109](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7483109). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [32816541](https://pubmed.ncbi.nlm.nih.gov/32816541).
527. **[^](https://en.wikipedia.org/wiki/COVID-19#cite_ref-527)**
Chin T, Kahn R, Li R, Chen JT, Krieger N, Buckee CO, et al. (September 2020). ["US-county level variation in intersecting individual, household and community characteristics relevant to COVID-19 and planning an equitable response: a cross-sectional analysis"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7467554). *BMJ Open*. **10** (9) e039886. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1136/bmjopen-2020-039886](https://doi.org/10.1136%2Fbmjopen-2020-039886). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [7467554](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7467554). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [32873684](https://pubmed.ncbi.nlm.nih.gov/32873684).
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Elgar FJ, Stefaniak A, Wohl MJ (October 2020). ["The trouble with trust: Time-series analysis of social capital, income inequality, and COVID-19 deaths in 84 countries"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492158). *Social Science & Medicine*. **263** 113365. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1016/j.socscimed.2020.113365](https://doi.org/10.1016%2Fj.socscimed.2020.113365). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [7492158](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492158). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [32981770](https://pubmed.ncbi.nlm.nih.gov/32981770).
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Abu El Kheir-Mataria W, Khadr Z, El Fawal H, Chun S (21 March 2024). ["COVID-19 vaccine intercountry distribution inequality and its underlying factors: a combined concentration index analysis and multiple linear regression analysis"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10993910). *Frontiers in Public Health*. **12** 1348088. [Bibcode](https://en.wikipedia.org/wiki/Bibcode_\(identifier\) "Bibcode (identifier)"):[2024FrPH...1248088A](https://ui.adsabs.harvard.edu/abs/2024FrPH...1248088A). [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.3389/fpubh.2024.1348088](https://doi.org/10.3389%2Ffpubh.2024.1348088). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [2296-2565](https://search.worldcat.org/issn/2296-2565). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [10993910](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10993910). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [38577285](https://pubmed.ncbi.nlm.nih.gov/38577285).
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Mortiboy M, Zitta JP, Carrico S, Stevens E, Smith A, Morris C, et al. (2024). ["Combating COVID-19 Vaccine Inequity During the Early Stages of the COVID-19 Pandemic"](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019425). *Journal of Racial and Ethnic Health Disparities*. **11** (2): 621–630\. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1007/s40615-023-01546-0](https://doi.org/10.1007%2Fs40615-023-01546-0). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [2197-3792](https://search.worldcat.org/issn/2197-3792). [PMC](https://en.wikipedia.org/wiki/PMC_\(identifier\) "PMC (identifier)") [10019425](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019425). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [36929491](https://pubmed.ncbi.nlm.nih.gov/36929491).
Further reading
- ["Progress report on the coronavirus pandemic"](https://doi.org/10.1038%2FD41586-020-02414-1). *[Nature](https://en.wikipedia.org/wiki/Nature_\(journal\) "Nature (journal)")*. **584** (7821): 325. 1 August 2020. [doi](https://en.wikipedia.org/wiki/Doi_\(identifier\) "Doi (identifier)"):[10\.1038/D41586-020-02414-1](https://doi.org/10.1038%2FD41586-020-02414-1). [ISSN](https://en.wikipedia.org/wiki/ISSN_\(identifier\) "ISSN (identifier)") [1476-4687](https://search.worldcat.org/issn/1476-4687). [PMID](https://en.wikipedia.org/wiki/PMID_\(identifier\) "PMID (identifier)") [32814893](https://pubmed.ncbi.nlm.nih.gov/32814893). [Wikidata](https://en.wikipedia.org/wiki/WDQ_\(identifier\) "WDQ (identifier)") [Q98568681](https://www.wikidata.org/wiki/Q98568681 "d:Q98568681").
- [COVID-19 infection prevention and control measures for primary care, including general practitioner practices, dental clinics and pharmacy settings: first update](https://www.ecdc.europa.eu/en/publications-data/covid-19-infection-prevention-and-control-primary-care). *[European Centre for Disease Prevention and Control](https://en.wikipedia.org/wiki/European_Centre_for_Disease_Prevention_and_Control "European Centre for Disease Prevention and Control") (ECDC)* (Report). October 2020.
External links
Health agencies
- [Coronavirus disease (COVID‑19)](https://www.who.int/emergencies/diseases/novel-coronavirus-2019) [Facts](https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters) by the World Health Organization (WHO)
- [Coronavirus (COVID‑19)](https://www.nhs.uk/conditions/coronavirus-covid-19/) by the UK [National Health Service](https://en.wikipedia.org/wiki/National_Health_Service "National Health Service") (NHS)
- [Coronavirus 2019 (COVID-19)](https://www.cdc.gov/coronavirus/2019-ncov/index.html) by the US [Centers for Disease Control and Prevention](https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention "Centers for Disease Control and Prevention") (CDC)
Directories
- [Coronavirus Resource Center](https://centerforinquiry.org/coronavirus/) at the [Center for Inquiry](https://en.wikipedia.org/wiki/Center_for_Inquiry "Center for Inquiry")
- [COVID‑19 Information on FireMountain.net](https://www.firemountain.net/covid19.html) [Archived](https://web.archive.org/web/20220113160833/http://firemountain.net/covid19.html) 13 January 2022 at the [Wayback Machine](https://en.wikipedia.org/wiki/Wayback_Machine "Wayback Machine")
- [COVID‑19 Resource Directory on OpenMD](https://openmd.com/directory/covid-19)
Medical journals
- [BMJ's Coronavirus (covid‑19) Hub](https://www.bmj.com/coronavirus) by the [BMJ](https://en.wikipedia.org/wiki/BMJ_\(company\) "BMJ (company)")
- [Coronavirus (Covid‑19)](https://www.nejm.org/coronavirus) by *[The New England Journal of Medicine](https://en.wikipedia.org/wiki/The_New_England_Journal_of_Medicine "The New England Journal of Medicine")*
- [Coronavirus (COVID‑19) Research Highlights](https://www.springernature.com/gp/researchers/campaigns/coronavirus) by [Springer Nature](https://en.wikipedia.org/wiki/Springer_Nature "Springer Nature")
- [Coronavirus Disease 2019 (COVID‑19)](https://jamanetwork.com/journals/jama/pages/coronavirus-alert) by *[JAMA](https://en.wikipedia.org/wiki/JAMA_\(journal\) "JAMA (journal)")*
- [COVID‑19 Resource Centre](https://www.thelancet.com/coronavirus) by *[The Lancet](https://en.wikipedia.org/wiki/The_Lancet "The Lancet")*
- [Covid‑19: Novel Coronavirus](https://novel-coronavirus.onlinelibrary.wiley.com/); [Archived](https://web.archive.org/web/20200924195411/https://novel-coronavirus.onlinelibrary.wiley.com/) 24 September 2020 at the [Wayback Machine](https://en.wikipedia.org/wiki/Wayback_Machine "Wayback Machine") by [Wiley Publishing](https://en.wikipedia.org/wiki/Wiley_\(publisher\) "Wiley (publisher)")
- [Novel Coronavirus Information Center](https://www.elsevier.com/connect/coronavirus-information-center) by [Elsevier](https://en.wikipedia.org/wiki/Elsevier "Elsevier")
Treatment guidelines
- ["Bouncing Back from COVID-19: Your Guide to Restoring Movement"](https://web.archive.org/web/20200629012405/https://www.hopkinsmedicine.org/physical_medicine_rehabilitation/coronavirus-rehabilitation/_files/impact-of-covid-patient-recovery.pdf) (PDF). Johns Hopkins Medicine. Archived from [the original](https://www.hopkinsmedicine.org/physical_medicine_rehabilitation/coronavirus-rehabilitation/_files/impact-of-covid-patient-recovery.pdf) (PDF) on 29 June 2020.
- ["Coronavirus Disease 2019 (COVID-19) Treatment Guidelines"](https://files.covid19treatmentguidelines.nih.gov/guidelines/covid19treatmentguidelines.pdf) (PDF). National Institutes of Health.
- ["Guidelines on the Treatment and Management of Patients with COVID-19"](https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/). Infectious Diseases Society of America.
- ["JHMI Clinical Recommendations for Available Pharmacologic Therapies for COVID-19"](https://www.hopkinsguides.com/hopkins/ub?cmd=repview&type=479-1279&name=40_538747_PDF) (PDF). Johns Hopkins Medicine.
- [National Guidance for post-COVID syndrome assessment clinics](https://www.england.nhs.uk/coronavirus/publication/national-guidance-for-post-covid-syndrome-assessment-clinics/) (Report). NHS England. 28 July 2022.
- [Therapeutics and COVID-19: living guideline, 14 January 2022](https://www.who.int/publications/i/item/therapeutics-and-covid-19-living-guideline) (Report). World Health Organization. 2022. [hdl](https://en.wikipedia.org/wiki/Hdl_\(identifier\) "Hdl (identifier)"):[10665/351006](https://hdl.handle.net/10665%2F351006). WHO/2019-nCoV/therapeutics/2022.1. |
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