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Symptoms and Signs of Coronavirus (COVID-19 [2019-nCoV], SARS, MERS)

Doctor's Notes on Coronavirus (Wuhan Coronavirus [2019-nCoV], SARS, MERS)

Wuhan coronavirus (2019-nCoV) is a new RNA coronavirus found in late 2019 in the Chinese city of Wuhan. It causes moderate to severe respiratory problems in humans. It is contagious and spreads from person to person. Signs and symptoms vary in intensity. Infected people initially may have flu-like symptoms that can rapidly progress in severity. The primary signs and symptoms of moderate to severe infections are as follows:

Wuhan coronavirus is related to SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome).

The cause of signs and symptoms of the Wuhan, China, respiratory outbreak is the 2019-nCoV virus or Wuhan coronavirus. It may cause severe viral pneumonia. Unfortunately, many people who become infected require hospitalization for supportive care. There is no specific drug or vaccine against this virus. Some patients require hospital-based respiratory supportive care. This hospital-based care can rapidly run out if the outbreak is not slowed or stopped. In the Wuhan outbreak, China and many other countries are using quarantine measures to help slow or stop the spread of 2019-nCoV.

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Medically Reviewed on 2/4/2020

Coronavirus (Wuhan Coronavirus [2019-nCoV], SARS, MERS) Symptoms

Most people have had one or more coronavirus infections and were unaware that they had a coronavirus. Most coronavirus infections, as with many respiratory viruses that circulate throughout the year, cause a self-limited cold, with typical symptoms of sore throat, runny nose, and nasal congestion for a few days. Often, there is no or very mild, brief fever. Symptoms resolve within a few days to a week without lasting aftereffects in mild infections.

Rarely with specific species of coronavirus (like MERS-CoV, SARS-CoV, and Wuhan coronavirus [2019-nCoV]) do coronaviruses cause additional symptoms. These viruses may cause shortness of breath or difficulty breathing if the illness progresses to viral pneumonia or lung inflammation. With more severe infection, the viral pneumonia may cause respiratory failure (severe acute respiratory syndrome) and require mechanical ventilation support. In addition, severe infection may cause kidney failure (requiring hemodialysis), and systemic inflammatory syndrome that leads to shock and death. Depending on the coronavirus, other symptoms might include headaches, body aches, nausea, vomiting, and diarrhea.

Coronavirus (Wuhan Coronavirus [2019-nCoV], SARS, MERS) Causes

Risk and complications vary according to the species of coronavirus. The main risk factor for a coronavirus infection is exposure to the respiratory secretions of an animal or person infected with a strain that can infect humans. Coronaviruses are thus most easily spread when there is crowding and frequent contact of surfaces by many people or frequent contact with saliva and respiratory secretions. For example, child care centers and schools are often sources of upper respiratory virus infections such as coronaviruses. Workplaces, public transit, and shopping centers pose risks during an outbreak. Cold weather brings more groups and public crowding indoors and increases the risk of cold viruses like coronavirus, among many other respiratory viruses. Thus, they often peak during winter and spring.

Risk factors for Wuhan coronavirus (2019-nCoV) include the following:

  • Having close contact with someone who has recently visited Wuhan, China (Avoid travel to Wuhan, China, until the CDC or World Health Organization changes the travel status.)
  • Coming in contact with secretions from an infected person
  • Eating or handling wild animals native to China

MERS-CoV is not currently circulating. Risk factors for MERS-CoV generally include exposure to

  • a sick traveler returning from the Arabian Peninsula;
  • camels, camel markets, or camel meat or dairy products; and
  • travel in the Arabian Peninsula or other area, especially if involved during a known outbreak of MERS-CoV.

There are no specific risk factors for SARS-CoV at this time because it is not known to be circulating. Because most coronavirus are mild and self-limited and patients with symptoms are not expected to cause outbreaks, health care workers have been at risk for severe coronavirus and some have died. This has happened especially early during an outbreak when infection prevention measures have not yet been established.

Wuhan Coronavirus Outbreak (2019-nCoV) 10 Things You Need to Know Slideshow

Wuhan Coronavirus Outbreak (2019-nCoV) 10 Things You Need to Know Slideshow

The coronavirus is a big family of pathogens. Some of them cause mild illnesses like the common cold. Others can cause fatal infections. A coronavirus gets its name from how it looks. Under an electron microscope, these pathogens exhibit spikes that resemble the angles of a crown. There are many coronaviruses that only infect animals. Some evolve in their animal hosts to infect humans. The type that infects humans was first identified in the 1960s. Since then, seven human-infecting types of coronavirus have been identified, including 2019-nCoV, also known as Wuhan Coronavirus.


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.