Respiratory System >
“COVID-19 is a new betacoronavirus. It is a variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)“
- Older age
- Some medical conditions
- Immunocompromised patients
- Serious heart conditions like heart failure or coronary artery disease
- Use of certain medications
- Poverty and crowding
- Certain occupations
- SARS-CoV-2 belongs to the Sarbecovirus subgenus of the Coronaviridae family and is the seventh coronavirus known to infect humans. The virus has been found to be similar to SARS-like coronaviruses from bats, but it is distinct from SARS-CoV and MERS-CoV.
- COVID-19 has a predilection for the upper and lower respiratory tract alveolar cells and is spread human-human by droplets from sneezing and coughing.
- Not fully understood.
- SARS-CoV-2 binds to the angiotensin-converting enzyme-2 (ACE2) receptor in humans > downregulation of ACE2 > toxic overaccumulation of plasma angiotensin-II > may induce acute respiratory distress syndrome and fulminant myocarditis
- ACE2 is expressed in the lungs, heart, oesophagus, kidneys, bladder and ileum, which may explain the extrapulmonary manifestations associated with infection.
- The illness is variable in severity from asymptomatic, to mild upper respiratory tract infection in some people to severe pneumonia in others.
- Commonest symptoms:
- Shortness of breath.
- Other symptoms:
- Headache, muscle pain, confusion, chest pain, vomiting and diarrhoea, loss of sense of smell, skin rashes (especially in younger people).
- Rapid serological testing for antibodies
- Respiratory viral panel to look for other causes
- Chest X-Ray
- Chest CT
- RT-PCR Test
- Mild or asymptomatic:
- 7 day isolation at home, rest and fluids, and hygiene advice (wear face masks, wash hands regularly, catch sneezes in tissues etc.)
- Severe symptoms:
- Supportive care via fluids, oxygen, ventilatory support in the prone position; dexamethasone; convalescent plasma therapy, medications are in clinical trials, 7-day isolation
- There is no clinical benefit with Remdesivir, Lopinavir, Ritonavir, Chloroquine and Hydroxychloroquine
- No specific curative treatment for coronavirus infection at present. Treat patients according to their individual pathophysiology.
- Acute Respiratory Distress Syndrome
- Septic shock
- Pulmonary fibrosis
- Acute kidney/ liver/ cardiac injury
- Disseminated intravascular coagulation
- Blood clots