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Q. What kind of virus is COVID-19?

‘Coronavirus (Cov)’ is a type of virus that can be transmitted to animals and humans[1]. It is called coronavirus because the external spike protein observed with the electron microscope reminds of an iconic crown shape[2]. There had been 6 types of human-infecting coronaviruses (4 types of cold, MERS-CoV, and SARS-CoV) identified so far, but with COVID-19(SARS-CoV-2) added there are 7 in total[3]. COVID-19, like SARS and MERS, is categorized as betacoronavirus[4] and is 89.1% similar to bat SARS-like coronavirus according to the genome sequence test result by the Korea Centers for Diseases Control and Prevention (KCDC)[5]. Signs of COVID-19 vary from mild to severe symptoms including fever, cough, and breathing difficulties after 2-14 days of contact[6].

Q. How long is the incubation period of COVID-19?

In clinical terms, the “incubation period” describes the time between catching the virus and showing symptoms. The “Latent period” is the time before the actual release of the pathogen[1]. Because it is difficult to accurately calculate the latent period, the contact tracing period is determined based on the estimated incubation period identified with the symptoms[1]. With the result of the WHO’s analysis on MERS, SARS and COVID-19 cases so far the incubation period lasts 1-12.5 days with median of 5-6 days. Thus, the COVID-19’s incubation period has been settled as 14 days last February[1].

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Q. COVID-19 weaker in high temperature, thus safe in summer?

Defer Judgment. According to the Infectious Diseases Division expert, because COVID-19 is a new virus its correlation with temperature and humidity remains unknown[1]. In fact, there have been confirmed cases in Singapore and Malaysia with a temperature around 30℃/86℉ and 60% humidity. Therefore, it is difficult to determine the definite correlations between the COVID-19’s durability and the atmosphere’s temperature and humidity[1][2]. However, it is recommended to maintain indoor humidity at an appropriate level of 30 to 60 percent to prevent common germs and viruses[3].

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Q. Can COVID-19 virus survive outside the body for more than five days?

Mostly False. This is a description of the coronaviruses and may differ from the actual characteristics of COVID-19. The lifespan of viruses depend on factors including the temperature, humidity and surface characteristics of the environment[1][2]. The US Center for Disease Control and Prevention described the lifespan of virus outside the body to be “several hours"[3]. According to a paper published by the German research team in ‘the Journal of Hospital Infection’, “human coronaviruses can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62–71% ethanol...within 1 minute”[1]. The Korean Doctor Association and Defense Association also announced that there is no risk of infection 24 hours after stringent disinfection procedure[4].

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Q. Can mutations lead to a stronger COVID-19?

Viruses undergo mutation during proliferation, which can lead to changes in pathogenicity and infectivity[1]. According to the Korea Centers for Disease Control and Prevention’s interim report on February 27, 2020, there was no mutation found in the gene that determines the pathogenicity of the virus. Thus, new virus strains from toxicity changes are not a big concern yet[2]. The COVID-19 sequence concordance announced in 16 overseas countries was 100%, corroborating the fact that there are few errors in the genetic testing[2].  

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Q. How contagious is COVID-19 exactly?

The contagiousness of a virus is measured through the concept of R0, which is a measure of how many people 1 person can transmit the disease[1]. If R0 is less than 1, each existing infection causes less than one new infection, and the disease will decline and eventually die out. If R0 is more than 1, each existing infection causes more than one new infection, spreading between people[1]. Currently, the R0 value of COVID-19 is around 2-2.5. In other words, if left untouched, this is a very contagious virus that causes at least 2 additional cases per infected person, which is about the same rate as Ebola and the Spanish flu[2][3].

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Q. Runny nose or sputum means COVID-19 negative?

False[1]. According to the WHO, the most common symptoms of COVID-19 are fever, dry cough, and breathing difficulties. However, some patients may have a runny nose, sore throat, or nasal congestion[1]. The Central Clinical Committee of Korea has confirmed that domestic patients have developed symptoms such as fever, chills, diarrhea, dry cough, sputum, runny nose, sore throat, headache, and muscle aches[2][3]. Moreover, according to the ‘Patient Care Guideline of COVID-19’ by the Korea Academy of Respiratory Diseases, symptoms may vary among individuals[4][5].

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Q. Do children have more severe symptoms when infected with COVID-19?

Mostly False. According to the CDC, although there is a limited number of cases, children generally had only mild symptoms in China. There were cases with severe symptoms, but this was rare[1]. However, children with underlying diseases are more likely to have severe symptoms. This only means that most children had mild symptoms and not that they do not get infected, so precautions should be taken[1]. 

Q. Will COVID-19 be followed by pulmonary fibrosis in most cases?

Mostly False. According to Ji-hwan Bang, an expert from the Division of Infectious Diseases, Boramae Medical Center, “We don’t exactly know the progress rate of pulmonary fibrosis but it is thought to be less than that of MERS. Even for patients whose lungs have turned white on X-rays due to pneumonia, cases of pulmonary fibrosis are likely to decrease in number"[1][2]. Moreover, Woojoo Kim, a medical specialist from the Infectious Diseases Division of Korea University Guro Hospital said, “Pulmonary fibrosis happens with patients in critical conditions and with most COVID-19 cases being less severe, pulmonary fibrosis is unlikely"[1][2].

Q. What factors cause increase in death rate
of COVID-19 patients?

According to the Severance Hospital’s Laboratory Medicine expert, “The matter of life and death may be impacted by the level of immunity, but the most significant factor is age and underlying diseases”. Research published in China showed that patients aged over 80 had a 14.8% death rate and those in their 70s had approximately 8%[1][2]. Most deaths in Korea were of those aged 65 and above, and those with risk factors such as chronic kidney disease, chronic heart disease, diabetes, cancer, and high blood pressure showed higher death rates[2][3][4].

Q. Will I get pneumonia for sure if infected with COVID-19?

Dong-a University Hospital’s Infectious Disease specialist has mentioned that, according to Zhong Nanshan’s research team, 80% of all COVID-19 patients develop pneumonia[1]. In Korea’s case, it is 65%[2][3]. COVID-19 is known to invade the lungs, the lower respiratory tract[4], but there needs to be further research on pulmonary fibrosis[3].

Q. I'm worried that I might have been infected 
because I keep coughing. What should I do?

According to a recommendation recently issued by the ‘Academia for COVID-19 Emergency Committee', when mild respiratory symptoms such as runny nose, nasal congestion, sore throat, cough, and fever occur, one should refrain from outdoor activities and take over-the-counter (OTC) cold medicines for 4-5 days[1][2]. However, if a fever of 38 degrees or higher persists, he/she should visit a nearby public clinic or call 1339 (Korea Centers for Disease Control and Prevention Hotline) immediately[2].

Q. Do pregnant women with COVID-19 have a high risk of miscarriage and stillbirth?

Defer Judgment. The CDC explained that "Although there is no data on the impact of COVID-19 on pregnancy, other related coronaviruses such as SARS and MERS have reported cases of miscarriage and stillbirth". High fever in the progravid (first 3 months) can increase the risk[1]. Recent studies have hypothesized that there is a higher risk of premature birth and the virus may affect childbirth but there is no clear evidence[1]. Moreover, the risk of mother-to-child transmission is still ungrounded[2].