🦠 Infectious

COVID-19

SARS-CoV-2 infection ranging from mild respiratory illness to severe pneumonia.

Overview

COVID-19 is caused by the SARS-CoV-2 virus. Most cases are mild but high-risk groups can develop severe disease, blood clots and long COVID.

Symptoms

  • Cough
  • Fever
  • Sore throat
  • Loss of smell or taste
  • Fatigue
  • Breathlessness

Risk factors

  • Older age
  • Obesity
  • Diabetes
  • Heart or lung disease
  • Immunosuppression
  • Unvaccinated status

Causes

  • SARS-CoV-2 virus, airborne droplet and aerosol spread

🚨 Red flags — seek urgent care

  • Oxygen saturation <94%
  • Severe breathlessness
  • Confusion
  • Chest pain
  • Bluish lips

When to seek care

  • High-risk patient with positive test
  • Symptoms worsening after day 5–7
  • Persistent fever beyond 5 days

Diagnosis

  • Clinical features: fever, cough, anosmia, sore throat, fatigue, breathlessness
  • Lateral flow antigen test or PCR confirmation
  • Risk stratify: pulse oximetry (silent hypoxia), age, comorbidities, vaccination status

Treatment

  • Most cases: rest, fluids, paracetamol, isolation per current public-health advice
  • Antivirals (nirmatrelvir/ritonavir, molnupiravir, remdesivir) for high-risk outpatients within 5 days of onset
  • Hospital: oxygen for SpO2 <94%, dexamethasone if on oxygen, anticoagulation, IL-6 inhibitors in selected cases
  • Address long-COVID with multidisciplinary rehab

Prevention

  • Vaccination per current schedule (primary + boosters)
  • Hand hygiene and well-ventilated indoor spaces
  • Masks in high-risk settings during community surges
  • Stay home and test when symptomatic

Complications

  • Hypoxaemic respiratory failure and ARDS
  • Venous thromboembolism, stroke, myocarditis
  • Acute kidney injury and multi-organ dysfunction
  • Post-COVID condition (long COVID): fatigue, breathlessness, cognitive symptoms
  • Secondary bacterial infection

Education & self-care

Vaccination, ventilation and early testing remain the most effective strategies. Pulse oximetry at home is a useful early warning tool.

Frequently asked questions

When am I no longer infectious?

Most people are no longer infectious 5–10 days after symptom onset, sooner if afebrile.

Do I need antivirals?

Eligible high-risk patients benefit from antivirals if started within 5 days of symptom onset.

When can I stop isolating?

Current UK advice is to stay home and avoid contact with vulnerable people for 5 days after a positive test or symptom onset, longer if still feverish. Specific occupational guidance may differ.

Are antivirals like Paxlovid for everyone?

No — they are reserved for people at higher risk of severe disease (older age, immunosuppression, certain chronic conditions) and must be started within 5 days of symptoms to be effective.

What is long COVID?

Persistent symptoms — fatigue, breathlessness, brain fog, palpitations — lasting beyond 12 weeks and not explained by another diagnosis. Multidisciplinary rehabilitation gives the best results.

Medically reviewed by Dr. Handel Emery, MD, FRCP (UK) · Last reviewed 2026-06-08