Pandemic Devastating Coronavirus Disease 2019 (COVID19)

Coronavirus were first discovered in 1930’s when an acute respiratory infection of domesticated chickens was shown to be caused IBV . The name coronavirus is derived from Latin.  Corona  meaning “crown” or “ wreath” . 

Coronavirus comprise a vast family of viruses. 7 of which are known to cause disease in humans.  Some coronavirus that typically infect animals have been known to evolve to infect humans.  SARS CoV 2 is likely one such virus.  Recent case WHO reported who have no contact with animals or animal markets that suggesting the virus is now spreading from person to person . 

• SARS and MERS (severe acute respiratory syndrome & Middle east respiratory syndrome) also caused by coronavirus that jumped from animal to human 

Coronavirus disease 2019 (COVID19) 

Coronavirus disease 2019(COVID19) is defined as illness caused by novel coronavirus now called SARS CoV2 ; formally called  2019-nCoV) which was first identified in wuhan city ,hubei province , China. 

● Initially reported to the WHO on December 31 ,2019 

● WHO Declared global health emergency on jan 30, 2020 

● WHO Declared global pandemic  on March 11, 2020 

As of May 2, 2020 more than 3.3 Million confirmed case has been reported  across 187 countries and territories and about 235,000 deaths . More than 1.04 millions people have recovered. 

Route of Transmission

• via respiratory droplets from coughing and sneezing 
• via respiratory secretions 
• via direct contact with mucous membrane
• The virus can also persist on surfaces to varying durations & degrees of infectivity (one study found that SARS CoV2 remained detectable up to 72 hours some surface despite decreasing infectivity over time . The study reported that no viable SARS CoV2 was measured after 4 hours on copper or after 24 hours on cardboard ) 

– Data have suggested that asymptomatic patients are still able to transmit infection 

How long the new coronavirus can live on surfaces 

1. Paper and tissue paper-  3 hours 
2. Copper                           – 4 hours 
3. Cardboard.                    -24 hours
4. Wood.                             – 2 days 
5. Clothes.                           – 2 days 
6. Stainless  steel.              – 2- 3 days 
7. Plypropyline plastic.   – 3 days 
8. Glass.                             – 4 days 
9. Paper money.                – 4 days 
10. Outside of surgical  mask – 7 days.  

Critical Complications of COVID19 

Pre-existing illnesses that make person  at higher risk of (COVID19)

• cardiovascular disease such as cardiomyopathies , etc
• Diabetes ( DM)
• Chronic respiratory disease such as COPD , Asthma etc 
• Hypertension( HTN)
• Cancer of different types  
• Immunocompromised patients( TB ,HIV etc )

Sign and symptoms of COVID19

Most common symptoms: 

1. Fever (88%)
2. Dry Cough (67%)
3. Myalgia (15 %)
4. Fatigue (38%)

Less common symptoms :

1. Headache(14%)
2. Sore throat (14%)
3. Loss of taste 
4. Sputum production
5. Runny nose
6. Vomiting 
7. Diarrhea 
8. Malaise
9. Shortness of breath/ dyspnea (19%)
10. Respiratory distress 

• The most common serious manifestation of covid19 is pneumonia. 
• Anosmia (loss of sense of smell ) 
• Symptoms in children with infection appears to be uncommon although some case have been reported 

Diagnosis of COVID19

COVID-19 should be considered a possibility in (1) patients with respiratory tract symptoms and newly onset fever or (2) in patients with severe lower respiratory tract symptoms with no clear cause. Suspicion is increased if such patients have been in an area with community transmission of SARS-CoV-2 or have been in close contact with an individual with confirmed or suspected COVID-19 in the preceding 14 days.     

    Laboratory Tests for Diagnosis  

1. RT-PCR (Real time Polymerase chain reaction )
2. rRT-PCR (Real time Reverse transcription Polymerase Chain Reaction) 
3. Isothermal amplification assays
4. Antigen Test (Antigen tests are seen by many as the only way it will be possible to scale up testing to the numbers that will really be needed to detect acute infection)

IMAGING

1. CT-Scan – Chest CT scanning in patients with COVID-19–associated pneumonia usually shows ground-glass opacification , possibly with consolidation. Some studies have reported that abnormalities on chest CT scans are usually bilateral, involve the lower lobes, and have a peripheral distribution. Pleural effusion, pleural thickening, and lymphadenopathy have also been reported, although with less frequency
2. Chest Radiograph 

PREVENTION of COVID19

No vaccine  is currently available for COVID19  so avoidance is principle method. 

Methods are 

1. Hand washing with soap and water for at least 20 seconds. 
2. Avoid touching their eyes, nose, and mouth with unwashed hands.
3. Individuals should avoid close contact with sick people.
4. Sick people should stay at home (eg, from work, school).
5. Coughs and sneezes should be covered with a tissue, followed by disposal of the tissue in the trash.

TREATMENT COVID19

No specific antiviral treatment is recommended for COVID19 

• supportive care help alleviate symptoms.
• some medical professionals recommended paracetamol over ibuprofen for first line use 
• steroids such as methylprednisolone are not recommended unless the disease is complicated by acute respiratory distress syndrome (ARDS)
• Remdesivir- The broad spectrum antiviral agent (Gs-5734; Gilead sciences inc) is a nucleotide analog product.  It shown to inhibit replication of other human coronavirus associated with high morbidity in tissue cultures including SARS-CoV  MERS 
• Lopinavir/Ritonavir- A combination of lopinavir/ritonavir plus IFNb treatment improved clinical parameters in mice which was infected with MERS -CoV.

INVESTIGATIONAL DRUGS 

1. Hydroxychloroquine/Chloroquine 
2. Hydroxychloroquine plus azithromycin 
3. Tradipitanl 
4. Corticosteroids 
5. Convalescent plasma 
6. Nitric oxide  

Certain Research Going on 

1 pet cats in New York (USA) state have tested +ve for the novel coronavirus, marking the 1st confirmed cases in companion animals in the United States.

The cats, which had mild respiratory illnesses and are expected to recover, are thought to have contracted the virus from people in their households or neighborhoods.

2. Ukraine becomes the 5th country in the world where ELISA tests are developed to determine the titer of antibodies to SARS-CoV-2 .

Coronavirus testing for pets isn’t recommended unless an animal has been exposed to a person with Covid-19.

 3. High-Dose Chloroquine For COVID-19 Stopped Early Due to Patient Deaths.

The antimalarial medication Hydroxychloroquine and the antibiotic azithromycin are currently gaining attention as potential treatments for COVID-19, and each have potential serious implications for people with existing cardiovascular disease.

Complications include severe electrical irregularities in the heart such as arrhythmia (irregular heartbeat), polymorphic ventricular tachycardia (including Torsade de Pointes) and long QT syndrome, and increased risk of sudden death.”

4. Hope fruitful in coming future to save from Pandemic (COVID 19) .

Coronavirus survivors’ plasma could save lives.

Two independent research studies have shown the benefit of receiving infusions of blood from COVID-19 survivors.

The teams – both based in China – extracted blood plasma from patients who had recovered from COVID-19, which contained antibodies against the disease. The first study from the National Engineering Technology Research Center for Combined Vaccines in Wuhan (uploaded to medRxiv and yet to be peer-reviewed) gave plasma to 10 patients who were severely ill with COVID-19. Six days after receiving the infusion, the COVID-19 virus was undetectable in seven of the 10 patients.

5. COVID19  ( Antibiotics used ) 

Treatment protocols from French study

# Hydroxychloroquine sulphate :- 200mg P0 × TDS up to 10 days .

# Azithromycin :- 500mg PO once for first day then 250 mg PO on day 2nd ,3rd, 4 th and 5th day.

6. Coronavirus can be transmitted through faces, Chinese University study confirms, with experts suggesting stool tests as alternative screening tool.

7. USA Doctors are using huge amount of vitamin C while treating COVID19 positive patients and found it’s quit effective in improving patients health but still research going on, it still not clear.

That’s why vitamin C containing diets might help to fight against viruses or flu .

If possible consume it.

You may also like Hantavirus (HV)

No matter what you are going through there is light at the end of tunnel

Author (Dr. Umesh Kumar Yadav MD) , contact umeshyadav77777@gmail.com