Tishk International University

Faculty of Dentistry
Pathology Course
Report

Novel Corona Virus

By Mohammad Mustafa Ibrahim Omar

What is Corona virus?
Coronaviruses are a group of related RNA viruses that cause diseases in mammals and birds. In
humans, these viruses cause respiratory tract infections that can range from mild to lethal. Mild
illnesses include some cases of the common cold while more lethal varieties can
cause SARS, MERS, and COVID-19. Symptoms in other species vary: in chickens, they cause
an upper respiratory tract disease, while in cows and pigs they cause diarrhea.

What is the history of the already known corona virus?

Coronaviruses were first discovered in the 1930s when an acute respiratory infection of
domesticated chickens was shown to be caused by infectious bronchitis virus (IBV). Arthur
Schalk and M.C. Hawn described in 1931 a new respiratory infection of chickens in North
Dakota. The infection of new-born chicks was characterized by gasping and listlessness.

The chicks' mortality rate was 40–90%. Fred Beaudette and Charles Hudson six years later
successfully isolated and cultivated the infectious bronchitis virus which caused the disease.
In the 1940s, two more animal coronaviruses, mouse hepatitis virus (MHV) and transmissible
gastroenteritis virus (TGEV), were isolated. It was not realized at the time that these three
different viruses were related.
Human coronaviruses were discovered in the 1960s.
They were isolated using two different methods in the United Kingdom and the United
States. E.C. Kendall, Malcom Byone, and David Tyrrell working at the Common Cold Unit of
the British Medical Research Council in 1960 isolated from a boy a novel common cold virus
B814.
The virus was not able to be cultivated using standard techniques which had successfully
cultivated rhinoviruses, adenoviruses and other known common cold viruses.

In 1965, Tyrrell and Byone successfully cultivated the novel virus by serially passing it
through organ culture of human embryonic trachea. The new cultivating method was introduced
to the lab by Bertil Hoorn. The isolated virus when intranasally inoculated into volunteers caused
a cold and was inactivated by ether which indicated it had a lipid envelope. Around the same
time, Dorothy Hamre and John Procknow at the University of Chicago isolated a novel cold
virus 229E from medical students, which they grew in kidney tissue culture. The novel virus
229E, like the virus strain B814, when inoculated into volunteers caused a cold and was
inactivated by ether.
The two novel strains B814 and 229E were subsequently imaged by electron microscopy in 1967
by Scottish virologist June Almeida at St. Thomas Hospital in London. Almeida through electron
microscopy was able to show that B814 and 229E were morphologically related by their
distinctive club-like spikes. Not only were they related with each other, but they were
morphologically related to infectious bronchitis virus (IBV). A research group at the National
Institute of Health the same year was able to isolate another member of this new group of viruses
using organ culture and named the virus strain OC43 (OC for organ culture). Like B814, 229E,
and IBV, the novel cold virus OC43 had distinctive club-like spikes when observed with the
electron microscope.
The IBV-like novel cold viruses were soon shown to be also morphologically related to the
mouse hepatitis virus. This new group of IBV-like viruses came to be known as coronaviruses
after their distinctive morphological appearance. Human coronavirus 229E and human
coronavirus OC43 continued to be studied in subsequent decades. The coronavirus strain B814
was lost. It is not known which present human coronavirus it was. [38] Other human coronaviruses
have since been identified, including SARS-CoV in 2003, HCoV NL63 in 2004, HCoV HKU1 in
2005, MERS-CoV in 2012, and SARS-CoV-2 in 2019.[39][40] There have also been a large
number of animal coronaviruses identified since the 1960s.

Ethymology of corona virus:

The name "coronavirus" is derived from Latin corona, meaning "crown" or "wreath", itself a
borrowing from Greek κορώνη korṓnē, "garland, wreath". The name was coined by June
Almeida and David Tyrrell who first observed and studied human coronaviruses. The word was
first used in print in 1968 by an informal group of virologists in the journal Nature to designate
the new family of viruses. The name refers to the characteristic appearance of virions (the
infective form of the virus) by electron microscopy, which have a fringe of large, bulbous
surface projections creating an image reminiscent of the solar corona or halo. This morphology is
created by the viral spike peplomers, which are proteins on the surface of the virus.

novel corona virus:

Novel coronavirus (nCoV) is a provisional name given to coronaviruses of medical
significance before a permanent name is decided upon. Although coronaviruses are endemic in
humans and infections normally mild, such as the common cold (caused by human
coronaviruses in ~15% of cases), cross-species transmission has produced some
unusually virulent strains which can cause viral pneumonia and in serious cases even acute
respiratory distress syndrome and death.
What is the disease which is related to NCov?
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified in December 2019
in Wuhan, China, and has resulted in an ongoing pandemic. The first case may be traced back to
17 November 2019. As of 16 June 2020, more than 8.05 million cases have been reported across
188 countries and territories, resulting in more than 437,000 deaths. More than 3.88 million
people have recovered.

What are the symptoms of Covid-19?

Common symptoms include fever, cough, fatigue, shortness of breath, and loss of
smell and taste. While the majority of cases result in mild symptoms, some progress to acute
respiratory distress syndrome (ARDS) possibly precipitated by cytokine storm, multi-organ
failure, septic shock, and blood clots. The time from exposure to onset of symptoms is typically
around five days, but may range from two to fourteen days.
Fever is the most common symptom of COVID-19, but is highly variable in severity and
presentation, with some older, immunocompromised, or critically ill people not having fever at
all. In one study, only 44% of people had fever when they presented to the hospital, while 89%
went on to develop fever at some point during their hospitalization. A lack of fever does not
verify someone is disease free.
Other common symptoms include cough, loss of appetite, fatigue, shortness of breath, sputum
production, and muscle and joint pains. Symptoms such as nausea, vomiting, and diarrhoea have
been observed in varying percentages. Less common symptoms include sneezing, runny nose,
sore throat, and skin lesions. cases in China initially presented with only chest
tightness and palpitations. A decreased sense of smell or disturbances in taste may occur. Loss of
smell was a presenting symptom in 30% of confirmed cases in South Korea.
In addition, some patients progress to acute respiratory distress syndrome (ARDS) possibly
precipitated by cytokine storm, multi-organ failure, septic shock, and blood clots. The time from
exposure to onset of symptoms is typically around five days, but may range from two to fourteen
daysSome
The transmission of covid-19:
The virus is primarily spread between people during close contact, most often via small
droplets produced by coughing, sneezing, and talking. The droplets usually fall to the ground or
onto surfaces rather than travelling through air over long distances. Less commonly, people may
become infected by touching a contaminated surface and then touching their face.
Sputum and saliva carry large amounts of viruses. Although COVID-19 is not a sexually
transmitted infection, kissing, intimate contact, and faecal-oral routes are suspected to transmit
the virus. Some medical procedures are aerosol-generating, and result in the virus being
transmitted more easily than normal.

In addition, about coronavirus generally;

Infected carriers are able to shed viruses into the environment. The interaction of the coronavirus
spike protein with its complementary cell receptor is central in determining the tissue
tropism, infectivity, and species range of the released virus. Coronaviruses mainly
target epithelial cells. They are transmitted from one host to another host, depending on the
coronavirus species, by either an aerosol, fomite, or fecal-oral route.
Human coronaviruses infect the epithelial cells of the respiratory tract, while animal
coronaviruses generally infect the epithelial cells of the digestive tract.[5] SARS coronavirus, for
example, infects via an aerosol route,[59] the human epithelial cells of the lungs by binding to
the angiotensin-converting enzyme 2 (ACE2) receptor.[60] Transmissible gastroenteritis
coronavirus (TGEV) infects, via a fecal-oral route,[58] the pig epithelial cells of the digestive tract
by binding to the alanine aminopeptidase (APN) receptor.[43]

What is the incubation period of novel coronavirus?

The typical incubation period for COVID-19 is five or six days, but it can range from one to
fourteen days with approximately ten percent of cases taking longer.

What complications we may face during COVID-19 infection?

Complications may include pneumonia, acute respiratory distress syndrome (ARDS), multi-
organ failure, septic shock, and death. Cardiovascular complications may include heart
failure, arrhythmias, heart inflammation, and blood clots. Approximately 20-30% of people who
present with COVID-19 have elevated liver enzymes reflecting liver injury. Neurologic
manifestations include seizure, stroke, encephalitis, and Guillain–Barré syndrome (which
includes loss of motor functions). Following the infection, children may develop paediatric
multisystem inflammatory syndrome, which has symptoms similar to Kawasaki disease, which
can be fatal.
COVID-19 diagnosis:
The WHO has published several testing protocols for the disease. The standard method of testing
is real-time reverse transcription polymerase chain reaction (rRT-PCR). The test is typically
done on respiratory samples obtained by a nasopharyngeal swab; however, a nasal swab
or sputum sample may also be used. Results are generally available within a few hours to two
days. Blood tests can be used, but these require two blood samples taken two weeks apart, and
the results have little immediate value. Chinese scientists were able to isolate a strain of the
coronavirus and publish the genetic sequence so laboratories across the world could
independently develop polymerase chain reaction (PCR) tests to detect infection by the virus. As
of 4 April 2020, antibody tests (which may detect active infections and whether a person had
been infected in the past) were in development, but not yet widely used. The Chinese experience
with testing has shown the accuracy is only 60 to 70%. The FDA in the United States approved
the first point-of-care test on 21 March 2020 for use at the end of that month.
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 who had at least two of the following symptoms in addition to a history of
travel to Wuhan or contact with other infected people: fever, imaging features of pneumonia,
normal or reduced white blood cell count, or reduced lymphocyte count.
A study asked hospitalised COVID-19 patients to cough into a sterile container, thus producing a
saliva sample, and detected the virus in eleven of twelve patients using RT-PCR. This technique
has the potential of being quicker than a swab and involving less risk to health care workers
(collection at home or in the car).
Along with laboratory testing, chest CT scans may be helpful to diagnose COVID-19 in
individuals with a high clinical suspicion of infection but are not recommended for routine
screening. Bilateral multilobar ground-glass opacities with a peripheral, asymmetric, and
posterior distribution are common in early infection. Subpleural dominance, crazy
paving (lobular septal thickening with variable alveolar filling), and consolidation may appear as
the disease progresses.
In late 2019, the WHO assigned emergency ICD-10 disease codes U07.1 for deaths from lab-
confirmed SARS-CoV-2 infection and U07.2 for deaths from clinically or epidemiologically
diagnosed COVID-19 without lab-confirmed SARS-CoV-2 infection.

how to manage COVID-19:

People are managed with supportive care, which may include fluid therapy, oxygen support, and
supporting other affected vital organs. The CDC recommends those who suspect they carry the
virus wear a simple face mask. Extracorporeal membrane oxygenation (ECMO) has been used to
address the issue of respiratory failure, but its benefits are still under consideration. Personal
hygiene and a healthy lifestyle and diet have been recommended to improve immunity.
Supportive treatments may be useful in those with mild symptoms at the early stage of infection.
The WHO, the Chinese National Health Commission, and the United States' National Institutes
of Health have published recommendations for taking care of people who are hospitalised with
COVID-19. Intensivists and pulmonologists in the U.S. have compiled treatment
recommendations from various agencies into a free resource, the IBCC.
What are prevention measures against COVID-19?
Preventive measures to reduce the chances of infection include staying at home, avoiding
crowded places, keeping distance from others, washing hands with soap and water often and for
at least 20 seconds, practising good respiratory hygiene, and avoiding touching the eyes, nose, or
mouth with unwashed hands. The U.S. Centers for Disease Control and Prevention (CDC)
recommends covering the mouth and nose with a tissue when coughing or sneezing and
recommends using the inside of the elbow if no tissue is available. Proper hand hygiene after any
cough or sneeze is encouraged. The CDC has recommended cloth face coverings in public
settings where other social distancing measures are difficult to maintain, in part to limit
transmission by asymptomatic individuals. The U.S. National Institutes of Health guidelines do
not recommend any medication for prevention of COVID-19, before or after exposure to the
SARS-CoV-2 virus, outside the setting of a clinical trial.
Social distancing strategies aim to reduce contact of infected persons with large groups by
closing schools and workplaces, restricting travel, and cancelling large public gatherings.
Distancing guidelines also include that people stay at least 6 feet (1.8 m) apart. There is no
medication known to be effective at preventing COVID-19. After the implementation of social
distancing and stay-at-home orders, many regions have been able to sustain an effective
transmission rate ("Rt") of less than one, meaning the disease is in remission in those areas.
As a COVID-19 vaccine is not expected until 2021 at the earliest, a key part of managing
COVID-19 is trying to decrease and delay the epidemic peak, known as "flattening the curve".
This is done by slowing the infection rate to decrease the risk of health services being
overwhelmed, allowing for better treatment of current cases, and delaying additional cases until
effective treatments or a vaccine become available.
Several countries have recommended that healthy individuals wear face masks or cloth face
coverings (like scarves or bandanas) at least in certain public settings, including China, Hong
Kong, Spain, Italy, Russia, and the United States. This recommendation is meant to reduce the
spread of the disease by asymptomatic and pre-symtomatic individuals and is a complementary
measure to established preventive measures such as social distancing. Face coverings minimise
the excretion of respiratory droplets by infected individuals while breathing, talking and
coughing. Non-medical cloth face coverings such as a scarf or a bandana are recommended for
the general public in places where social distancing is difficult to maintain. Medical grade
facemasks such as N95 masks should be reserved and prioritised for healthcare workers and first
responders.
Those diagnosed with COVID-19 or who believe they may be infected are advised by the CDC
to stay home except to get medical care, call ahead before visiting a healthcare provider, wear a
face mask before entering the healthcare provider's office and when in any room or vehicle with
another person, cover coughs and sneezes with a tissue, regularly wash hands with soap and
water and avoid sharing personal household items. The CDC also recommends that individuals
wash hands often with soap and water for at least 20 seconds, especially after going to the toilet
or when hands are visibly dirty, before eating and after blowing one's nose, coughing or
sneezing. It further recommends using an alcohol-based hand sanitiser with at least 60% alcohol,
but only when soap and water are not readily available.
The recommended sanitizers?

For areas where commercial hand sanitisers are not readily available, the WHO provides two
formulations for local production. In these formulations, the antimicrobial activity arises
from ethanol or isopropanol. Hydrogen peroxide is used to help eliminate bacterial spores in the
alcohol; it is "not an active substance for hand antisepsis". Glycerol is added as a humectant.

Novel corona virus is totally a new kind of the already known corona virus, it should be taken
seriously by following the instrcutions of WHO and health care authorities of your areas to be
away from it.
scientists are working day and night for a cure & vaccine for COVID-19 but nothing certain till
now.

References:
*World health organization.
*American food and drug association.
*International Journal of Infectious Diseases.
*Tropical Medicine & International Health.
*European Centre for Disease Prevention and Control.
*New England Journal of Medicine.
*BC Centre for Disease Control.
*Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi.