COVID-19 Virus

"CORONA-VIRUS DISEASE"

BY:

DR.HUSSAM HUSSEIN OTHMAN ALI

DR.MOHAMED YASSIN ABD.ALGHANY
DR.HAMDY SHERIF ALLATHY

UNDER SUPERVISION
"DR.WAFAA KHAIRY MOHAMED"
-MINIA UNIVERSITY-
MASTER JAN 2020
Content Page
Abstract and Keywords 2
Introduction 3,4
Transmission and how to protect 5
yourself
Symptoms 6
Diagnosis 7,8
Complications 9,10
Management 11,12
Concolusion 12
References 13,14

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Abstract:
At the end of 2019, Wuhan city, the capital of Hubei province in China
became The focus of the world's attention because of an outbreak of
pneumonia with unknown cause.

With the Beginning of 2020 precisely Jan 7, 2020 Chinese scientists announced
the emergence of a new virus, new member of corona visuses family (SARS-
CoV-2; previ-ously known as 2019-nCoV) severe acute respiratory syndrome
coronavirus 2 later known as COVID-19 according to WHO.3.
Transmission started from animals then they Noticed its transmission from to
person to person, another problem SARS-CoV-2 is a wide- spread. In a few
months COVID-19 has spread greatly, 4.16 million cases have been reported
across 187 countries and 285,000 deaths.
In this atricle we aim to talk about 2019-nCoV acute respiratory disease, how
can we protect ourselves, causes, diagnosis, symptoms, risk factors,
complications, and current and expected treatment.

Keywords: COVID-19, Corona, Respiratory,

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Introduction
COVID 19 is one of 11 different types forming Coronaviridae monogeneric
family, they are considered respiratory and gastrointestinal
disorders.Coronaviridae are spherical, bear, widely spaced, 60-220 in length,
club-shaped surface projections about 20 nm in length. [1]

Coronavirus, COVID 2019-nCoV, acute respiratory disease, Novel

coronavirus pneumonia[1][2], and Severe pneumonia with novel pathogens. All
these previous names are given to this virus.

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 People With Mild to moderate respiratory illness have high recovery rate
and often recover without treatment.but older people with some chronic
diseases as chronic respiratory disease, diabetes, cardiovascula, and cancer…
etc are more likely to have complications. [1,2]
All information about this atricle and all articles that talk about this topic are
gathered from WHO. All data about covid-19 is collected daily and updated to
represent a renewed and comperhansive sources of this topic.
Up to this point there is no serum and all treatments are only available for
symptoms.
Unfortunately, the number of people infected with the virus increases every
day, but in this research we will try to clarify all available information, to be
fully aware of COVID 19 and protect ourselves from this wicked virus. [1]

How to protect yourself ?

In order to protect yourself, you must first know how the virus is
transmitted. The virus spreads between people through close contact (6 feet or

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less), droplets when the virus carrier talks, coughs, or sneezes. these droplets
may fall and settle to surfaces. When someone else touches these surfaces then
touches his face, the virus can enter his body via mouth or nose and reach the
lung.
Untill now There is no evidence thar its traveling through the air without
close contact and droplets. [3]
Now you can know how to protect yourself from the virus: [3,4]
1. Wash your hands with soap and water regulary and after coughing
blowing your nose,or sneezing at least 20 sec.
2. Use an antiseptic that contains at least 60% alcohol.
3. Never touching your face without washing or disinfecting your hands.
4. Avoid any close contact less thqt 6 feets with other people because you
can't distinguish a person who is COVID-19 positive and has not yet had
symptoms.
5. Avoid crowds and if it necessary avoid close contact.
6. Disinfect surfaces.
7. To help protect others use a cloth face, cloth face is not indicated for any
person who can't remove masks without help.

Symptoms

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 They range from mild to severe according to the patients health and immune
status, and the age of the patient.young patients with Mild to moderate
respiratory illness have a mild symptoms. but, old patients with bad General
health condition generally have severe symptoms. [5]
What are these symptoms? [6]
Fever (85-90%)
Cough (65-70%)
Fatigue (35-40%)
Sutum production (30-35%)
Shortness of breath (15-20%)
difficulty breathing (15-20%)
Chills (10-12%)
Muscle pain (10-15%)
Sore throat (10-15%)
New loss of taste or smell
These symptoms don't include everything, other symptoms may appear and it
has already been reported as nusea (10%), vomiting (10%), and diarrhea (5%).
After exposure the mentioned symptoms may appear after 2-14 days,
children have the same for symptoms but generally are mild.

Diagnosis

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 If you suspect that you have a virus contact the relevant health centers of the
ministry of health, then if you appeare at least two of the symptoms mentioned
previously and history of contact with carrier people doctors will make plain x-
ray, CT scan on the chest and CBC. [7]

1.Radiograph
The most characteristic features of COVID-19 are 1. GGO which refere to
ground glass opacities (80% bilateral),2. crazy paving appearance which mean
ground glass opacities and intra-lobular septal thickening, 3.consolidation and
4.traction bronchiectasis. [8]
CT on the chest Shows 4 stages [8]

Stage From-to Ct scan features

Initial 0-4 days A. Normal
B. May be GGO
appearance only
Progressive 5-8 days A. ⬆️GGO
B. paving appearance
Peak 9-13 days Consolidation
Absorption More than 14 days Fibrous strips

2.CBC (complete blood count) [8]

To indicate the immune status of the body. The reported results of COVID-
19 patients are ⬇️lymphocytes and normal or ⬇️wbcs
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 3.tests: two types of tests [9]

Viral test A. Showing current infection

Antibody test A. Showing previous infection
B. Not recommended for current
infection because, you need 1.3
weeks to make antibodies

4. (PCR-rRT) real-time reverse transcription polymerase chain reaction.

Take more than 24 hours, So its the last test performed and the most acuurate
one.
Patients are asked to cough in a sterile container, in another way nasal,
nasopharyngeal and sputum sample but it's more dangerous and slower than the
first method. [9]

Complications:
1-Pneumonia:

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 The first symptom announced, it was arrangeddevided into four types
according to severity. [10]

Type Symptoms
Minor A. Minor serous exudation
B. Little fibrin exudation
Mild A. Pulmonary oedema
B. Atypical pneumocytes
C. Interstitial inflammation
Severe A. Diffuse alveolar damage
B. Diffuse alveolar exudates
C. ARDS
Healing A. Pulmonary interstitial fibrosis
B. Alv cavities exudates are
organized

2.acute respiratory distress syndrome [11]

early compication associated with inflammation of the lung,and rapid and
short breathing.
3.septic shock [11[ Due to infection (sepsis), this infection leads to organ
failure, it Causes low blood pressure. [11]
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4.heart failure
5.arrhythmias
6.liver injury
7.encephalitis
8.stroke or seizure
9.paediatric multisystem inflammatory syndrome.

Causes of mortality:
● 53% respiratory failure
● 33% respiratory failure with heart failure
● 7% heart failure
● Unknown

Management :
To this point, no vaccine has yet been discovered, scientists and
researchers still working to find effective treatments and vaccine.
All available treatments just works to treat the symptoms, e.g
1.paracetamol and NSAIDS. [ 12]

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2.ACE inhibitors and angiotensin receptor blockers, less mortality rate
with patients of hypertension.
3.steroids only with ARDS.
4.heparin gives better results in cases of COVID-19 companion with
coagulopathy.
Warning, tocilizumab is contraindicated because it may lead to mortality in
severe conditions. [12]

Equipments:
1.PEE
personal protective equipment is used to reduce virus transmission, you must
Follow some guidelines to protect yourself as wearing PEE gown, eye
protection, medical gloves, and N95 respirators or facemasks or face shields.
[13]
2.Mechanical ventilation
For Severe cases, only 2.3% of all cases. [14]

Severity Plan
Mild A. Quarantine
B. Supporative care
C. Asses the clinical condition of
the patient.
Moderate(dyspnoea, hypoeximia, A. Hospital isolation
and consolidation) B. Follow local community
acquired pneumonia ttt
guidelines(empirical A. B)
C. oseltamivir 75/150mg BD
D. If a progression is expected

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 hydroxychloroquine or
lopinavir are used.

Concolusion:
COVID-19 or Corona virus is one of the most dangerous, Until this moment
that I write, it has no effective treatment. Therefore, we must implement all
WHO recommendations , Wash your hands with soap and water, use antiseptic,
and stay home to avoid any crowds. We mentioned above most of important
points and informations about this virus to know your enemy well and beat him.
At last we hope That this cloud disappear and scientists can find an effective
vaccine.

References
1.Hui DS, I Azhar E, Madani TA, Ntoumi F, Kock R, Dar O, et al. (February
2020)"The continuing 2019-nCoV epidemic threat of novel coronaviruses to
global health - The latest 2019 novel coronavirus outbreak in Wuhan, China".
International Journal of Infectious .[3]

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2.Fisher D, Heymann D.(February 2020)"Q&A: The novel coronavirus
outbreak causing COVID-19". BMC Medicine. [4]
3.Velavan TP, Meyer CG. "The COVID-19 epidemic". Tropical Medicine &
International Health (March 2020). [5]
4.Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. (March 2020). "Severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-
2019 (COVID-19): The epidemic and the challenges". International Journal of
Antimicrobial Agents. [5]
5. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al.(February 2020)"Clinical
features of patients infected with 2019 novel coronavirus in Wuhan, China".
Lancet. .[6]
6.Hessen MT(27 January 2020). "Novel Coronavirus Information Center:
Expert guidance and commentary". Elsevier Connect. [6]
7.Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al.(February 2020).
"A rapid advice guideline for the diagnosis and treatment of 2019 novel
coronavirus (2019-nCoV) infected pneumonia (standard version)". Military
Medical Research [7]
8.Salehi S, Abedi A, Balakrishnan S, Gholamrezanezhad A.(March
2020)."Coronavirus Disease 2019 (COVID-19): A Systematic Review of
Imaging Findings in 919 Patients". AJR. American Journal of Roentgenology
[ 7,8]
9..Petherick A.(April 2020)."Developing antibody tests for SARS-CoV-2".
Lancet [9]
10.Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al.(May 2020)"Clinical course
and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan,
China: a single-centered, retrospective, observational study". The Lancet.
Respiratory Medicine.[10]

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11.Lillicrap D (April 2020).
"Disseminated intravascular coagulation in patients with 2019-nCoV
pneumonia". Journal of Thrombosis and Haemostasis [10]
12.Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin E, et al.
(April 2020)."COVID-19 and Thrombotic or Thromboembolic Disease:
Implications for Prevention, Antithrombotic Therapy, and Follow-up". Journal
of the American College of Cardiology. [12]
13..Cheung JC, Ho LT, Cheng JV, Cham EY, Lam KN.(April 2020)."Staff
safety during emergency airway management for COVID-19 in Hong Kong".
The Lancet. Respiratory Medicine. [12]
14. Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB..(April
2020)"Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19):
A Review". JAMA. [13]

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