COVID-19
Coronaviruses are a group of viruses be appropriate to the family of Coronaviridae, which infect both animals and humans. Human coronaviruses can cause mild disease
similar to a common cold, while others cause more severe disease (such as MERS – Middle East Respiratory Syndrome and SARS – Severe Acute Respiratory Syndrome). A new coronavirus that previously has not been identified in humans emerged in Wuhan, China in December 2019. COVID-19 outbreak
The COVID-19 outbreak was treated as a case of pneumonia with unknown etiology
appeared in the Wuhan city of China, at the end of December 2019, which spread across
the country to worldwide with a high rate. The COVID-19 thought the third outbreak of the coronavirus which affected more than
209 countries including Pakistan. According to the World Health Organization (WHO), total of 1,093,349 confirmed cases with 58,620 mortalities. To date, the number of
highest positive cases encountered in USA followed by Italy and Spain. Strains of coronaviruses
There are six currently known strains of coronaviruses that infect humans. The most
common infection globally is from human coronaviruses 229E, NL63, OC43, and HKU1. The
much publicized human coronavirus, SARS-CoV, which causes severe acute respiratory
syndrome, or SARS, has a unique pathogenesis because it causes both upper and lower
respiratory tract infections and can also cause gastroenteritis. The six human coronaviruses are: alpha coronaviruses 229E and NL63, and beta
coronaviruses OC43, HKU1, SARS-CoV (SARS), and MERS-CoV (the coronavirus that
causes Middle East Respiratory Syndrome or MERS).
SARS-CoV, Signs and symptoms include
- Respiratory symptoms and include fever, cough and shortness of breath.
- In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome and sometimes death
Transmission of SARS-CoV-2 Infection
- Epidemiologic data suggest that droplets expelled during face-tofaceexposure during talking, coughing, or sneezing is the most commonmodeoftransmission.
- Prolonged exposure to an infected person (being within 6 feet for at least 15minutes) and briefer exposures to individuals who are symptomatic(eg, coughing) are associated with higher risk for transmission, whilebriefexposures to asymptomatic contacts are less likely to result in transmission.
- Contact surface spread (touching a surface with virus on it) is another oftransmission.
- Transmission may also occur via aerosols
- Standard recommendations to prevent the spread of COVID-19 include
- frequent cleaning of hands using alcohol-based hand rub or soap and water
- covering the nose and mouth with a flexed elbow or disposable tissuewhencoughing and sneezing;
- and avoiding close contact with anyone that has a fever and cough
Standard recommendations to prevent the spread of COVID-19 include
- frequent cleaning of hands using alcohol-based hand rub or soap and water;
- covering the nose and mouth with a flexed elbow or disposable tissuewhencoughing and sneezing;
- and avoiding close contact with anyone that has a fever and cough.
- Assessment and Diagnosis
- Diagnosis of COVID-19 is typically made using polymerase chainreactiontesting via nasal swab
- However, because of false negative test result rates of SARS-CoV-2PCRtesting of nasal swabs, clinical, laboratory, and imaging findings may alsobeused to make a presumptive diagnosis.
- Factors contributing to false-negative test results include the adequacyof thespecimen collection technique, time from exposure, and specimen source.
Treatment
Supportive Care and Respiratory Support Currently, best practices for supportivemanagement of acute hypoxic respiratory failure and ARDS should be followed. Targeting the Virus and the Host Response The following classes of drugsarebeing evaluated or developed for the management of COVID-19:
- Antivirals (eg, remdesivir, favipiravir),
- Antibodies (eg, convalescent plasma, hyperimmune immunoglobulins),
- Anti-inflammatory agents (dexamethasone, statins), targetedimmunomodulatory therapies (eg, tocilizumab, sarilumab, anakinra, ruxolitinib),
- Anticoagulants (eg, heparin), and antifibrotics (eg, tyrosinekinaseinhibitors).
It is probable that altered treatment modalities might have differentcompetences at diverse stages of illness and in different manifestationsofdisease.
Studies of corticosteroids for viral pneumonia and ARDS have producedmixedresults.However, the Randomized Assessment of COVID-19 Therapy (RECOVERY) trial, which randomized 2104 patients with COVID-19 to receive 6 mg dailyofdexamethasone for up to 10 days and 4321 to receive usual care, foundthatdexamethasone reduced 28-day all-cause mortality (21.6% vs 24.6%; age adjustedrateratio, 0.83 [95% CI, 0.74-0.92]; P < .001). The advantage was highest in patients with symptoms for more than 7 daysandpatients who required mechanical ventilation.
Vaccine for Covid 19
As of 12 January 2022, the following vaccines have obtained EUL:
- The Pfizer/BioNTech Comirnaty vaccine, 31 December 2020.
- The SII/COVISHIELD and AstraZeneca/AZD1222 vaccines, 16 February 2021.
- The Janssen/Ad26.COV 2.S vaccine developed by Johnson & Johnson, 12March2021.
- The Moderna COVID-19 vaccine (mRNA 1273), 30 April 2021.
- The Sinopharm COVID-19 vaccine, 7 May 2021.
- The Sinovac-CoronaVac vaccine, 1 June 2021.
- The Bharat Biotech BBV152 COVAXIN vaccine, 3 November 2021.
- The Covovax (NVX-CoV2373) vaccine, 17 December 2021.
- The Nuvaxovid (NVX-CoV2373) vaccine, 20 December 2021