Coronavirus disease 2019 (COVID-19) communicable disease caused by the virus strain "severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).The disease was first identified in 2019 in Wuhan, China, and has since spread globally, leading to the 2019–20 coronavirus pandemic.Common symptoms include fever, cough, and shortness of breath. Muscle pain, sputum production and pharyngitis are less common.While the bulk of cases end in mild symptoms, some reach severe pneumonia and multi-organ failure.As of three March 2020, the speed of deaths per number of diagnosed cases is 3.4%,but ranges from 0.2% to fifteen counting on age and other health problems.
This type of infection is essentially transferred via respiratory droplets produced during coughing and sneezing.Basically symptoms of this virus seen between 2 to 14 days with a mean of 5 days.The standard method of diagnosis is by reverse transcription polymerase chain reaction (rRT-PCR) from a nasopharyngeal swab. The infection also can be diagnosed from a mixture of symptoms, risk factors and a chest CT scan showing features of pneumonia.
The preventive ways of COVID-19 are hand washing, maintaining distance from others (social distancing), and keeping hands faraway from the face.The use of masks is seems necessary for all the people.There is any sort of medicine or vaccine of this virus.Management involves treatment of symptoms, supportive care, isolation, and experimental measures.
The World Health Organization (WHO) declared the 2019–20 coronavirus outbreak an epidemic and a Public Health Emergency of International Concern (PHEIC). Evidence of local transmission of the disease has been found in many countries across all six WHO regions.
Personal protective equipment
Management of individuals infected by the virus includes taking precautions while applying therapeutic manoeuvres, especially when performing procedures like intubation or hand ventilation which will generate aerosols.
CDC outlines the precise personal protective equipment and therefore the order during which healthcare providers should put it on when handling someone who may have COVID-19:
1) gown,
2) mask or respirator,
3) goggles or a face shield,
4) gloves.
Mechanical ventilation
Most cases of COVID-19 aren't severe enough to need mechanical ventilation (artificial assistance to support breathing), but a percentage of cases do. this is often commonest in older adults (those older than 60 years and particularly those older than 80 years). Many developed countries don't have enough hospital beds per capita, which limits a health system's capacity to handle a sudden spike within the number of COVID-19 cases severe enough to need hospitalization. This limited capacity may be a significant driver of the necessity to flatten the curve (to keep the speed at which new cases occur and thus the amount of individuals sick at one point in time lower).One study in China found 5% were admitted to medical care units, 2.3% needed mechanical support of ventilation, and 1.4% died.
Experimental treatment
No medication are approved to treat the disease by the WHO although some are recommended by individual national medical authorities. Research into potential treatments started in January 2020, and a number of other antiviral drugs are in clinical trials. Although new medications may take until 2021 to develop, several of the medications being tested are already approved for other uses, or are already in advanced testing.
Antiviral medication could also be tried in people with severe disease. The WHO recommended volunteers participate in trials of the effectiveness and safety of potential treatments.[103] Korean Health Authorities recommend chloroquine and therefore the Chinese 7th edition guidelines include interferon, ribavirin, chloroquine, or umifenovir.
Information technology
In February 2020, China launched a mobile app to affect the disease outbreak. Users are asked to enter their name and ID number. The app is in a position to detect 'close contact' using surveillance data and thus a possible risk of infection. Every user also can check the status of three other users. If a possible risk is detected, the app not only recommends self-quarantine, it also alerts local health officials.
In March 2020, the Israeli government enabled security agencies to trace mobile data of individuals alleged to have coronavirus. The measure was taken to enforce quarantine and protect those that may inherit contact with infected citizens.
Psychological support
Infected individuals may experience distress from quarantine, travel restrictions, side effects of treatment, or fear of the infection itself. to deal with these concerns, the National Health Commission of China published a national guideline for psychological psychotherapy on 27 January 2020.
Prognosis
The severity of COVID-19 varies. The disease may take a light course with few or no symptoms, resembling other common upper respiratory diseases like the cold . Mild cases typically recover within fortnight , while those with severe or critical disease may take three to 6 weeks to recover. Among those that have died, the time from symptom onset to death has ranged from two to eight weeks.
some patients COVID-19 may affect the lungs causing pneumonia. In those most severely affected, COVID-19 may rapidly reach acute respiratory distress syndrome (ARDS) causing respiratory failure, septic shock, or multi-organ failure. Complications related to COVID-19 include sepsis, abnormal clotting, and damage to the guts , kidneys, and liver. Clotting abnormalities, specifically a rise in prothrombin time, are described in 6% of these admitted to hospital with COVID-19, while abnormal kidney function is seen in 4% of this group. Liver injury as shown by blood markers of liver damage is usually seen in severe cases.
any of these who die of COVID-19 have preexisting conditions, including hypertension, DM , and disorder .The Italian Istituto Superiore di Sanità reported that, out of over 2000 deaths from the disease within the country, 99.8% had a minimum of one preexisting condition with the typical patient having 2.7. consistent with an equivalent report, the median time between onset of symptoms and death was eight days with a difference of 1 day between patients who were been[clarification needed] treated in an ICU compared to those that were notn a study of early cases, the median time from exhibiting initial symptoms to death was 14 days, with a full range f six to 41 days. during a study by the National Health Commission (NHC) of China, men had a death rate of two .8% while women had a death rate of 1.7%. Histopathological examinations of post-mortem lung samples show diffuse alveolar damage with cellular fibromyxoid exudates in both lungs. Viral cytopathic changes were observed within the pneumocytes. The lung picture resembled acute respiratory distress syndrome (ARDS). In 11.8% of the deaths reported by the National Health Commission of China, heart damage was noted by elevated levels of troponin or asystole .
Availability of medical resources and therefore the socioeconomics of a neighborhood can also affect mortality. Estimates of the mortality from the condition vary due to those regional differences, but also due to methodological difficulties. The under-counting of mild cases can cause the deathrate to be overestimated. However, the delay in death occurring can mean the deathrate is underestimated.
It is unknown if past infection provides effective and long-term immunity in people that get over the disease. Immunity is probably going , supported the behaviour of other coronaviruses, but cases during which recovery from COVID-19 are followed by positive tests for coronavirus at a later date are reported. it's unclear if these cases are the results of reinfection, relapse, or testing error.
Concerns are raised about long-term sequelae of the disease. The Hong Kong Hospital Authority found a drop of 20% to 30% in lung capacity in some people that recovered from the disease, and lung scans suggested organ damage.
Epidemiology
The case deathrate (CFR) depends on the supply of healthcare, the standard age and health problems within the population, and therefore the number of undiagnosed cases. Preliminary research has yielded case deathrate numbers between 2% and 3%; in January 2020 the WHO suggested that the case deathrate was approximately 3%, and a couple of in February 2020 in Hubei. Other CFR numbers, which adjust for differences in time of confirmation, death or remission but aren't peer reviewed, are respectively 7% and 33% for people in Wuhan 31 January. An unreviewed preprint of 55 deaths noted that early estimates of mortality could also be too high as asymptomatic infections are missed. They estimated a mean infection fatality ratio (IFR, the mortality among infected) starting from 0.8% to 0.9%. The outbreak in 2019–2020 has caused a minimum of 244,517 confirmed infections and 10,030 deaths.
An observational study of nine people found no vertical transmission from mother to the newborn. Also, a descriptive study in Wuhan found no evidence of viral transmission through vaginal sex (from female to partner), but authors note that transmission during sex might occur through other routes.
Terminology
The World Health Organization announced on 11 February 2020 that "COVID-19" would be the official name of the disease. World Health Organization chief Tedros Adhanom Ghebreyesus said "co" stands for "corona", "vi" for "virus" and "d" for "disease", while "19" was for the year, because the outbreak was first identified on 31 December 2019. Tedros said the name had been chosen to avoid references to a selected geographical location (i.e. China), animal species, or group of individuals in line with international recommendations for naming aimed toward preventing stigmatisation.
While the disease is known as COVID-19, the virus that causes it's named severe acute respiratory syndrome coronavirus 2 or SARS-CoV-2. The virus was initially mentioned because the 2019 novel coronavirus or 2019-nCoV. The WHO additionally uses "the COVID-19 virus" and "the virus liable for COVID-19" publicly communications.
Contents for COVID-19 VIRUS
1 Signs and symptoms
2 Cause
3 Diagnosis
4 Prevention
5 Management
5.1 Personal protective equipment
5.2 Mechanical ventilation
5.3 Experimental treatment
5.4 Information technology
5.5 Psychological support
6 Prognosis
7 Epidemiology
8 Terminology
9 Research
9.1 Vaccine
9.2 Antivirals
9.3 Anti-cytokine storm
9.4 Passive antibody therapy
10 See also
11 References
12 External links
Signs and symptoms
Although those infected with the virus could also be asymptomatic, many develop flu-like symptoms including fever, cough, and shortness of breath.Less commonly, upper respiratory symptoms like sneezing, runny nose, or pharyngitis could also be seen. Gastrointestinal symptoms like nausea, vomiting, and diarrhea are seen during a minority of cases, and a few of the initial cases in China presented with only cardiac symptoms, like chest tightness and palpitations. In some, the disease may reach pneumonia, multi-organ failure, and even death.
As is common with infections, there's a delay from when an individual is infected with the virus to once they develop symptoms, referred to as the time period . The time period for COVID-19 is usually five to 6 days but may range from two to 14 days.
Cause
The disease is caused by the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), previously mentioned because the 2019 novel coronavirus (2019-nCoV). it's primarily spread between people via respiratory droplets from coughs and sneezes. The virus can remain viable for up to 3 days on plastic and chrome steel . SARS-CoV-2 can last up to 3 days, or in aerosols for 3 hours.The virus has also been found in faeces, but as of March 2020 it's unknown whether transmission through faeces is feasible , and therefore the risk is predicted to be low.
The lungs are the organs most suffering from COVID-19 because the virus accesses host cells via the enzyme ACE2, which is most abundant within the type II alveolar cells of the lungs. The virus uses a special surface glycoprotein, called "spike", to attach to ACE2 and enter the host cell. The density of ACE2 in each tissue correlates with the severity of the disease therein tissue and a few have suggested that decreasing ACE2 activity could be protective, though another view is that increasing ACE2 using angiotensin II receptor blocker medications might be protective which these hypotheses got to be tested. because the alveolar disease progresses, respiratory failure might develop and death may follow.
The virus is assumed to be natural and have an animal origin, through spillover infection. it had been first transmitted to humans in Wuhan, China, in November or December 2019, and therefore the primary source of infection became human-to-human transmission by early January 2020. The earliest known infection occurred on Revolutionary Organization 17 November 2019. As of 14 March 2020, 67,790 cases and three ,075 deaths thanks to the virus are reported in Hubei province; a case fatality rat (CFR) of 4.54%.
Diagnosis
The WHO has published several testing protocols for the disease. the quality method of testing
is real-time reverse transcription polymerase chain reaction (rRT-PCR). The test are often done on respiratory samples obtained by various methods, including a nasopharyngeal swab or sputum sample. Results are generally available within a couple of hours to 2 days. Blood tests are often used, but these require two blood samples taken fortnight apart and therefore the results have little immediate value. Chinese scientists were ready to isolate a strain of the coronavirus and publish the genetic sequence in order that laboratories across the planet could independently develop polymerase chain reaction (PCR) tests to detect infection by the virus.
As of 26 February 2020, there have been no antibody tests or point-of-care tests though efforts to develop them are ongoing.
Diagnostic guidelines released by Zhongnan Hospital of Wuhan University suggested methods for detecting infections based upon clinical features and epidemiological risk. These involved identifying people that had a minimum of two of the subsequent symptoms additionally to a history of visit Wuhan or contact with other infected people: fever, imaging features of pneumonia, normal or reduced white blood corpuscle count, or reduced lymphocyte count. A study published by a team at the Tongji Hospital in Wuhan on 26 February 2020 showed that a chest CT scan for COVID-19 has greater sensitivity (98%) than the polymerase chain reaction (71%). False negative results may occur thanks to PCR kit failure, or thanks to either issues with the sample or issues performing the test. False positive results are likely to be rare.
One study in China found that CT scans showed ground-glass opacities in 56%, but 18% had no radiological findings. Bilateral and peripheral ground glass opacities are the foremost typical CT findings, though they're non-specific. Consolidation, linear opacities and reverse halo sign are other radiological findings. Initially, the lesions are confined to at least one lung, but because the disease progresses, indications manifest in both lungs in 88% of so-called "late patients" within the study group (the subset for whom time between onset of symptoms and chest CT was 6–12 days). Ground glass opacities also are a standard feature in children's disease.
Prevention
Because a vaccine against SARS-CoV-2 isn't expected to become available until 2021 at the earliest, a key a part of managing the COVID-19 pandemic is trying to decrease the epidemic peak, referred to as flattening the epidemic curve through various measures seeking to scale back the speed of latest infections. Slowing the infection rate helps decrease the danger of health services being overwhelmed, allowing better treatment of current cases, and provides longer for a vaccine and treatment to be developed.
According to the WHO, the utilization of masks is merely recommended if an individual is coughing or sneezing or when one is taking care of somebody with a suspected infection.
To prevent transmission of the virus, the Centers for Disease Control and Prevention (CDC) within the us recommends that infected individuals stay home except to urge medical aid , call ahead before visiting a healthcare provider, wear a mask when exposed to a private or location of a suspected infection, cover coughs and sneezes with a tissue, regularly wash hands with soap and water and avoid sharing personal home items . CDC also recommends that individuals wash hands often with soap and water for a minimum of 20 seconds, especially after getting to the rest room or when hands are visibly dirty, before eating and after blowing one's nose, coughing, or sneezing. It further recommended using an alcohol-based hand sanitizer with a minimum of 60% alcohol, but only soap and water aren't readily available. For remote areas where commercial hand sanitizers aren't readily available, WHO suggested two formulations for the local production. In both of those formulations the antimicrobial activity of ethanol or isopropanol is enhanced by low concentration of peroxide while glycerol acts as a humectant. The WHO advises individuals to avoid touching the eyes, nose, or mouth with unwashed hands. Spitting publicly places also should be avoided.
Management
People are managed with supportive care which can include fluid, oxygen support, and supporting other affected vital organs. The WHO and Chinese National Health Commission have published recommendations for taking care of individuals who are hospitalised with COVID-19. Steroids like methylprednisolone aren't recommended unless the disease is complicated by acute respiratory distress syndrome. Intensivists and pulmonologists within the US have compiled treatment recommendations from various agencies into a free resource, the IBCC. CDC recommends that those that suspect they carry the virus wear an easy mask .
The WHO doesn't recommend against the utilization of ibuprofen or related non-steroidal anti-inflammatory drugs for the treatment of Covid-19 symptoms. Nevertheless, paracetamol is suggested for first-line use.
Extracorporeal membrane oxygenation (ECMO) has been wont to address the difficulty of respiratory failure, but its benefits are still into account .
Research
Because of its key role within the transmission and progression of the disease, ACE2 has been the main target of a big proportion of research and various therapeutic approaches are suggested.
Vaccine
There is no available vaccine, but research into developing a vaccine has been undertaken by various agencies. Previous work on SARS-CoV is being utilised because SARS-CoV-2 and SARS-CoV both use the ACE2 receptor to enter human cells. There are three vaccination str
Antivirals
Several existing antiviral medications are being checked out to treat COVID-19 and a few are getting into clinical trials.
There is tentative evidence for remdesivir as of March 2020. Remdesivir inhibits SARS-CoV-2 in vitro. Phase 3 clinical trials are being conducted within the US, in China, and in Italy.
Chloroquine, previously wont to treat malaria, was being studied in China in February 2020, with positive preliminary results. Chloroquine and hydroxychloroquine effectively inhibit SARS-CoV-2 in vitro, with hydroxychloroquine proving to be stronger than chloroquine and with a more tolerable safety profile. Preliminary results from an attempt suggested that chloroquine is effective and safe in treating COVID-19 associated pneumonia, "improving lung imaging findings, promoting a virus-negative conversion, and shortening the disease course". However, there are involves more review of the research so far . The Guangdong Provincial Department of Science and Technology and therefore the Guangdong Provincial Health and Health Commission issued a report stating that chloroquine phosphate "improves the success rate of treatment and shortens the length of patient’s hospital stay" and recommended it for people diagnosed with mild, moderate and severe cases of novel coronavirus pneumonia. On 17 March, the Italian Pharmaceutical Agency included chloroquine and hydroxychloroquine within the list of medicine with positive preliminary results for treatment of COVID-19.
Teicoplanin appears to inhibit SARS-CoV-2 and therefore the related MERS conaviruses and is viewed as a possible treatment for COVID-19.
In 2020, a randomized controlled trial published within the New England Journal of drugs found that lopinavir/ritonavir was ineffective against COVID19 and didn't cause shorter hospital stays or better outcomes compared to plain care alone. Nitazoxanide has been recommended for further in vivo study after demonstrating low concentration inhibition of SARS-CoV-2.
Studies have demonstrated that initial spike protein priming by transmembrane protease serine 2 (TMPRSS2) is important for entry of SARS-CoV-2 via interaction with the ACE2 receptor. These findings suggest that the TMPRSS2 inhibitor camostat approved to be used in Japan for inhibiting fibrosis in liver and renal disorder might constitute an efficient off-label treatment.
Anti-cytokine storm
Tocilizumab has been included in treatment guidelines by China's National Health Commission after alittle study was completed. it's undergoing a phase 2 non randomized test at the national level in Italy after showing positive leads to people with severe disease. Combined with a serum ferritin biopsy to spot cytokine storms, it's meant to counter such developments, which are thought to be the explanation for death in some affected people. The interleukin-6 receptor antagonist was approved by the FDA for treatment against cytokine release syndrome induced by a special cause, CAR T cell therapy, in 2017.
Passive antibody therapy
Using blood donations from people that have recovered from COVID-19 is being investigated, a technique that was tried for SARS. The mechanism of action is that the antibodies produced by the immune systems of these who have already recovered are transferred to people in need of them via a nonvaccine sort of immunization. Other sorts of passive antibody therapy, like with manufactured monoclonal antibodies, are in development. Convalescent serum production might be increased for quicker deployment.ategies being investigated. First, researchers aim to create an entire virus vaccine. the utilization of such an epidemic , be it inactive or dead, aims to elicit a prompt immune reaction of the physical body to a replacement infection with COVID-19. A second strategy, subunit vaccines, aims to make a vaccine that sensitises the system to certain subunits of the virus. within the case of SARS-CoV-2 such research focuses on the S-spike protein that helps the virus intrude the ACE2 enzyme receptor. a 3rd strategy is that the macromolecule vaccines (DNA or RNA vaccines, a completely unique technique for creating a vaccination). Experimental vaccines from any of those strategies would need to be tested for safety and efficacy.
On 16 March 2020, the primary clinical test of a vaccine started with four volunteers in Seattle. The vaccine contains a harmless ordering copied from the virus that causes the disease.
Links;
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
Coronavirus disease (COVID-19) outbreak | World Health Organization
Stay safe and remain healthy ✌✌
peace💖
No comments:
Post a Comment