Categories: Coronavirus

Coronavirus & Respiratory system

Coronaviruses are a large family of viruses that are common in people and many different species of animals including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people such as with MERS-COV, SARS-COV and now with this new virus (named SARS-COV-2).

This SARS-COV-2 virus is a beta coronavirus, like MERS-COV, SARS-COV. On February 11, 2020, the World Health Organization announced an official name for this disease that is causing the 2019 novel coronavirus outbreak, first identified in Wuhan, China. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. In COVID-19, “CO” stands for “Corona”, “VI” stands for “Viruses” and “D” for “Disease”.

There are many types of human coronaviruses including some that commonly cause mild upper respiratory tract illness, like coronaviruses 229 E, NL 63, OC 43 or HKU1 but SARS-COV-2 is a new strain of coronaviruses that have not been previously identified in humans.

The Clinical spectrum of COVID-19 ranges from mild disease with non-specific signs and symptoms of acute respiratory illness to severe pneumonia with respiratory failure and septic shock. There have also been reports of asymptomatic infection with COVID-19.

Current estimates of the incubation period range from 1 to 14 days, according to the WHO and the US Centers for disease control and precautions. The median incubation period has been estimated to be 5 days. Transmission may be possible during the incubation period.

Preliminary reports suggest that the reproductive numbers (RO), the numbers of people who acquire the infection from an infected person, is approximately 2.2. However, as the situation is still evolving, the RO may be higher or lower.

While the pathophysiology of the condition is currently unknown, structural analysis suggests that the viruses may be able to bind to the angiotensin-converting enzyme 2 (ACE2) receptor in humans, which suggests that it may have similar pathogenesis to SARS. However, a unique structural feature of the spike glycoprotein receptors binding domain of SARS-COV- 2 (which is responsible for the entry of the virus into host cells) confesses a potentially higher binding affinity for ACE2 on host cells compared to SARS-COV. Furin like cleavage site has been identified in the spike protein of the viruses; this does not exist in other SARS-like coronaviruses.

Based on an early analysis of case series, the most common symptoms are fever, dyspnoea, myalgia, fatigue, and less common include anorexia, sputum production, sore throat, confusion, etc.

Approximately 90% of patients present with more than one symptom and 15% of patients present with fever, cough, and dyspnoea.

The most common laboratory abnormalities in patients hospitalized with pneumonia include leucopenia, lymphopenia, leupocytosis, and elevated liver enzymes. Other abnormalities include neutrophilia, thrombocytopenia, decreased haemoglobin, decreased albumin and renal impairment. Pulse oximetry may reveal low oxygen saturation (SpO2<90%).

In Chest X-Ray unilateral lung infiltrates are found in 25% of patients and bilateral lung infiltrates are found in 75% of patients.

CT scan of the chest is particularly helpful in patients with suspected pneumonia who have a normal chest X-Ray in order to detect infiltrates with greater sensitivity.

Patients with asthma should never stop taking their preventer inhaler unless asked to do so by a medical professional. Stopping your steroid inhaler could put you at a higher risk of complications with COVID-19 due to making your asthma worse.

People with bronchiectasis might be at higher risk of complications if they get the COVID-19. So there are some suggestions to reduce your risk of getting the infection and the risk of complications if you do.

Along with all preventive measure as suggested to all common people, peoples with bronchiectasis should follow:

  1. Make sure you take all of your regular medications.
  2. Ensure you do your airway clearance exercise regularly, this clears regularly mucus from the lungs and reduces the risk of a flare-up.
  3. If you develop a fever and cough but feel well try to increase the frequency of your airway clearance and take paracetamol to reduce fever. If you become more unwell, seek medical advice.

Because COPD patients have lung problems, to begin with, they may be more likely to experience breathlessness with COVID-19 and more likely therefore need hospital treatment. Patients with severe COPD and emphysema are among those considered to be at higher risk of complications from COVID-19 and if the lungs are already slightly damaged, they have less ability to fight the virus.

Dr. Swarup Paul, Associate Consultant – Pulmonology, Anaesthesia & Critical Care, Narayana Multispeciality Hospital, Barasat

Narayana Health

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