Corona Virus

Corona Virus

Corona Virus ( COVID-19) is a infectious disease contain large family of viruses. 

Zoonatic Disease : It is zoonatic disease transmitted from animal to animal and people. Especially from civet cats, camels, bats.

Incubation Period : 2-12 Days.

Family : Corona Viridae, ssRNA Genome.

It is first finding in 31-DEC-2019 at Wuhan City of China. Later it spread through Worldwide.

Symptoms  :

• Fever 100.4 F
• Dry Cough
• Pneumonia
• Shortness of Breath
• Kidney failure
• Body ache and Muscle pain
• Death
• Fatigue
• Sore throat
• Headache
• Chills
• Nausea and vomiting
• Nasal congestion
• Diarrhoea
• Hemoptysis
• Conjunctival congestion.

Pathogenesis :

Unique feature it causes both Upper Respiratory Tract infection and Lower Respiratory Tract Infection

1.Virus attaches to specific cellular receptors via the spike protein

2.Transformational change, leading to fusion between the viral and cell membrane

3.Release of nucleocapsid into the cell

4.Alteration of cell function and production

5.Release of excess cytokines and chemokines ( IL-1, IL-6,IL7, IL-8,IL-9, IL-10,TNF and Increased ESR, Increased CRP, Procalcitonin).

6.Cause of Death Due to complication effects caused by Cytokine storm syndrome.

7.Severe Acute Respiratory Distress Syndrome (SARS)
Fulminant Myocarditis ( Cardiac affinity )

Spread :

1. Droplet infection ( cough,sneeze )
2. Surface ( Table, Desks, etc )

Screening / Laboratory Analysis :

• WBC count may vary Leukopenia/ Leukocytosis
• Decreased Lymphocyte count Lymphopenia ( Most common findings )
• Increased LDH levels ( Due to affinity of cytokines for cardiac tissue hepatic tissue )
• Increased Ferrin Level ( Early finding )
• Increased AST ALT ( Aminotransferases )
• Increased ESR, Increased D-Dimer,Increased Procolcitonin.
• Virus confirmed by rtPCR Technique.
• Culture : Not done for preacacution purposes
• Imaging : 

       - CT-Chest
       - Ground glass opacification w/wo consolidation
       - B/L peripheral involvement esp lower lobe.- 

       - Can be found even before onset of symptoms but no specific           for COVID.

Prevention Methods : 

• Hand Washing
• Wearing Mask and goggles to prevent the entry of virus through Mouth, Nose, and Eyes.

Risk Factors

Infant, Children, Old age group people, History of Respiratory issues like Asthma, Diabetes, Heart problem are more pron to get affect severe complication from Corona Virus.

Treatment :

• There is presently no treatment for Corona Virus. Symptomatic treatment for illness and Isolation measures.
• Nothing has been postulated officially.
• Hospitalisation only for severe cases

Supportive Treatment

• Maintain Airway, Breathing, Circulation.
• Ventilation if required (if Po2<55%)
• Isolation ( To prevent spread )
• Correction of electrolytic imbalance
• Correct temperature.

Corticosteroids Avoided : Due to potential for prolonging viral replication.

Drugs :

• TOCLIZUMAB ( IL-6 BLOCKADE )
• ANAKINRA ( IL BLOCKADE ) : Against effects of cytokinesorm.
• Remdesivir ( in spotlight these days for its effect shown 
• Lopinavir  / Ritonavir ( HIV Tt )
• Favilavir 

Note : Anitviral, Anti Hiv drugs also can be used.

• Omer AntiMalarials also showed results ( Hydrochloroquine derivative of chloroquine phosphate.

There is no certain specific treatment protocol published by WHO.