COVID-19 natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2] Syed Hassan A. Kazmi BSc, MD [3]


In symptomatic patients, the clinical features of the disease usually start within a week, consisting of fever, cough, nasal congestion, fatigue, and other signs of upper respiratory tract infections. Disease progression and severity is manifested by dyspnea and severe chest symptoms corresponding to pneumonia in approximately 75% of the patients.

Natural History

Global Course

Currently, 952,100 cases of COVID-19 have been reported worldwide to date (April 2, 2020) with 48,100 confirmed deaths. This pandemic can have three possible scenarios in relation to its global course:

    • If all countries work together to contain the virus, due to its similarity with the SARS virus which caused an outbreak in 2003, the pandemic may be contained by July-August, 2020 but it should be taken into account that in the 2003 outbreak, international travel was not as frequent as it is today which may worsen the situation due to imported cases.
  • The second scenario may occur if the virus stays until the summer of 2020 in the northern hemisphere subsequent to which it may turn up in the southern hemisphere and reappear in the northern hemisphere during the months of November-December. This would be the case if the virus behaves as seasonal flu.
  • The third scenario is where we develop vaccination and vaccinate the human race against this fatal virus and eradicate it similar to other viruses such as smallpox, polio and others.


Cardiovascular Complications

Dermatologic Complications

Gastrointestinal and Hepatic Complications

  • COVID-19-associated digestive symptoms

Hematologic Complications

Infectious Disease Complications

Nephrologic Complications

Neurologic Complications

  • COVID-19-associated CNS manifestations
  • COVID-19-associated PNS manifestations

Pulmonary Complications

Endocrine Complications

Pediatric Complications


  1. Heymann, David L; Shindo, Nahoko (2020). "COVID-19: what is next for public health?". The Lancet. 395 (10224): 542–545. doi:10.1016/S0140-6736(20)30374-3. ISSN 0140-6736.
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  3. Velavan, Thirumalaisamy P.; Meyer, Christian G. (2020). "The COVID‐19 epidemic". Tropical Medicine & International Health. 25 (3): 278–280. doi:10.1111/tmi.13383. ISSN 1360-2276.
  4. Guan, Wei-jie; Ni, Zheng-yi; Hu, Yu; Liang, Wen-hua; Ou, Chun-quan; He, Jian-xing; Liu, Lei; Shan, Hong; Lei, Chun-liang; Hui, David SC; Du, Bin; Li, Lan-juan; Zeng, Guang; Yuen, Kowk-Yung; Chen, Ru-chong; Tang, Chun-li; Wang, Tao; Chen, Ping-yan; Xiang, Jie; Li, Shi-yue; Wang, Jin-lin; Liang, Zi-jing; Peng, Yi-xiang; Wei, Li; Liu, Yong; Hu, Ya-hua; Peng, Peng; Wang, Jian-ming; Liu, Ji-yang; Chen, Zhong; Li, Gang; Zheng, Zhi-jian; Qiu, Shao-qin; Luo, Jie; Ye, Chang-jiang; Zhu, Shao-yong; Zhong, Nan-shan (2020). doi:10.1101/2020.02.06.20020974. Missing or empty |title= (help)