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WELLNESS AND HEALTHY

Volume 2, Number 1, February 2020, p. 187
ISSN 2655-9951 (print), ISSN 2656-0062
Corona virus diseases (Covid
Yuliana
*)
Faculty of Medicine, University of Lampung
Email: y​ lianaa98@gmail.com
ARTICLE INFO
Keyword:
Coronavirus
Covid-19
Pneumonia
Wuhan
*) corresponding author
Students, Faculty of Medicine,
University of Lampung
Jl.Prof. Dr. Ir. Sumantri Brojonegoro No. 1,
Gedong Meneng, Kec. Rajabasa, City
Bandarlampung, 35145 Indonesia
first time an
PRELIMINARY
Beginning in 2020, the world was shocked with mer
(SARS-CoV-2) and the disease is called Coronavi
this virus originated from Wuhan, China. Ditem
there are currently 65 countries that have been confirmed
March 2020) (PDPI, 2020).
Initially epidemiological data
showed 66% of patients were related or exposed
Wuhan, Hubei Province of China (Huang, et.al., 2

NESS AND HEALTHY MAGAZINE

87 - 192
0062 (online)
https://wellness.journalpress.id/we
Email: wellness.buletin@gma

Covid-19); A literature review

ABSTRACT
Coronavirus Disease (Covid-19). In 2020, a new type of coronavi
(SARS-CoV-2) was spread, called a disease called Coronavirus dise
2019 (COVID-19). This virus was discovered in Wuhan, China for
first time and has infected 90,308 people as of March 2, 2020.
number of deaths reached 3,087 people or 6%, the number of patie
recovering 45,726 people. This type of single positive RNA str
infects the human respiratory tract and is sensitive to heat and
effectively be activated by chlorine-containing disinfectants. The sou
of the host is thought to come from animals, especially bats, and ot
vectors such as bamboo rats, camels and ferrets. Common Sympto
include fever, cough and difficulty breathing. Clinical syndrome
divided into uncomplicated, mild pneumonia and severe pneumon
Specimen examination is taken from the throat swab (nasopharynx a
oropharynx) and lower airway (sputum, bronchial rinse, endotrach
aspirate). Isolation was carried out on patients prove
with Covid-19 to prevent wider spread.
This is an open access article under the ​CC -
stirred by the spread of a new virus, the bar type coronavirus
the activity is called Coronavirus disease 2019 (COVID-19). Unknown, as
Wuhan, China. Discovered in late December 2019. Samp
there are 65 countries that have contracted this one virus. (WHO data,
related to or exposed to a seafood market or live market
ion China (Huang, et.al., 2020). Samples of isolates from patients were examined
premises

Y MAGAZINE
ess.journalpress.id/wellness
wellness.buletin@gmail.com
, a new type of coronavirus
called Coronavirus disease
red in Wuhan, China for the
as of March 2, 2020. The
6%, the number of patients
single positive RNA strain
It's sensitive to heat and can
ing disinfectants. The source
ls, especially bats, and other
ferrets. Common symptoms
hing Clinical syndrome is
nia and severe pneumonia.
roat swab (nasopharynx and
ronchial rinse, endotracheal
tients proven to be infected
–BY-SA ​license.
a new type of coronavirus
19). Unknown, origin
bucket of 2019. Until
s this one. (WHO data, 1
afood or live market at
of the patients studied with

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Wellness and Healthy Magazine, 2 (1), February 2020, - 188
Yuliana
Copyright © 2020, Wellness and Healthy Magazine
ISSN 2655-9951 (print), ISSN 2656-0062 (online)
the results showed a coronavirus infection, a new type of betacoronavirus, named
2019
Coronavirus novel (2019-nCoV). On February 11, 2020,
The World Health Organization​ named the new virus ​Severe acute respiratory
syndrome
coronavirus-2​ (SARS-CoV-2) and the name of the disease as Coronavirus disease
2019 (COVID-
19) (WHO, 2020). At first the transmission of this virus could not be determined
whether it could be through
between humans. The number of cases continues to increase over time. In addition,
there are
the case of 15 medics was infected by one patient. One of these patients was
suspected of a case
"Super spreader". (Channel News Asia, 2020). Finally confirmed that the
transmission of pneumonia
it can spread from human to human (Relman, 2020). Until now this virus quickly
spread is still mysterious and research is still continuing.
At present there are as many as 65 countries infected with the corona virus.
According to WHO data as of March 2
2020 the number of sufferers 90,308 infected with Covid-19. In Indonesia, until now
infected with 2
person. The death rate reached 3,087 or 2.3% with a cure rate of 45,726 people.
It is proven that Covid-19 Confirmation patients in Indonesia started from an event in
Jakarta where
sufferers in contact with a foreign national (foreigner) from Japan who lives in
Malaysia.
After the meeting patients complained of fever, coughing and shortness of breath
(WHO, 2020).
Based on data up to March 2, 2020, the mortality rate worldwide is 2.3%
specifically in Wuhan city it was 4.9%, and in Hubei province 3.1%. This figure is in
another province in
China is 0.16% .8.9 Based on the study of the first 41 patients in Wuhan there were
6
people died (5 patients in ICU and 1 patient in non-ICU) (Huang, et.al., 2020). Case
many deaths in the elderly and with concomitant diseases. The first case of death of
a patient
61-year-old man with concomitant intraabdominal tumor disease and abnormalities
in the liver (The Straits
Time, 2020).
Extraordinary events by Coronavirus is not the first time. 2002
severe acute respiratory syndrome​ (SARS) caused by SARS-coronavirus
(SARS-CoV) and
Middle East respiratory syndrome​ (MERS) disease in 2012
caused by MERS-Coronavirus (MERS-CoV) with a total accumulative case of
around 10,000
(1,000 cases of MERS and 8000 cases of SARS). Mortality due to SARS is around
10% whereas
MERS is higher at around 40%. (PDPI, 2020).
METHOD
Case report journals are taken from cases in puskesmas and references from
various sources
from (Medscape, emedicine, WHO data and others) then a summary is taken from
the source
that is made into reading material.
RESULTS AND DISCUSSION
Coronavirus is a single positive, encapsulated, non-segmented RNA virus.
Coronavirus belongs to the order Nidovirales, Coronaviridae family. Coronavirus
structure forms
cube-like structure with protein S located at
the surface of the virus. S protein or spike protein is one of the main antigen proteins
of the virus and
is the main structure for writing genes. This S protein plays a role in attachment and
entry of the virus into host cells (interaction of protein S with its receptors in host
cells) (Wang,
2020). Coronavirus is heat sensitive and can effectively be activated by
disinfectants containing chlorine, lipid solvents at a temperature of 56 ℃ for 30
minutes, ether, alcohol,

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Corona virus diseases (COVID-19); A literature review
Perioxysietic acid, non-ionic detergent, formalin, oxidizing agent and chloroform.
Chlorhexidine
ineffective in deactivating viruses (Wang, 2020; Korsman, 2012).
Pathogenesis and Pathophysiology
Most Coronaviruses infect animals and circulate in animals. Coronavirus causes
a large number of diseases in animals and their ability to cause severe disease in
animals
like pigs, cows, horses, cats and chickens. Coronavirus is called a zoonotic virus, a
virus
which is transmitted from animals to humans. Many wild animals can carry
pathogens and
acts as a vector for certain infectious diseases. Bats, bamboo mice, and camels
Weasel is a host commonly found for Coronavirus. Coronavirus in bats
is the main source for the occurrence of ​severe acute respiratory syndrome​ (SARS)
and ​Middle
East respiratory syndrome​ (MERS) (PDPI, 2020).
Coronavirus can only reproduce itself through its ​host​ cell . Viruses cannot live
without cells
the host​ . Following the cycle of Coronavirus after finding ​host​ cells according to its
tropism. First,
attachment and entry of the virus to the host cell is mediated by Protein S which is
on the surface of the virus
S protein is the main determinant in infecting its host species and its tropical
determinants (Wang, 2020).
In the study of SARS-CoV protein S binds to the receptor in the host cell, the
enzyme ACE-2
(angiotensin-converting enzyme 2). ACE-2 can be found on oral and nasal mucosa,
nasopharynx, lung, stomach, small intestine, large intestine, skin, thymus, bone
marrow, spleen, liver, kidney,
brain, pulmonary alveolar epithelial cells, small intestinal enterocyte cells, venous
arterial endothelial cells, and smooth muscle cells.20
After successfully entering the next translation of gene replication of the RNA viral
genome. Next
replication and transcription wherein the synthesis of RNA viruses through
translation and assembly of complexes
virus replication. The next stage is the assembly and release of the virus (Fehr,
2015). Following the picture
virus life cycle (figure 1).
After transmission, the virus enters the upper airway and then replicates in epithelial
cells
upper airway (carrying out its life cycle). After that spread to the lower airway.
In acute infections the virus decays from the airways and the virus can continue to
decay
some time in the gastrointestinal cells after healing. The incubation period for the
virus to appear
disease around 3-7 days (PDPI, 2020).
Clinical Manifestations
COVID-19 infection can cause mild, moderate or severe symptoms. The main
clinical symptoms are
appear namely fever (temperature> 380C), cough and difficulty breathing. Moreover,
it can be accompanied by
weight tightness, fatigue, myalgia, gastrointestinal symptoms such as diarrhea and
other respiratory symptoms.
Half of patients develop shortness in one week. In severe cases worsening rapidly
and progressive, such as ARDS, septic shock, metabolic acidosis that is difficult to
correct and
coagulation system bleeding or dysfunction within a few days. In some patients,
symptoms are
appear mild, not even accompanied by fever. Most patients have a good prognosis,
with a small percentage in critical condition even dying. The following clinical
syndromes that can
appears if infected. (PDPI, 2020). The following clinical syndromes that can arise if
infected.
(PDPI, 2020)
a. Not complicated
This condition is the lightest condition. Symptoms that appear in the form of
symptoms that are not specific.
The main symptoms still appear such as fever, cough, can be accompanied by sore
throat,
nasal congestion, malaise, headaches, and muscle aches. It should be noted that in
patients
with elderly and immunocompromised patients the presentation of symptoms
becomes distinctive or
atypical. In addition, in some cases were found not accompanied by fever and
relative symptoms

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Yuliana
Copyright © 2020, Wellness and Healthy Magazine
ISSN 2655-9951 (print), ISSN 2656-0062 (online)
light. In this condition the patient has no symptoms of complications including
dehydration, sepsis
or shortness of breath.
b. Mild pneumonia
The main symptoms can appear such as fever, cough, and tightness. But there is no
sign
severe pneumonia. In children with not severe pneumonia characterized by coughing
or
difficulty breathing
c. Severe pneumonia. In adult patients:
Symptoms that appear include fever or suspicion of an airway infection
Signs that appear are tachypnea (breath frequency:> 30x / minute), severe
respiratory distress
or the patient's oxygen saturation <90% outside air. 26
Enforcement of the Diagnosis
In the history of the symptoms that can be found that is, three main symptoms: fever,
dry cough
(a small portion of phlegm) and difficulty breathing or tightness.
a. Patients under surveillance or suspected / possible cases
1. Someone who experiences:
a. Fever (≥380C) or history of fever
b. Cough or runny nose or sore throat
c. Mild to severe pneumonia based on clinical and / or radiological features. (on
the patient is presumably atypical immunocompromised presentation) AND is
accompanied by at least one
conditions as follows:
· Have a history of travel to China or the affected region / country *
in 14 days before symptoms appear
· Health workers who are sick with the same symptoms after treating an infected
patient
severe acute respiratory tract (ARI) of unknown cause / etiology
his illness, regardless of travel history or residence.29
2. Patients with acute respiratory infections with mild to severe severity and one
the following in the 14 days before the onset of symptoms:
a. Close contact with patients with confirmed or probable COVID-19 cases, OR
b. History of contact with infectious animals (if animals have been identified), OR
c. work or visit health care facilities with confirmed cases or
probable COVID-19 infection in infected China or region / country. *
d. Have a history of travel to Wuhan and have a fever (temperature ≥380C) or history
fever.29
b. Insider Monitoring
Someone who has symptoms of fever or a history of fever without having pneumonia
travel history to China or the affected region / country, and do not have one
or more exposure history including:
· History of close contact with COVID-19 confirmation cases
· Work or visit health facilities related to patient confirmation
COVID-19 in China or affected regions / countries (according to developments
disease),
· Has a history of contact with infectious animals (if infectious animals have been
identified) at
China or the affected region / country (according to disease progression

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Corona virus diseases (COVID-19); A literature review
c. Probable Case
Patients under surveillance were examined for COVID-19 but were inconclusive or
not
can be concluded or someone with a positive result of pan-coronavirus or beta
coronavirus.29,30
d. Case confirmed
Someone who is laboratory confirmed COVID-19.
Supporting Examination​ (PDPI, 2020)
1. Radiological examination: chest X-ray, chest CT scan, chest ultrasound. On
imaging can be
shows: bilateral opacity, subsegmental consolidation, lobar or pulmonary collapse or
nodules,
groundglass​ display .
2. Examination of upper and lower airway specimens
Upper respiratory tract with throat swabs (nasopharynx and oropharynx)
Lower respiratory tract (sputum, bronchial rinse, LAB, when using the endotracheal
tube
can be endotracheal aspirates
3. Bronchoscopy
4. Pleural puncture according to conditions
5. Examination of blood chemistry
6. Microorganism culture and sensitivity test of airway material (sputum, bronchial
rinse,
pleural fluid) and blood26,27 Blood culture for bacteria is carried out, ideally before
therapy
antibiotics. However, don't delay antibiotic therapy by waiting for the results of blood
culture) 26
7. Stool and urine examination (to investigate possible transmission).
General Management
1. Isolation in all cases
In accordance with clinical symptoms that appear, both mild and moderate.
2. Implementation of infection prevention and control (PPI) 26
3. Chest X-ray series to assess disease progression27
4. Oxygen supplementation
Providing immediate oxygen therapy to patients with respiratory distress, hypoxemia
or shock.
The first oxygen therapy is around 5L / min with a SpO2 target of ≥90% in
nonpregnant patients
and ≥ 92-95% in pregnant patients
5. Recognize severe hypoxemic respiratory failure
6. Fluid therapy
Conservative fluid therapy is given if there is no evidence of shock Patients with
SARI should
pay attention to in fluid therapy, because if the administration of fluid is too
aggressive it can be
aggravate the condition of breath distress or oxygenation. Monitoring fluid balance
and
electrolyte
7. Provision of empirical antibiotics
8. Symptomatic therapy
Symptomatic therapy is given such as antipyretics, cough medicines and others if
indeed
is required.
9. Provision of systemic corticosteroids is not routinely given in the treatment of viral
pneumonia or
ARDS besides other indications.
10. Close observation
11. Understand the patient's comorbid
At present there is no specific research or evidence of work on COVID-19. There is
no management yet
antivirals for Coronavirus infections that have proven to be effective. In the study of
SARSCoV, combination

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Yuliana
Copyright © 2020, Wellness and Healthy Magazine
ISSN 2655-9951 (print), ISSN 2656-0062 (online)
lopinavir and ritonavir are associated with clinical benefits. At present the use of
lopinavir and
ritonavir is still being studied in terms of effectiveness and safety in COVID-19
infection. The management
untested / licensed may only be given in clinical trial situations approved by the
committee
ethics or through the ​Monitored Emergency Use of Unregistered Interventions
Framework​ (MEURI),
with strict monitoring. In addition, there is currently no vaccine to prevent pneumonia
This COVID-19 (PDPI, 2020).
CONCLUSIONS AND SUGGESTIONS
Covid-19 is a new viral infection that causes infection of 90,308 people per date
March 2, 2020. This virus began in Wuhan, China on December 31, 2019. The virus
is
This single positive RNA virus infects the respiratory tract. The diagnosis is started
from common symptoms such as fever, cough and difficulty breathing to close
contact with
countries that have been infected. Intake of throat and airway swabs become
 ​ anagement in the
the basis for establishing a diagnosis of ​coronavirus disease. M
form of isolation must be done
to prevent further spread.
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critical
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Fehr, AR, Perlman, S. (2015). Coronavirus: An Overview of Their Replication and
Pathogenesis.
Mol Molol Methods. 2015; 1282: 1–5
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Zan, G. Li., Fan, G., etc. (2020).
Clinical features of
patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. January
24, 2020.
Korsman, SNJ, van Zyl, GU, Nutt, L., Andersson, MI, Presier, W. (2012). Viroloy.
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Churchill Livingston Elsevier
Indonesian Lung Doctors Association. (2020). Clinical Practice Guide: Pneumonia
2019-nCoV.
PDPI: Jakarta
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officials-confirm-2020- 1 /? r = US & IR = T.
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briefing-on-2019-ncov-on-11-february- 2020. (Feb 12th 2020)
Wang, Z., Qiang, W., Ke, H. (2020). A Handbook of 2019-nCoV Pneumonia Control
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Teks asli
(SARS-CoV-2) was spread, called a disease called Coronavirus dise
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