Coronavirus disease 2019 (COVID-19)

COVID-19, also called coronavirus disease 2019, is a sickness caused by a virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This virus is a coronavirus.

Coronavirus is a family of viruses that can cause illnesses such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

Many people with COVID-19 have mild to moderate symptoms and can recover on their own. But COVID-19 can serious illness and lead to death in some people. People at higher risk include older adults, and the risk increases with age. Also at higher risk for serious illness are people with existing medical conditions.

Getting a COVID-19 vaccine helps prevent serious illness, the need for hospital care due to COVID-19 and death from COVID-19.

Symptoms of coronavirus disease 2019 (COVID-19) may appear 2 to 14 days after exposure. This time after exposure and before having symptoms is called the incubation period. You can still spread COVID-19 before you have symptoms. This is called presymptomatic transmission. Common symptoms can include:

• Fever.
• Cough.
• Tiredness.

Early symptoms of COVID-19 may include a loss of taste or smell.

Other symptoms may include:

• Shortness of breath or difficulty breathing.
• Muscle aches.
• Chills.
• Sore throat.
• Runny nose.
• Headache.
• Chest pain.
• Pink eye (conjunctivitis).
• Nausea.
• Vomiting.
• Diarrhea.
• Rash.

This list isn't complete. Children have similar symptoms to adults and generally have mild illness.

The severity of COVID-19 symptoms can range from very mild to severe. Some people may have only a few symptoms. Some people may have no symptoms at all, but can still spread it. This is called asymptomatic transmission.

Some people may experience worsened symptoms, such as worsened shortness of breath and pneumonia, about a week after symptoms start. Some people experience COVID-19 symptoms for more than four weeks after they're diagnosed. These health issues are sometimes called post-COVID-19 conditions.

Some children experience multisystem inflammatory syndrome, a syndrome that can affect some organs and tissues, several weeks after having COVID-19. Rarely, some adults experience the syndrome too.

When to see a doctor

If you have COVID-19 symptoms or you've been in contact with someone diagnosed with COVID-19, contact your health care team right away for medical advice.

Your health care professional will likely recommend that you get tested for COVID-19.

If you have emergency COVID-19 symptoms, seek care immediately. Emergency symptoms can include:

• Trouble breathing.
• Constant chest pain or pressure.
• Trouble staying awake.
• New confusion.
• Pale, gray or blue-colored skin, lips or nail beds — depending on skin color.

This list isn't complete. Let your health care team know if you are an older adult or have chronic medical conditions, such as heart disease or lung disease, as you may have a greater risk of becoming seriously ill with COVID-19.

Infection with severe acute respiratory syndrome coronavirus 2, also called SARS-CoV-2, causes coronavirus disease 2019 (COVID-19).

The virus that causes COVID-19 spreads easily among people. Data has shown that the COVID-19 virus spreads mainly from person to person among those in close contact. The virus spreads by respiratory droplets released when someone with the virus coughs, sneezes, breathes, sings or talks. These droplets can be inhaled or land in the mouth, nose or eyes of a person nearby.

Sometimes the COVID-19 virus can spread when a person is exposed to very small droplets or aerosols that stay in the air for several minutes or hours — called airborne transmission.

The virus also can spread if you touch a surface with the virus on it and then touch your mouth, nose or eyes. But the risk is low.

The COVID-19 virus can spread from someone who is infected but has no symptoms. This is called asymptomatic transmission. The COVID-19 virus also can spread from someone who is infected but hasn't developed symptoms yet. This is called presymptomatic transmission.

It's possible to get COVID-19 more than once.

Risk factors for COVID-19 appear to include:

• Close contact with someone who has COVID-19, especially someone with symptoms.
• Being coughed or sneezed on by an infected person.
• Being near an infected person when in an indoor space with poor airflow.

Risk factors for serious COVID-19 illness

Some people are at a higher risk of serious COVID-19 illness than others. This includes people who are older, and the risk increases with age.

People with existing medical conditions also may have a higher risk of serious illness. This includes people who have:

• Sickle cell disease or thalassemia.
• Serious heart diseases, such as heart failure, coronary artery disease or cardiomyopathy, and possibly high blood pressure.
• Chronic kidney, liver or lung diseases.

People with dementia or Alzheimer's are also at higher risk, as are people with brain and nervous system conditions such as stroke. Smoking increases the risk of serious COVID-19 illness. And people with body mass index in the overweight category or obese category may have an increased risk as well.

Other medical conditions that may increase the risk of serious illness from COVID-19 include:

• Cancer.
• Type 1 or type 2 diabetes.
• Weakened immune system from solid organ transplants or bone marrow transplants, some medicines, or HIV.
• Pregnancy.
• Down syndrome.
• Substance use disorders.

This list is not complete. Other medical conditions may increase your risk of serious illness from COVID-19.

Although most people with COVID-19 have mild to moderate symptoms, the disease can cause severe medical complications and lead to death in some people.

Older adults or people with existing medical conditions are at greater risk of becoming seriously ill with COVID-19.

Complications can include:

• Pneumonia and trouble breathing.
• Organ failure in several organs.
• Heart problems.
• A severe lung condition that causes a low amount of oxygen to go through your bloodstream to your organs, called acute respiratory distress syndrome.
• Blood clots.
• Acute kidney injury.
• Additional viral and bacterial infections.

The Centers for Disease Control and Prevention (CDC) recommends a COVID-19 vaccine for everyone age 6 months and older. The COVID-19 vaccine can lower the risk of death or serious illness caused by COVID-19. It lowers your risk and lowers the risk that you may spread it to people around you.

Getting a COVID-19 vaccine also is important because the flu and COVID-19 may be spreading at the same time and cause similar symptoms. Getting a COVID-19 vaccine and a flu vaccine is the best way to protect against both.

The COVID-19 vaccines available in the United States are:

• 2023-2024 Pfizer-BioNTech COVID-19 vaccine. This vaccine is available for people age 6 months and older.

  Among people with a typical immune system:

  • Children age 6 months up to age 4 years are up to date after three doses of a Pfizer-BioNTech COVID-19 vaccine.
  • People age 5 and older are up to date after one Pfizer-BioNTech COVID-19 vaccine.
  • For people who have not had a 2023-2024 COVID-19 vaccination, the CDC recommends getting an additional shot of that updated vaccine.

• 2023-2024 Moderna COVID-19 vaccine. This vaccine is available for people age 6 months and older.

  Among people with a typical immune system:

  • Children age 6 months up to age 4 are up to date if they've had two doses of a Moderna COVID-19 vaccine.
  • People age 5 and older are up to date after one Moderna COVID-19 vaccine.
  • For people who have not had a 2023-2024 COVID-19 vaccination, the CDC recommends getting an additional shot of that updated vaccine.

• 2023-2024 Novavax COVID-19 vaccine. This vaccine is available for people age 12 years and older.

  Among people with a typical immune system:

  • People age 12 years and older are up to date if they've had two doses of a Novavax COVID-19 vaccine.
  • For people who have not had a 2023-2024 COVID-19 vaccination, the CDC recommends getting an additional shot of that updated vaccine.

In general, people age 5 and older with typical immune systems can get any vaccine that is approved or authorized for their age. They usually don't need to get the same vaccine each time.

Some people should get all their vaccine doses from the same vaccine maker, including:

• Children ages 6 months to 4 years.
• People age 5 years and older with weakened immune systems.
• People age 12 and older who have had one shot of the Novavax vaccine should get the second Novavax shot in the two-dose series.

Talk to your healthcare professional if you have any questions about the vaccines for you or your child. Your healthcare team can help you if:

• The vaccine you or your child got earlier isn't available.
• You don't know which vaccine you or your child received.
• You or your child started a vaccine series but couldn't finish it due to side effects.

People with weakened immune systems

Your health care team may suggest added doses of COVID-19 vaccine if you have a moderately or severely weakened immune system.

Vaccination and other actions

You can take many steps to lower your risk of infection from the COVID-19 virus and lower the risk of spreading it to others. The World Health Organization (WHO) and CDC recommend following these precautions:

• Get vaccinated. COVID-19 vaccines reduce the risk of getting and spreading COVID-19.
• Avoid close contact with anyone who is sick or has symptoms.
• Keep distance between yourself and others when you're in indoor public spaces. This is especially important if you have a higher risk of serious illness. Keep in mind some people may have COVID-19 and spread it to others, even if they don't have symptoms or don't know they have COVID-19.
• Avoid crowds and indoor places that have poor airflow, also called ventilation.
• Wash your hands often with soap and water for at least 20 seconds. Or use an alcohol-based hand sanitizer that contains at least 60% alcohol.
• Wear a face mask in indoor public spaces if you're in an area with a high number of people with COVID-19 in the hospital. The CDC recommends wearing the most protective mask possible that you'll wear regularly, fits well and is comfortable.
• Improve the airflow indoors. Open windows. Turn on fans to direct air out of windows. If you can't open windows, consider using air filters. And turn on exhaust fans in your bathroom and kitchen. You also might consider using a portable air cleaner.
• Cover your mouth and nose. Cover your mouth and nose with your elbow or a tissue when you cough or sneeze. Throw away the used tissue. Wash your hands right away.
• Avoid touching your eyes, nose and mouth.
• Avoid sharing dishes, glasses, towels, bedding and other household items if you're sick.
• Clean and disinfect high-touch surfaces. For example, clean doorknobs, light switches, electronics and counters regularly.
• Stay home from work, school and public areas, and stay home in isolation if you're sick, unless you're going to get medical care. Avoid public transportation, taxis and ride-hailing services if you're sick.

If you have a chronic medical condition and may have a higher risk of serious illness, check with your health care professional about other ways to protect yourself.

Travel

If you're planning to travel, first check the CDC and WHO websites for updates and advice.

The CDC recommends that you wear a mask on planes, buses, trains and other public transportation traveling to, within or out of the U.S., as well as in places such as airports and train stations.

Use appropriate hand hygiene when in public.

You also may want to talk with your health care team if you have health conditions that make you more susceptible to respiratory infections and complications.

If you develop symptoms of coronavirus disease 2019 (COVID-19) or you've been exposed to the COVID-19 virus, contact your health care team. Also let your health care team know if you've had close contact with anyone who has been diagnosed with COVID-19.

Factors used to decide whether to test you for the virus that causes COVID-19 may differ depending on where you live. Depending on your location, you may need to be screened by your clinic to determine if testing is appropriate and available.

In the U.S., your health care team will determine whether to conduct tests for the virus that causes COVID-19 based on your symptoms, as well as whether you have had close contact with someone diagnosed with COVID-19.

You also may be tested if you are at higher risk of serious illness or you are going to have a medical procedure.

If you have had close contact with someone with COVID-19 but you've had COVID-19 in the past month, you don't need to be tested.

If you are up to date with the recommended COVID-19 vaccines and you've had close contact with someone with COVID-19, get tested five days after you've had contact with that person.

To test for the COVID-19 virus, a health care professional takes a sample from the nose (nasopharyngeal swab), throat (throat swab) or saliva. The samples are then sent to a lab for testing. If you're coughing up sputum, that may be sent for testing.

At-home tests for COVID-19 are available at many pharmacies. Some of these tests require a prescription, but some, called antigen tests, are available without a prescription. Antigen tests are not as reliable as the test done in a lab. But it is a fast and easy way to test yourself as soon as you have symptoms or at least five days after you've been exposed to the virus that causes COVID-19.

If you test negative, you can take the test a second time a few days later to help ensure your test results are accurate. The accuracy of each of these tests varies. So a negative test does not completely rule out having the COVID-19 virus.

Only get an at-home test that's authorized by the FDA or approved by your health care professional or local health department.

Currently, a few medicines have been approved to treat COVID-19. No cure is available for COVID-19. Antibiotics aren't effective against viral infections such as COVID-19. Researchers are testing a variety of possible treatments.

The FDA has approved the antiviral medicine remdesivir (Veklury) to treat COVID-19 in adults and children who are age 12 and older in the hospital. Remdesivir may be prescribed for people who are hospitalized with COVID-19 and need supplemental oxygen or have a higher risk of serious illness. It's given through a needle in the vein.

Paxlovid is another medicine approved to treat COVID-19 in adults. It includes nirmatrelvir — a drug that blocks the activity of a specific enzyme needed for the virus that causes COVID-19 to replicate — and an antiviral drug called ritonavir that helps slow the breakdown of nirmatrelvir. Paxlovid continues to be available under emergency use authorization to treat mild to moderate COVID-19 in people age 12 and older who are at higher risk of serious illness. Paxlovid pills are taken by mouth.

The FDA also has approved the rheumatoid arthritis drugs baricitinib (Olumiant) and tocilizumab (Actemra) to treat COVID-19 in some cases. Baricitinib is a pill that seems to work against COVID-19 by reducing inflammation and having antiviral activity. Tocilizumab is an injection. It seems to work against COVID-19 by reducing inflammation. Both medicines may be used in people in the hospital with COVID-19 who are on mechanical ventilators or need supplemental oxygen.

The FDA has authorized another drug called molnupiravir (Lagevrio) to treat mild to moderate COVID-19 in adults who are at higher risk of serious illness and who aren't able to take other treatment options. The medicine is taken by mouth as a pill.

The U.S. National Institutes of Health has recommended the corticosteroid dexamethasone for people hospitalized with severe COVID-19 who are on supplemental oxygen or need mechanical ventilation. Other corticosteroids, such as prednisone, methylprednisolone (Medrol) or hydrocortisone, may be used if dexamethasone isn't available.

In some cases, the drugs remdesivir, tocilizumab or baricitinib may be given with dexamethasone in people who are on mechanical ventilation or need supplemental oxygen in the hospital.

Other therapies also may be used for people who need oxygen or who are on mechanical ventilation or extracorporeal membrane oxygenation, called ECMO. The immune system suppression drug anakinra (Kineret) was authorized by the FDA for people who need supplemental oxygen. And vilobelimab (Gohibic), a monoclonal antibody, was authorized by the FDA for those who are on mechanical ventilation or ECMO.

The FDA also has authorized COVID-19 convalescent plasma therapy with high antibody levels to treat COVID-19. Convalescent plasma is blood donated by people who've recovered from COVID-19. Convalescent plasma with high antibodies may be used to help people diagnosed with COVID-19 who have weakened immune systems.

Many people with COVID-19 may have mild illness and can be treated with supportive care. Supportive care is aimed at relieving symptoms and may include:

• Pain relievers, such as ibuprofen or acetaminophen.
• Cough syrup or medicine.
• Rest.
• Fluid intake.

There is no evidence that ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs) need to be avoided.

If you have mild symptoms, your health care professional will likely recommend that you recover at home.

You may be given special instructions to monitor your symptoms and to avoid spreading the illness to others. You'll likely be asked to isolate yourself as much as possible from family and pets while you're sick, wear a mask when you're around people and pets, and use a separate bedroom and bathroom.

And improve airflow in your home by opening windows and using air filters when possible.

Your health care team will likely recommend that you stay in home isolation for a period of time except to get medical care. Your health care professional will likely follow up with you regularly.

Follow guidelines from your health care team and local health department about when you can end home isolation.

If you're very ill, you may need to be treated in the hospital.

It's common to feel fearful and anxious during the COVID-19 pandemic. You may be worried that you or those you love will get sick. You may be concerned about taking care of yourself or others who are ill.

During this time, remember to take care of yourself and manage your stress.

• Eat healthy meals.
• Get enough sleep.
• Get physical activity.
• Try relaxation exercises such as deep breathing, stretching and meditation.
• Avoid watching or reading too much news.
• Connect with friends and family, such as with phone or video calls.
• Do activities you enjoy, such as reading a book or watching a funny movie.

If you're ill with COVID-19, it's especially important to:

• Get plenty of rest.
• Drink fluids.
• Let your health care professional know right away if your symptoms worsen.

Having COVID-19 or caring for someone with the disease can cause stress and anxiety. If stress is affecting your daily life after several days, contact your health care professional and consider requesting a referral to a mental health professional.

To be treated for COVID-19, you may start by seeing your primary care doctor or other health care professional. Or you may be referred immediately to a specialist trained in treating infectious diseases. If you think you have COVID-19, tell your health care professional before going in for an appointment. Your health care team can then:

• Contact infection prevention and control and public health officials.
• Prepare to move you to a room quickly.
• Have a mask ready for you.

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance. Make a list of:

• Your symptoms, including any that seem unrelated to the reason for your appointment.
• Your recent travels, including any international travels.
• Key personal information, including major stresses, recent life changes and family medical history.
• All medications, vitamins or other supplements you take, including the doses.
• Questions to ask your doctor.

Take a family member or friend along, if possible, to help you remember the information you're given. Avoid bringing more than one or two people. Check before you go to the appointment, as your hospital or clinic may have visitor restrictions.

Some basic questions to ask your health care team include:

• How likely is it that COVID-19 is causing my symptoms?
• What are other possible causes for my symptoms?
• What tests do I need?
• What course of action do you recommend?
• Are there restrictions I need to follow?
• Should I see a specialist?

What to expect from your doctor

Your health care professional is likely to ask you several questions, such as:

• When did your symptoms begin?
• Where have you traveled recently?
• Who have you been in close contact with?
• How severe are your symptoms?