CORONA VIRUS

Resti Yudhawati

PULMONOLOGI DAN ILMU KEDOKTERAN RESPIRASI

FAKULTAS KEDOKTERAN UIVERSITAS AIRLANGGA
RSU Dr. SOETOMO – SURABAY
 • The name
“coronavirus,”
coined in 1968, is
derived from the
“corona”-like or
crown-like

Weiss SR and Martin SN, 2005

 RNA VIRUS

INFLUENZA PANDEMI

SARS-CoV, MERS-CoV,
2019-nCoV
,

Cahscient.fies.eordpress.com/2008/textbook-mikrobologi15.doc 3
 Orthomyxoviridae Coronaviridae
- Ada 3 stubtipe (influenza A, B, C) Virus 229E, OC43, NL63, HKU1 menyebabkan gejala
URI relatif ringan
Pandemik: Epidemik
influenza A: 2002 – 2003
1918 (H1N1) Novel coronavirus
Flu Spanyol , 100 juta kematian disebut:
1957 (H2N2) SARS-CoV 8422 kasus, 912 kematian
Asian flu, 2 juta kematian 2012-2013
1968 (H3N2) Novel coronavirus,
Hongkong flu, 500 ribu kematian Semenanjung. Arab:
2003 (H5N1) MERS-CoV 2494 kasus, 858 Kematian
China (Avian Influenza), 345 fatal Kematian 2019 -
H1N1 pdm 2009 2019-nCoV (Wuhan CoV)
USA , 12,469 Kematian 6065 kasus, 132 kematian

Indonesia → Indonesia → (-)

H5N1 2003 – 2017
(201 kasus, 167 kematian )
H1N1 pdm 2009
 TAXONOMY

• Order: Nidovirales
• Family: Coronaviridae
• Genus: Alphacoronavirus, Betacoronavirus,
Gamacoronavirus, Deltacoronavirus
• ssRNA positive-strand virus
 • Mammals ( humans, bats, cows, pigs)
Coronaviruses • Birds, chickens

Zoonosis
Alpha coronavirus
• Type Species : Human coronavirus 229 E, miniopterus Bat
coronavirus HKUB
Beta coronavirus
• Type Species : SARS CoV, MERS CoV, Human coronavirus
OC43, Wuhan coronavirus (2019-nCoV)
Gama coronavirua
• Type species: Avian corona virus, duck coronavirus
Delta coronavirus
• Type species: Bulbul coronavirusHKU11, Munia coronavirus
 Classification of human coronavirus.

Alphacoronavirus Betacoronavirus

Lim et al, 2016

• 2019- novel Cov Beta coronavirus

 Human coronaviruses
(HCoVs)
• HCoVs have long been considered inconsequential
pathogens, causing the “common cold”
• 21st century, 2 highly pathogenic HCoVs—(SARS-
CoV) and (MERS-CoV) emerged from animal
reservoirs to cause global epidemics
• December 2019, novel coronavirus (2019-nCoV), was
recognized in Wuhan, China, and has caused serious
illness and death

Paules et al, 2020

1. Human coronavirus 229E (HCoV-229E)
2. Human coronavirus OC43 (HC0V-OC43)
3. SARS-CoV
4. Human coronavirus NL63 (HCoV-NL63,
New Haven coronavirus)
5. Human coronavirus HKUI
6. Middle East respiratory syndrome
coronavirus (NERS-Cov)
7. 2019 Novel coronavirus (2019-nCoV)
 Structural proteins :
• Glycoproteins spike (S)
• Envelope (E)
• Membrane (M)
• Nucleocapsid (N)

Positive SS RNA
26-32 KB
 Animal origins of human coronaviruses

16

Cui et al., 2020

Genome organisation of human coronaviruses (HCoVs)

Lim et al, 2016

Cellular Receptor

• CoV infection is initiated by the attachment to specific host

cellular receptors via the spike (S) protein.
• The host receptor is a major determinant of pathogenicity,
tissue tropism and host range of the virus

Lim et al, 2016

 SARS-CoV MERS-CoV

Jia

Cui et al., 2020 Cui et al., 2020

Respiratory epithelia , renal and Lower airway, gastrointestinal tract

cardiovascular tissue, and epithelia of and kidney
the small intestine Paules et al, 2020
Jia et al, 2005
Pneumonia, diarhea, kidney injury
Pneumonia, diarhea, kidney injury,
Acute cardiac injury
Coronavirus replication cycle

Cui et al., 2020

 MERS-CoV : SARS-CoV
• Clinical similarity
• Cause severe illness in people.
• Zoonosis
• Person-to-person transmission appears to be very low
• SARS-CoV rapidly spread across the globe, but not
MERS-CoV

,
Mortality rates of 10% for SARS-CoV and 37% for MERS-CoV
Cui,2019
 Human Transmission

• Direct exposure (physical contact) → touching, feeding, cleaning,

slaughtering, milking
• Indirect exposure (No physical contact) → visiting exposure areas
(markets, racing tracks, farms)
Novel Coronavirus (2019-nCoV)
(Wuhan Coronavirus)
WHO, Data as reported by 29 January 2020*
 Genetically distinct from other
known coronavirus that infect humans
(MERS CoV, SARS CoV)

• Preliminary analyses indicate that 2019- nCoV has some amino acid
homology to SARS-CoV and may be able to use ACE2 as a
receptor.
Paules et al, 2020
Phylogenetic Analysis of 2019-nCoV and Other Betacoronavirus
Genomes in the Orthocoronavirinae Subfamily

Rhinolophus sinicus

Zhu N, 2020
 2019-nCoV

Zhu N, 2020
How dose 2019-nCoV spread
 Huanan seafood
Market

Large seafood market selling

many species of live animals
The reservoir or intermediary →
Suspected Animals sold for food
Natural reservoir
or Intermediate
host ?
Human to Human spread ??
 Human to Human spread
• 20 January 2020 → Human-to-human spread was confirmed in Guangdong

Human-to-human transmission of 2019-nCoV occurs, as evidenced by the

infection of 15 health care practitioners in a Wuhan hospital
 Clinical features of patients infected with 2019 novel
coronavirus in Wuhan

41 patients confirmed 2019-nCoV

• Underlying diseases (diabetes, hypertension and cardiovascular disease (32%)
• exposed to Huanan seafood market (66%)
• Common symptoms : fever (98%], cough ( 76%), and myalgia/ fatigue (44%);
• Less common symptoms were sputum production, headache, haemoptysis, and
diarrhoea
• Dyspnoea (55%) (median time from illness onset to dyspnoea 8·0 days)
• Lymphopenia. (63%)
• All 41 patients had pneumonia with abnormal fndings on chest CT.
• Complications included ARDS (29%)), aemia (15%), acute cardiac injury ([12]) and
secondary infection (10%).
• Admitted to an ICU (32%), Died (15%)
• Procalcitonin <0·1 ng/mL (69%] Huang Cet al, 2020
 Abnormal fndings on chest CT
A B

Huang Cet al, 2020

 Severity (2019-nCoV)

• Not fully clear.

• Illnesses have ranged from infected people
with little to no symptoms to severely ill and
dying.

Ongoing investigations

CDC, 2020
 Incubation period

• Current estimates of the incubation period of the

virus range from 2-14 days
• Detailed epidemiological information from more
people infected is needed
• Transmission can occur from asymptomatic
individuals or during the incubation period ??

WHO, 2020
 Management
• No specific treatment
• Focused on alleviation of symptoms.
• Anti viral are being studied
• So far, the fatality rate of 2019-nCoV is lower than
that of SARS-CoV and MERS-CoV; however, the
ultimate scope and effects of the outbreak remain to
be seen.
CDC, 2020

• The novel coronavirus' case fatality rate is currently estimated at

around 2%, according to the WHO on January 29, 2020.
• Fatality rate can change as a virus can mutate, according to
epidemiologists.
WHO, 2020
 PREVENTION

• Coronavirus sensitif terhadap

panas
• Dapat diinaktifkan oleh
desinfektan mengandung klorin,
pelarut lipid dengan suhu 56℃
selama 30 menit, eter, alkohol,
asam perioksiasetat, detergen
non-ionik, formalin, oxidizing
agent dan kloroform.
THANK YOU