https://www.ncbi.nlm.nih.

gov/pmc/articles/PMC7090728/

Coronavirus, Origin and Transmission

◾ Positive sense RNA virus, size ranging fr 60-140 nm in diameter
◾ Has spike-like projection in its surface -> corona/crown-like structure ->
coronavirus
◾ Four coronaviruses have been circulation in human and generally causes
mild respiratory disease
◾ In past two decades, there have been two events where crossover
transmission of coronavirus from animal to human resulted in severe
disease
- SARS by SARS-CoV (2002-2003): Bats origin, with cat as intermediary host,
first occurence at China and Hong Kong
- MERS by MERS-CoV (2012): Bat origin, camel as intermediary host,
emerged in Saudi Arabia (FR 34%)
◾ On 7th January the virus was identified as a coronavirus that had >95%
homology with the bat coronavirus and > 70% similarity with the SARS-
CoV.
*homologi: kemiripan struktur berdasarkan kesamaan origin/moyang
*similarity: kesamaan (persis)
◾ Environmental samples from the Huanan sea food market also tested
positive, signifying that the virus originated from there (Huanan Seafood
Market)
◾ Bukti transmisi human-to-human: peningkatan kasus secara signifikan,
sebagian pasien tidak punya riwayat ke pasar seafood Huanan
- Local transmission: penularan pada pasien outside China (Jepang, Thailand)
yang tidak punya riwayat travel dari China
- Transmisi virus dapat terjadi dari pasien simtomatik, asimtomatik dan
preclinical phase -> alasan diberlakukannya isolasi 14 hari
◾ Statistik infected and dead patients yang ada saat ini kemungkinan
underestimate karena limitasi surveillance and testing
Epidemiology and Pathogenesis
◾ All ages are susceptible
◾ Infection is transmitted through large droplets
- Generating during coughing, sneezing from positive patient
- Hasil riset: viral load pada nasal cavity > throat, tanpa ada perbedaan viral
load di antara pasien simtomatik dan asimtomatik
◾ Patients can be infectious for as long as the symptoms last and even on
clinical recovery
- Some people may act as super spreaders; a UK citizen who attended a
conference in Singapore infected 11 other people while staying in a resort in
the French Alps and upon return to the UK
- These infected droplets can spread 1–2 m and deposit on surfaces.
- The virus can remain viable on surfaces for days in favourable atmospheric
conditions but are destroyed in less than a minute by common disinfectants
like sodium hypochlorite, hydrogen peroxide etc.
◾ Infeksi didapat dengan menghirup infected droplets/menyentuh permukaan
yang telah terkontaminasi virus dan langsung menyentuh mata, hidung dan
mulut
◾ The virus also present in the stool and contamination of the water supply
and subsequent transmission via aerosolization/feco oral route is also
hypothesized
◾ The incubation period varies from 2 to 14 d [median 5 d]
◾ Studies have identified angiotensin receptor 2 (ACE2) as the receptor
through which the virus enters the respiratory mucosa
- ACE2 is a protein on the surface of many cell types (lungs, arteries, hearts,
kidneys and intestine). It is an enzyme that generates small proteins – by
cutting up the larger protein AT II – reducing the amount of angiotensin-II
and increasing Ang (1-7) thus lowers blood pressure
- Using the spike-like protein on its surface, the SARS-CoV-2 virus binds
to ACE2 – prior to entry and infection of cells. Hence, ACE2 acts as a
receptor for the virus that causes COVID-19