CORONAVIRUS

DISEASE (COVID-19)
The Pandemic Today
What is COVID-19
◦ Coronavirus disease (COVID-19) is an infectious disease caused
by a newly discovered coronavirus, SARS-CoV-2 virus.
◦ WHO first learned of this new virus from cases in Wuhan,
People’s Republic of China on 31 December 2019.
Mode of Transmission
◦ According to current evidence, COVID-19 virus is
primarily transmitted between people through
respiratory droplets and contact routes.
Mode of Transmission
◦ When the droplet particles are >5-10 μm in diameter they
are referred to as respiratory droplets, and when then are
<5μm in diameter, they are referred to as droplet nuclei
(airborne transmission).
◦ In an analysis of 75,465 COVID-19 cases in China,
airborne transmission was not reported. -Report of the WHO-
China Joint Mission on Coronavirus Disease 2019 (COVID-19)
Mode of Transmission
◦ Droplet transmission occurs when a person is in in close contact
(within 1 m) with someone who has respiratory symptoms.
◦ Transmission may also occur through fomites (indirect
contact) in the immediate environment around the infected
person.
Mode of Transmission
◦ In the context of COVID-19, airborne transmission may be
possible in specific circumstances and settings in which
procedures or support treatments that generate aerosols are
performed; i.e., endotracheal intubation, bronchoscopy,
nebulization.
 SIMPLIFIED
PATHOPHYSIOLOGY
Pathophysiology
◦ Once the virus has been transmitted and enters the respiratory
tract, it has an incubation period of 2-14 days.
◦ The virus goes deep into the alveoli and invades Type 2
alveolar epithelial cells.
Pathophysiology: Virus LIFE CYCLE
◦ The life cycle of the virus with the host consists of the following 5 steps:
attachment, penetration, biosynthesis, maturation and release.
◦ Once viruses bind to host receptors (attachment), ACE2 receptors
◦ They enter host cells through endocytosis or membrane fusion
(penetration). Once viral contents are released inside the host cells,
viral RNA enters the nucleus for replication(Biosynthesis).
◦ Then, new viral particles are made (maturation) and released.
Pathophysiology

◦ Alveolar epithelial cells release interferons and

cytokines.
◦ The release of these chemical mediators stimulates nerve
endings which causes coughing reflex.
Pathophysiology

◦ Cytokines are pro-inflammatory mediators which causes

increased vascular permeability within the alveoli.
◦ Fluids from blood vessels can shift into the alveoli
causing pulmonary edema resulting in dyspnea
and eventually hypoxemia.
Pathophysiology
◦ Increased vascular permeability also attracts
neutrophils which engulfs the virus but releases toxic
chemical by products that can damage the cells.
◦ Damaged alveolar cells would produce less surfactants and
release leukotrienes.
◦ Less surfactants increase the risk of alveolar collapse.
◦ Leukotrienes causes bronchoconstriction.
Pathophysiology: Signs and Symptoms
◦ Bronchoconstriction, pulmonary edema, hypoxemia, and
inflammatory response would cause symptoms of dry
cough, fever, and fatigue.
◦ OTHER UNCOMMON S/S:
◦ Loss of taste or smell
◦ Chills or dizziness
◦ Different types of skin rash
◦ Conjunctivitis
Pathophysiology

◦Continued inflammatory
response can lead to severe
lung damage.
 The major cause of death in
COVID-19 patients

BP drops, and the body is

starved of oxygen even
more and can cause organ
failure.
ARDS happens when so
much fluid has accumulated
within and around the lungs.
Some infected people can also be
asymptomatic.
 PATIENT
CLASSIFICATIO
N
• Asymptomatic or Presymptomatic Infection: Individuals who
test positive for SARS-CoV-2 using a virologic test (i.e., a nucleic
acid amplification test or an antigen test), but who have no symptoms
that are consistent with COVID-19.

• Mild Illness: Individuals who have any of the various signs and
symptoms of COVID-19 (e.g., fever, cough, sore throat, malaise,
headache, muscle pain, nausea, vomiting, diarrhea, loss of taste and
smell) but who do not have shortness of breath, dyspnea, or
abnormal chest imaging.
• Moderate Illness: Individuals who show evidence of
lower respiratory disease during clinical assessment or
imaging and who have saturation of oxygen (SpO2 ) ≥94%
on room air at sea level.
• Severe Illness: Individuals who have SpO2 <94%, RR:
30 breaths per minute, or lung infiltrates >50%.
• Critical Illness: Individuals who have respiratory
failure, septic shock, and/or multiple organ
dysfunction.
COVID-19
TESTING
 Two kinds of tests are available for
COVID-19: viral tests and antibody tests.

◦ A viral test tells you if you have a current

infection.
◦ An antibody test might tell you if you had a past
infection or encounter.
Viral Test – Also
called PCR
test
Antibody test –
Rapid Tests
Viral Test

◦ Virology test checks for antigens of Corona Virus within

nasal swabs.
◦ This is also called PCR tests or Polymerase Chain
Reaction Test