CORONAVIRUS/COVID-19

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Case Scenario:                                      

A 62-year old man presents with fever, malaise, and cough for the last 3 days. 2 weeks ago he was evacuated from a cruise ship that was approaching Venice, Italy. After arrival at home, the patient felt fine. 

Tactile fever: Not measured 

Cough: Dry and non-productive, with no associated chest pain or shortness of breath(SOB)

Malaise: Tiredness, decreased appetite, flu-like symptoms.


Epidemiology:

                  5 out of 7 coronaviruses were discovered this century and out of the 3 have provided the risk of a possible pandemic and death and the last one of the coronavirus also known as SARS-COV2 has become a significant part of our lives. Initial reports showed that its origin is bats. It is spread to each other through contact and human droplet route. Its RO value is 2.3 but it could be as high as 5.7. Its case fragility rate was 6.3 but it is different for different ages and countries, and it could be over 15%. Earlier studies have shown that it usually takes around 10-12 weeks to control an outbreak. While still, we learn about different case numbers, case fragility rates, and different death rates in different countries so it becomes increasingly important for us to go in-depth into the study of this virus even more.


Causes:

          Covid-19 is usually caused by the SARS-COV2 virus of the family of coronaviruses.


Symptoms:

More common symptoms:

  1. Fever
  2. Dry cough
  3. Tiredness.

Less common symptoms: 

  1. Aches and pain
  2. Sore throat
  3. Diarrhea
  4. Conjunctivitis
  5. Headache 
  6. loss of taste and smell
  7. A rash on the skin.

Severe Symptoms:

  1. Difficulty breathing or shortness of breath
  2. Chest pain or pressure
  3. Loss of speech and movement.
Seek immediate medical attention if you have serious symptoms. Always call before arriving at your doctor or health facility.

People who have mild symptoms and are otherwise healthy should manage their symptoms at home.


Complications:

  1. Acute respiratory failure
  2. Pneumonia
  3. Acute respiratory distress syndrome
  4. Acute liver injury
  5. Acute cardiac injury
  6. Secondary infection
  7. Acute kidney injury
  8. Septic shock
  9. Disseminated intravascular coagulation
  10. Blood clots
  11. Multisystem inflammatory syndrome in children
  12. Chronic fatigue
  13. Rhabdomyolysis

Transmission:

                 Current evidence suggests that the virus can spread to people in close contact such as 1 meter. A person can be infected when aerosols or droplets containing the virus are inhaled directly going to the mouth, nose, and eyes.


Differences and similarities between Influenza and COVID-19:

     Similarities: 

                  Firstly, Both the diseases have a similar disease presentation. That is they both cause respiratory diseases which present in a wide range of symptoms which range from Asymptomatic to moderate or can be severe to life-threatening.

        Differences:

  • The speed of transmission is an important point of difference between the two viruses. Influenza has a shorter median incubation period (the time from infection to appearance of symptoms) and a shorter serial interval (the time between successive cases) than the COVID-19 virus. The serial interval for the COVID-19 virus is estimated to be 5-6 days, while for the influenza virus, the serial interval is 3 days. This means that influenza can spread faster than COVID-19. 
 
  • Further, transmission in the first 3-5 days of illness, or potentially pre-symptomatic transmission –transmission of the virus before the appearance of symptoms – is a major driver of transmission for influenza. In contrast, while we are learning that there are people who can shed the COVID-19 virus 24-48 hours before symptom onset, at present, this does not appear to be a major driver of transmission.
      

  • The reproductive number – the number of secondary infections generated from one infected individual – is understood to be between 2 and 2.5 for the COVID-19 virus, higher than for influenza. However, estimates for both COVID-19 and influenza viruses are very context and time-specific, making direct comparisons more difficult.


  •  Children are important drivers of influenza virus transmission in the community. For the COVID-19 virus, initial data indicate that children are less affected than adults and that clinical attack rates in the 0-19 age group are low. Further preliminary data from household transmission studies in China suggest that children are infected from adults, rather than vice versa. 

  • While the range of symptoms for the two viruses is similar, the fraction with severe disease appears to be different. For COVID-19, data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe infections, requiring oxygen and 5% are critical infections, requiring ventilation. These fractions of severe and critical infection would be higher than what is observed for influenza infection.


  • Those most at risk for severe influenza infection are children, pregnant women, the elderly, those with underlying chronic medical conditions, and those who are immunosuppressed. For COVID-19, our current understanding is that older age and underlying conditions increase the risk for severe infection.


  •   Mortality for COVID-19 appears higher than for influenza, especially seasonal influenza. While the true mortality of COVID-19 will take some time to fully understand, the data we have so far indicated that the crude mortality ratio (the number of reported deaths divided by the reported cases) is between 3-4%, the infection mortality rate (the number of reported deaths divided by the number of infections) will be lower. For seasonal influenza, mortality is usually well below 0.1%. However, mortality is to a large extent determined by access to and quality of health care.

Diagnosis: 

             Thank you, Visita. Yes, this indeed is one of the most popular questions. There are three categories of testing if I would want to simplify them. The first one is to identify whether the actual COVID virus genetic material exists, and that's called a NAAT test, N-A-A-T. And it's the PCR testing where you would have a nasal pharyngeal swab or a pharyngeal swab taken. And then they look for the genetic material of the virus itself.


Management:

  • If you went to a hospital and got admitted there(which is very unlikely if you don't have severe symptoms) so the hospital will manage your condition on its own.

  • If the hospitals are full so what doctors may do is give you advice on how to take care of yourself and then you take care of yourself
 

  • If you are Asymptomatic then you will be asked to quarantine yourself at your home while taking basic care and that information will be provided by your primary health caretaker. 


  • If you are quarantined at home then you should have a separate room to yourself and if you can't manage that then you must have a separate area where nobody can come and go.


  • There should also be ventilation in the room and for this purpose, you should open the windows if it is safe to do so


  • The caregiver of that patient should only be a single person who does not have any underlying conditions and when the patient and caregiver are in contact then the caregiver and the patient should wear a mask at all times. The caregiver when he exits his room should wash his hands thoroughly because it reduces the percentage of infection happening.

Prevention:

  • Clean your hands often, with soap and water or an alcohol-based sanitizer.

  •  Maintain a safe distance from anyone who is coughing and sneezing.

  • Wear a mask where physical distancing is not possible   

  • Don't touch your eyes, nose, or mouth.

  • Cover your nose with a bent elbow or  a tissue when sneezing or coughing

  • Stay home if you feel unwell.

  • If you have a fever or a cough seek the attention of a doctor.


 References:

  • Website of WHO; Written by WHO; Topics took, CoronaVirus, Transmission, Differences between Coronavirus and Influenza

  • WHO podcast; By WHO; Topics took Episode 14: COVID-19 tests, Episode 36: Safe care at home

  • WebMD; written by WebMD; Topics took Complications of the COVID-19

  • https://journals.tubitak.gov.tr/; Written by  CEMAL BULUT, YASUYUKİ KATO; Topics is epidemiology of COVID-19
                     


     







                       




                                       




 

Comments

  1. SEO ExpertJuly 19, 2021 at 11:18 PM

    From the early December of 2019 of corona virus identification in China, it has taken many lives and the process is ongoing yet. Make sure to get home to safe and maintain hygiene and precaution. Best wishes Best wishes for everyone.

    ReplyDelete

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