It’s been nearly nine months since the news first broke of a novel coronavirus spreading in parts of Asia. The severe acute respiratory syndrome coronavirus (SARS-CoV-2) swept at unparalleled speed around the world causing what we now call coronavirus disease 2019 or COVID-19. Most of us, regardless of our experience within health care, were rapidly educated on the basic concepts of virology and epidemiology. Who would have thought that we would be discussing the dangers of disease transmission or the benefits of wearing a mask at the dinner table? And what exactly is a “long hauler” or “super-spreader”? Several new terms have entered our vocabularies, and many are confusing. I’ve compiled a glossary of words that are now part of our everyday COVID-19 lexicon.
Acute respiratory distress syndrome (ARDS)
: a life-threatening disease, characterized by an acute onset of hypoxia and pulmonary infiltrates, and brought on by conditions such as sepsis, pneumonia, trauma, burns, pancreatitis, and blood transfusion (Haskell, 2020
). ARDS causes diffuse lung inflammation which leads to increased pulmonary vascular permeability, pulmonary edema, and alveolar epithelial injury (Haskell, 2020
). COVID-19 patients may go on to develop ARDS but the presentation and management is not typical (Dabrow-Woods, 2020)
: suspension of tiny particles or droplets in the air, such as dust, mist, or fumes. These particles may be inhaled or absorbed by the skin and can sometimes cause adverse health effects for workers (Centers for Disease Control and Prevention [CDC], 2010).
: the spread of an infectious agent caused by the dissemination of aerosols that remain infectious when suspended in air over long distances (greater than one meter) and time. Some medical procedures can produce aerosolized droplets, and if performed on COVID-19 patients, the aerosols may contain the SARS-CoV-2 virus and could be inhaled by other individuals (World Health Organization [WHO], 2020a).
: molecules produced by the immune system to fight infection. People who have recovered from COVID-19 develop antibodies to the virus which could be used to help treat others who are infected and help researchers develop vaccines to prevent infection (National Institute for Health [NIH], 2020a). At this time, researchers do not know if the presence of antibodies indicates an individual is immune to SARS-CoV-2 in the future, or how long immunity might last.
detects the presence of antibodies to a specific pathogen and indicates whether an individual had a previous infection. This test will not indicate if an individual has a current infection and should not be used to diagnose COVID-19.
detects the presence of viral proteins; typically used in acute or early infection as the antigen is detected when the virus is actively replicating. This diagnostic test should indicate if an individual has a current infection.
: drugs that inhibit viral entry, viral membrane fusion, or viral replication. Antiviral therapies are being evaluated to treat COVID-19 and early data suggests these drugs may have the greatest effect in the earlier stages of the disease (NIH, 2020b). As of September 9, 2020, there are no drugs approved by the U.S. Food and Drug Administration (FDA) for the treatment of COVID-19.
: not exhibiting signs or symptoms of illness. In an asymptomatic individual, the SARS-CoV-2 virus RNA may be detectable, but symptoms don’t develop. Researchers have found evidence that supports asymptomatic transmission of COVID-19. (Furukawa, Brooks & Sobel, 2020).
Case fatality rate (CFR
): the proportion of individuals with a particular condition (case) who die from that condition. It is a measure of the severity of the condition (CDC, 2012).
an aggregation of cases grouped in place and time that are suspected to be greater than the number expected, even though the expected number may not be known (CDC, 2012).
: indicates that individuals in an area have been infected with the virus, with some individuals uncertain as to how or where they became infected (CDC, 2020a).
or contact investigation, is a public health approach used to contain the spread of pathogens. The goal of contact tracing is to identify, treat, and isolate current and potential cases of an infectious disease in order to control and prevent further human-to-human transmission.
plasma donated by individuals who have fully recovered from a disease and whose blood contains antibodies to that disease. This plasma may be administered to hospitalized patients currently fighting the disease and may help them recover.
: a group of viruses named for the crown-like spikes on their surface. There are four main sub-groupings of human coronaviruses, known as alpha, beta, gamma, and delta that are responsible for mild upper respiratory tract illnesses. Three additional sub-groups are associated with increased morbidity and mortality: Middle East Respiratory Syndrome coronavirus (MERS-CoV), severe acute respiratory syndrome coronavirus (SARS-CoV) and the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes COVID-19.
: coronavirus disease 2019, formerly referred to as “2019 novel coronavirus” or “2019-nCoV”, is caused by the SARS-CoV-2 and spreads from person to person through respiratory droplets. COVID-19 illness can range from mild to severe with symptoms such as fever, chills, cough, shortness of breath, fatigue, muscle/body aches, headache, loss of taste or smell, sore throat, congestion, runny nose, nausea, vomiting, or diarrhea. Severe illness can lead to hospitalization, ARDS, and increased morbidity and mortality.
an acute systemic inflammatory syndrome, or an excessive immune response, characterized by fever and multiple organ dysfunction (Porter & Maloney, 2019) that often develops after a severe viral infection. Some COVID-19 patients may experience a cytokine storm which could explain the development of critical illness in some and not in others.
Diagnostic COVID-19 test:
indicates whether an individual has a current, active infection. There are two types of diagnostic tests available for COVID-19: molecular tests detect the presence of viral genetic material and antigen tests detect the presence of viral proteins.
: respiratory infections can be transmitted through droplets of different sizes. If the droplet particles are greater than five-ten micrometers in diameter, they are referred to as respiratory droplets (WHO, 2020b). If the particles are less than five micrometers in diameter, they are referred to as droplet nuclei. Based on current evidence, COVID-19 virus is primarily transmitted between people through respiratory droplets and contact routes (WHO, 2020b).
Emergency use authorization (EUA
): allows the FDA to respond to public health threats such as chemical, biological, radiological and nuclear (CBRN) agents by facilitating the availability and use of medical countermeasures (MCMs) needed during public health emergencies (FDA, 2020b). Section 564 of the Federal Food, Drug, and Cosmetic Act permits the FDA to allow unapproved medical products to be used in an emergency to diagnose, treat, or prevent serious or life-threatening diseases caused by CBRN agents when there are no available alternatives (FDA, 2020b). The following products have EUA authorization for COVID-19: In Vitro diagnostic products, molecular-based laboratory tests, SARS-CoV-2 antibody tests, personal protective equipment, ventilators, drug and biological products (FDA, 2020b).
: the amount of a particular disease that is usually present in a community, the baseline, expected or observed level of the disease. It is the constant presence or usual prevalence of a disease or infectious agent in a population within a geographic area (CDC, 2012).
refers to an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area (CDC, 2012).
: the study of the distribution and determinants (causes) of health-related states or events in specified populations, and the application of this study to the control of health problems (CDC, 2012).
False positive result:
a test indicating a positive result, but disease is not present in the individual.
False negative result:
a test indicating a negative result, but disease is present in the individual.
“Flattening the curve”:
utilizing a combination of strategies to slow the spread of a disease (i.e. COVID-19) which would spread out the peak of the epidemic and prevent hospital capacity from being overrun (Kenyon, 2020).
: refers to the act of cleansing or sanitizing your hands in an effort to keep you healthy and prevent the spread of infections from one person to another. Washing your hands for at least 20 seconds or utilizing an alcohol-based hand sanitizer are both effective forms of hand hygiene. Germs can spread from other people or surfaces when you touch your eyes, nose, and mouth with unwashed hands; prepare or eat food and drinks with unwashed hands; touch a contaminated surface or objects; blow your nose, cough, or sneeze into hands and then touch other people’s hands or common objects (CDC, 2020b). The CDC provides a list of key times to wash your hands.
a threshold proportion of immune individuals that should lead to a decline in incidence of infection, or a pattern of immunity that should protect a population from invasion of a new infection (Fine, Eames & Heymann, 2011).
: is achieved through the presence of antibodies to that disease in a person’s system (CDC, 2017). There are two types of immunity (CDC, 2017):
- Active immunity results when exposure to a disease triggers the immune system to produce antibodies to that disease. This occurs either through natural immunity or vaccine-induced immunity.
- Passive immunity occurs when a person is given antibodies to a disease rather than producing them through their own immune system (i.e. newborn receives immunity from the mother).
prevents or stops the spread of infections in healthcare settings. There are two tiers: standard precautions for all patient care and transmission-based precautions used for patients with known or suspected infections, including contact precautions, droplet precautions, and airborne precautions.
as it relates to disease, is the time from exposure to a disease and the onset of initial symptoms. The incubation period for COVID-19 is between 2 and 14 days, with a median time of 4-5 days from exposure to symptom onset.
separation of a person or group of people known or reasonably believed to be infected with a communicable disease and potentially infectious from those who are not infected (CDC, 2020c).
a term used to describe individuals who contracted COVID-19 but whose symptoms linger for weeks or months as opposed to the typical 14 days. Recovery is tentative, variable, and not guaranteed (Yong, 2020).
similar to an epidemic; an increase, often sudden, in the number of cases of a disease above what is normally expected, but within a more limited geographic area (CDC, 2012).
an epidemic that has spread over several countries or continents, usually affecting a large number of people (CDC, 2012).
Personal protective equipment (PPE):
refers to protective clothing, helmets, gloves, face shields, goggles, facemasks and/or respirators or other equipment designed to protect the wearer from injury or the spread of infection or illness (FDA, 2020c). PPE used by healthcare providers caring for COVID-19 patients includes surgical masks, N95 respirators, medical gloves and gowns (FDA, 2020c).
with respect to COVID-19 refers to maintaining at least 6 feet of physical space from others to decrease the spread of SARS-CoV-2.
the phase in which viral genetic material (i.e. SARS-CoV-2 RNA) is detectable prior to the onset of symptoms. Researchers have found evidence that supports presymptomatic transmission of COVID-19 (Furukawa, Brooks & Sobel, 2020).
separation of people who are not yet symptomatic but have been exposed to a contagious person and are believed to be at risk of developing an infection.
Rapid diagnostic test (rapid antigen test):
immunoassay that detects the presence of a specific viral antigen, indicating a current viral infection. Rapid tests are often used to diagnose respiratory pathogens such as influenza. The FDA has granted EUA for antigen tests that can be used at point-of-care to identify SARS-CoV-2 in approximately 15 minutes (CDC, 2020d). These tests are performed on nasopharyngeal or nasal swab specimens and results are more accurate when individuals are tested in the early stages of infection, when viral load is highest (CDC, 2020d).
Reproductive rate (R0):
“R zero” or “R naught” refers to the average number of people that an individual with a virus can infect in a completely susceptible population (Randolph & Barreiro, 2020). Scientists believe the R0 for COVID-19 falls between two and three; in other words, one person can infect two to three people (WebMD, 2020a).
Reverse transcription polymerase chain reaction test (RT-PCR):
molecular test used to detect the presence of genetic material of a virus. COVID-19 RT-PCR tests are performed on nasopharyngeal swabs, oropharyngeal swabs, blood or stool samples. This diagnostic test is relatively accurate, but results take time.
severe acute respiratory syndrome coronavirus 2, a highly infectious pathogen that causes coronavirus disease 2019, or COVID-19.
with respect to testing, is the probability that an individual with the disease will test positive. A test that has high sensitivity will produce fewer false negative results.
an official order, issued during an emergency, that directs people to stay in the indoor place or building that they already occupy and not to leave unless absolutely necessary.
refers to remaining out of congregate settings, avoiding mass gatherings, and maintaining a distance of about 6 feet or 2 meters from others (CDC, 2020c).
with respect to testing, is the probability that an individual without the disease will test negative. A test that has high specificity will produce fewer false positive results.
restricts individuals from leaving their homes for anything other than essential activities such as medical care, to shop for food, and to perform essential work. This type of order has been issued during the COVID-19 pandemic to limit the number of people exposed to the virus.
an individual who is highly contagious and capable of transmitting a communicable disease to an unusually large number of uninfected individuals (Merriam-Webster, 2020).
showing symptoms of an illness or disease.
refers to the mechanism(s) by which an infectious agent may spread.
measurement of the amount or concentration of a virus in a standard volume of blood, plasma, saliva, mucous, or other bodily fluid; usually expressed as the number of virus particles per milliliter.
occurs when a virus replicates inside an organism and is released into the environment. In COVID-19, it is suspected that SARS-CoV-2 is most contagious when symptoms are worse and viral shedding is high (WebMD, 2020b).
I hope this compilation of COVID-19 terminology will help you in your understanding of the novel coronavirus. Are there any terms that I missed? Please share in the comments below.
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