Coronavirus Pandemic

COVID-19 (SARS CoV-2)

The name "coronavirus" is derived from the latin word corona, meaning "crown" as crown like spikes are seen on the surface of this virus.

• Coronavirus are large, lipid-enveloped, positive-sense, single-stranded RNA virus. These viruses are animal and human pathogens that can cause lethal zoonotic infection like SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome).

Classification 

Order: Nidovirales 

Family: Coronaviridae

Genus: Coronavirus 

Species: SARS-related coronavirus 

Strain: SARS Coronavirus-2 (SARS CoV-2)

• Human coronavirus commonly cause mild urinary tract infection although occasionally result in more severe diseases in immuno-compromised individuals. However, two novel human coronavirus SARS CoV and MERS CoV may cause serious viral pneumonitis leading to hospitalization and death. 
• SARS CoV seen mainly in China and travelers from there whereas MERS CoV seen specially seen in Saudi Arabia or visitors to that area, can cause more severe and sometimes life- threating human infections.
• Recently SARS CoV-2  that outbraek from the Wuhan city of China was designated a Public Heath Emergency of International Concern by the WHO on 30th Jan 2020 and declared it as a pandemic on 11th Mar 2020.

How is this virus transmitted?

The virus seems to be transmitted mainly via small respiratory droplets through sneezing, coughing, or when people interact with each other for some time in close proximity (usually less than one meter). These droplets can then be inhaled, or they can land on surfaces that others may come into contact with, who can then get infected when they touch their nose, mouth or eyes. The virus can survive on different surfaces from several hours (copper, cardboard) up to a few days (plastic and stainless steel). However, the amount of viable virus declines over time and may not always be present in sufficient numbers to cause infection.

**New research form China indicates that the SARS CoV-2 is also spread by fecal-oral transmission, not just by respiratory droplets or environmental contact.

What are the symptoms of SARS CoV-2 ?

Common symptoms of SARS CoV-2

Common symptoms includes:

-Fever

-Cough

-Sore throat

-General weakness and fatigue 

-Muscular pain

Symptoms in most severe cases:

-Severe pneumonia 

-Acute respiratory distress syndrome 

-Sepsis and Septic shock
-Severe heart problem like endocarditis

All potentially leading to death.

**NB: Elderly people above 70 years of age and those with underlying health conditions (e.g. hypertension, diabetes, cardiovascular disease, chronic respiratory disease and cancer) are considered to be more at risk of developing severe symptoms.

**Men in these groups also appear to be at a slightly higher risk than females.

Is there risk of infection in pregnant woman and neonates ?

There is limited scientific evidence on the severity of illness in pregnant women after SARS CoV-2 infection. No current evidence suggests that infection with SARS CoV-2 during pregnancy has a negative effect on the foetus. At present, there is no evidence of transmission of SARS CoV-2 from mother to baby during pregnancy and only one confirmed COVID-19 neonatal case has been reported to date. So its under the research.

How can we dfferentiate between hay fever/pollen allergy related respiratory symptoms and SARS CoV-2 ?

Table:Comparison of common symptoms between common cold, hay fever and SARS CoV-2

Is there a treatment for the SARS CoV-2 disease ?

There is no specific treatment or vaccine for this disease.Healthcare providers are mostly using a symptomatic approach, meaning they treat the symptoms rather than target the virus, and provide supportive care (e.g. oxygen therapy, fluid management) for infected persons, which can be highly effective.

In severe and critically ill patients, a number of drugs are being tried to target the virus.As this is a new virus, no vaccine is currently available. Although work on a vaccine has already started by several research groups and pharmaceutical companies worldwide, it may be months to more than a year before a vaccine has been tested and is ready for use in humans.

How can we avoid getting infected ?

The virus enters your body via your eyes, nose and/or mouth, so it is important to avoid touching your face with unwashed hands.

Washing of hands with soap and water for at least 20 seconds, or cleaning hands thoroughly with alcohol-based solutions, gels or tissues is recommended in all settings. It is also recommended to stay one meter or more away from people infected with SARS CoV-2 who are showing symptoms, to reduce the risk of infection through respiratory droplets.

How can we avoid infecting others ?

• Cough or sneeze into your elbow or use a tissue. If you use a tissue, dispose of it carefully after a single use
• Wash your hands with soap and water for at least 20 seconds.
• Stay one meter or more away from people to reduce the risk of spreading the virus through respiratory droplets.

**NB: If you feel unwell, stay at home. If you develop any symptoms suggestive of SARS CoV-2, you should immediately call your healthcare provider for advice.

Does lockdown help to control the spread of SARS CoV-2 infection ?

As we know there is no specific medications or vaccine till date so the only effective measure to control this infection is social distancing and for thus lockdown plays a great role.

Lockdown aims to reduce physical contact between potentially infected people and healthy people, or between population groups with high rates of transmission and others with low or no level of transmission. The objective of this is to decrease or interrupt the spread of SARS CoV-2.

**NB: For more detail information on COVID-19 Visit the website www.worldometer.info

By Deepak Mehta, MBBS, Cairo University 

02 April 2020