Viral Respiratory Infections: COVID-19.

Abstract

On March 11, 2020, the World Health Organization declared COVID-19 a pandemic. By late 2024, COVID-19 had become endemic, with regional surges caused by new variants and declining population immunity. Case fatality rates have decreased because of vaccination and the emergence of less virulent variants, but long COVID persists as a public health concern. Because of structural issues, including those related to employment, housing, health care access, and mistrust, minority and low-income individuals are at higher risk for COVID-19 infection and mortality. Preventive strategies include shared decision-making about vaccination for individuals 6 months and older, two vaccine doses for adults 65 and older, and vaccination for pregnant and breastfeeding individuals. COVID-19 can be distinguished from influenza and respiratory syncytial virus infection through testing. Rapid antigen tests are faster but less sensitive than polymerase chain reaction tests. Outpatient care of COVID-19 focuses on symptomatic relief and early antiviral use when indicated. Inpatient treatment involves remdesivir, corticosteroids, interleuken-6 inhibitors, anticoagulation, and respiratory support. Long-term complications of COVID-19 include cardiovascular, pulmonary, neurologic, mental health, and renal conditions. Thrombotic risk peaks during acute infection and remains elevated for up to 1 year. An effective community response to COVID-19 requires equitable vaccine access, integrated care, and rebuilding of patient trust to counter misinformation.