2019 Coronavirus disease (COVID-19) is caused by (SARS-CoV-2). The disease was first identified in 2019 in ,, and has since spread globally, which resulted. Common symptoms include ,, and. muscle aches, sore throat production and less common. While most of the cases resulted in mild symptoms, some progress to severe and. Is an average of 3.4%, from 0.2% in those under 20, about 15% of their parents more than 80 years.
The infection is usually spread from one person to another through coughing and sneezing generated during. The time from exposure to onset of symptoms is generally between two and 14 days, with an average of five days. The standard method of diagnosis is to (RRT-PCR) on. Infection also can be diagnosed from a combination of symptoms, risk factors and chest indicate pneumonia features.
Recommended measures to prevent infection include frequent, and do not touch the person’s face. The use of masks is recommended for those who suspect they have the virus and their caregivers, but not the general public. There is no specific or for COVID-19. Management involves treatment of symptoms ,,, and experimental measures.
(WHO) declared the outbreak and a coronavirus 2019-20 (PHEIC). Evidence of the disease has been found in many countries on all six.
Although they are infected with the virus may be, many developing, including fever, cough, and shortness of breath. Less commonly, symptoms such as sneezing, or sore throat can be seen. gastrointestinal symptoms such as nausea, vomiting, and is seen in a minority of cases. In some, the disease can develop into ,, and death.
As usual with the infection, there is a delay from when a person is infected with the virus when they develop symptoms, known as. To COVID-19 is usually five to six days, but can range from two to 14 days.
Mild cases usually heal within two weeks, while those with severe or critical illness may take three to six weeks to recover. Among those who have died, the time from onset of symptoms until death ranges from 2-8 weeks.
The severity COVID-19 varies. The disease can take a mild course with little or no symptoms resemble other common upper respiratory diseases such as the common cold. However, in some COVID-19 can affect the lungs causing pneumonia. In the most severely affected, COVID-19 can quickly develop into (ARDS) led to respiratory failure, septic shock or multi-organ failure.
Complications associated with COVID-19 included, and damage to the heart, kidneys, and liver. Clotting abnormalities, particularly an increase in the time it takes for blood to clot () has been described in 6% of those hospitalized with COVID-19, while abnormal kidney function seen in 4% of this group. Blood markers of damage to the heart () increased more than 50% of severe cases COVID-19, and the leading explained. liver injury as indicated by blood markers of liver damage often seen in severe cases, although not described as of March 2020.
Several factors predict the severity of the infection COVID-19. Children tend to have milder symptoms and a lower chance of more severe disease than adults. Older age and height (clinical scoring scale assessing metabolism and function of various organ systems, such as the lungs, heart, liver, kidney, etc.) associated with a worse prognosis. Those with existing heart conditions are at greater risk of heart complications. Blood tests were associated with more severe disease, including greater than 1 mg / mL at entry; an increase in blood levels, high sensitivity cardiac troponin I ,; and (a type of white blood cell).
This disease virus (SARS-CoV-2), which was previously referred to as the new coronavirus 2019 (2019-nCoV). It is mainly spread between people through respiratory droplets from and. The virus has been found in the feces of an infected person, but is probably not known.
SARS-CoV-2 is transmitted from person to person. It can survive in aerosols produced by humans when breathing or coughing for three hours. It can remain stable on hard surfaces as well. Plastic and stainless steel on SARS-CoV-2 can last up to three days.
The lungs are the organs most affected by COVID-19 for virus access to the host cell via the enzyme, which is most abundant in the lungs. The virus uses a special surface glycoproteins, called “spike”, to connect to the ACE2 and entry into host cells. ACE2 density in each tissue correlated with the severity of disease in the tissue and some have suggested that the reduction in ACE2 activity may be protective, although other view is that an increase in ACE2 using the drug can be protective and that this hypothesis needs to be tested. As the disease advances alveolar, respiratory failure may develop and death can follow. ACE2 may also be a way for the virus to cause a heart attack acute cardiac injury. People with existing cardiovascular conditions have the worst prognosis.
This virus is suspected of having, through. It was first transmitted to humans in China, in November or December 2019 and the main source of infection into a human-to-human transmission at the beginning of January 2020. At March 14, 2020, reported that 55-year-old from Hubei province could be the first has contracted the disease on November 17, 2019. Reviewed March 14, 2020, 67 790 cases and 3,075 deaths from the virus have been reported in Hubei province; a (CFR) of 4.54%. On March 17, 2020, scientists reported that the novel SARS-CoV-2 virus comes naturally, and not vice versa.
has published several testing protocols for this disease. The standard method of testing is a real-time (RRT-PCR). This test can be performed on respiratory samples obtained by various methods, including or samples. Results are generally available within a few hours to two days. Blood tests can be used, but it requires two blood samples taken two weeks and the results have little immediate value. Chinese scientists were able to isolate strains of coronavirus and publish so that laboratories worldwide can independently develop (PCR) test to detect infection by the virus.
On February 26, 2020, no antibody test or point-of-care tests despite their efforts to develop ongoing.
diagnostic guidelines released by the Zhongnan Hospital of the suggested method for detecting infection on clinical and epidemiological risk. It identifies the people involved who have at least two of the following symptoms in addition to a travel history or contact with an infected person include: fever, pneumonia imaging features, normal or decreased white blood cell count, or decreased number of lymphocytes. A study published by a team at Tongji Hospital in Wuhan on February 26, 2020 show that the chest to COVID-19 has a larger (98%) compared to the polymerase chain reaction (71%). False negative results may occur due to failure of the PCR kit, or as either a problem with the sample or test problems. False-positive results tend to be rare.
One study in China found that showed at 56%, but 18% do not have a radiological findings. Bilateral and peripheral ground glass opacities most typical CT findings, although they are not specific. , Linear turbidity and other radiological findings. Initially, limited to one lung, but as the disease advances, the real indication in both lungs in 88% of the so-called “patient late” in the study group (subset for whom the time between onset of symptoms and chest CT is 6 -12 day).
A typical CT imaging findings
CT imaging stage of rapid development
Because there is expected to be available until 2021 at the earliest, an important part of managing the pandemic COVID-19 is trying to lower the peak of the epidemic, known as evenly through measures seeking to reduce the rate of new infections. Slowing the rate of infection helps reduce the risk that overwhelmed health services, allowing for better treatment of the case at this time, and provide more time for vaccines and treatments to be developed.
Preventive measures to reduce the likelihood of infection at the site of the outbreak of the disease are similar to those published for the coronavirus as: residence, travel to avoid and public activities, wash your hands with soap and warm water frequently and at least 20 seconds (proper hand hygiene), practice good respiratory and avoid touching your eyes, nose, or mouth with unwashed hands. CDC recommends covering your mouth and nose with a tissue when coughing or sneezing and coughing or sneezing into the elbow if no tissue is available. They also recommend proper hand hygiene after every cough or sneeze. strategiesim to reduce contacts of people infected with large groups with closing schools and workplaces, restrict travel, and canceling mass gatherings.
According to the WHO, the use of masks is only recommended if a person coughs or sneezes or when someone is caring for someone with an infection is suspected.
To prevent transmission of the virus, which (CDC) in the United States recommends that infected people stay at home except to get medical care, call ahead before visiting a health care provider, wearing face masks when exposed individual or the site of infection suspected, cover coughs and sneezes with a tissue, wash your hands regularly with soap and water and avoid sharing items private households. The CDC also recommends that individuals wash hands frequently with soap and water for at least 20 seconds, especially after going to the toilet or when visibly dirty hands, before eating and after blowing one’s nose, coughing, or sneezing. Further recommended the use of alcohol-based with at least 60% alcohol, but only if soap and water are not available. For remote areas where commercial hand sanitizers are not available, WHO recommends two formulations for local production. In both of these formulations or enhanced antimicrobial activity with low concentrations while acting as a humectant. WHO advises people to avoid touching your eyes, nose, or mouth with unwashed hands. Spitting in public places should also be avoided.
There is no specific antiviral drugs. People run like a liquid and, if necessary, while at the same time, there is monitoring and supporting the vital organs affected by the other. WHO has published recommendations for the treatment of care for people hospitalized with COVID-19. such is not recommended unless the disease is complicated by. and in the United States have been prepared on the treatment of various agencies into free sources, it is. CDC recommends that those who suspect they are carrying the virus wearing face masks is simple.
, anti-inflammatory drug commonly used to reduce fever, has been used to treat flu-like symptoms brought on by COVID-19. Ibuprofen increase ACE2 enzymes at the cellular level, which could worsen the infection COVID-19, raising concerns about its use. WHO as well as an article published in warn against the use of ibuprofen, recommends using instead. 
Usage (ECMO) has been used to overcome the problem of respiratory failure, but the benefits are still under consideration.
The management of people infected by the virus, including taking precautions while applying therapeutic maneuver, especially when performing such procedures or to produce.
CDC outlines the specific and the sequence in which health care providers must put in when dealing with someone who might have COVID-19: 1) dress, 2) or respirator, 3) goggles or a face shield, 4) gloves hand.
Most of the cases COVID-19 is not severe enough to require (artificial assistance for respiratory support), but the percentage of cases do. It is most common in older adults (those older than 60 and especially older than 80 years). Many developed countries do not have enough hospital beds per capita, which limits a ‘s capacity to handle a sudden surge in the number of COVID-19 cases were severe enough to require hospitalization. This limited capacity is a significant driver of the need for (to keep the speed at which new cases occur and thus the number of people ill at one point of time is lower).
One study in China found 5% treated, 2.3% require mechanical ventilation support, and 1.4% died.
There is no cure has not been approved for treating coronavirus infection in humans by the WHO although some recommended by national health authorities of the individual. Research potential treatments for this disease began in January 2020, and some antiviral drugs already in clinical trials. Though completely new drug can take up to 2021 to develop, some of the drugs tested antivirus already approved for other indications, or is already in advanced testing.
antiviral drugs can be tested in people with severe illness. WHO recommends volunteers taking part in the test safety and effectiveness of potential treatments.
Look for more information about experimental treatments
In February 2020, China launched to deal with the plague. Users are asked to enter the name and ID number. This application is able to detect ‘close contact’ use of surveillance data and because of the potential risk of infection. Each user can also check the status of three other users. If the potential risk is detected, the application does not only recommend self-quarantine, also notify local health officials.
In March 2020, enabled the Israeli government’s security agencies to track data from the cell phone should have the coronavirus. Steps were taken to enforce quarantine and protect those who may come into contact with people infected.
infected individuals may experience distress from quarantine, travel restrictions, side effects of treatment, or fear of the infection itself. To resolve this problem, publish national guidelines for psychological crisis intervention on January 27, 2020.
Many of those who died from COVID-19 preexisting conditions, including ,, and. Italy reported that, of the more than 2,000 deaths from the disease in the country, 99.8% have at least one preexisting condition with the average patient had 2.7. According to the same report, the median time between onset of symptoms and death was 8 days with a difference of one day between patients who had been treated in the ICU than those who do not. In an early case study, the median time from initial symptoms to death was 14 days, with a range of 6 to 41 days. In a study by the National Health Commission (NHC) from China, males have a mortality rate of 2.8%, while women have a mortality rate of 1.7%. At younger than 50 years, the risk of death is less than 0.5%, while those older than 70 was more than 8%. No deaths occurred in people younger than 10 as of 26 Feb 2020. Pregnant women are at risk of severe infection.
availability of medical resources and social economy of a region also affect mortality. Estimated mortality from conditions vary due to regional differences, but also because of methodological difficulties. Under-counting mild cases can cause death rates were over-estimated. However, the lag time can mean death occurred mortality rate underestimated.
examination of postmortem lung samples showed with mobile fibromyxoid in both lungs. Changes were observed in the virus. Pictures resemble lung (ARDS).
It is not known whether past infection provides an effective and long-term in people who recovered from the disease. Immunity possibility, based on the behavior of other coronaviruses, but the cases where recovery of COVID-19 has been followed by a positive test for coronavirus has been reported at a later date. It is not clear whether these cases are the result of re-infection, relapse, or testing error.
The severity of cases diagnosed in China COVID19
Case fatality rate by age group in China. Data through February 11, 2020.
The death rate cases depending on other health problems
The number of deaths
found a reduction of 20% to 30% in lung capacity in two to three dozen or so people who recover from the disease. People who recover gasp when they run faster. Lung scans of nine people infected in suggesting they have sustained organ damage.
In a study of children in China with laboratory-confirmed cases or clinically-suspected COVID-19, children of all ages were found to be vulnerable and no gender differences in vulnerabilities found. Of all the children, 4.4% of cases are asymptomatic, 50.9% were mild, 38.8% moderate, 5.2% are by weight, and 0.6% critical. One death, a 14 year old boy, occurred in the study population.
(CFR) depending on the availability of health, age and the typical health problems in the population, and the number of undiagnosed cases. Initial research has resulted in a number of cases the death rate between 2% and 3%; in January 2020 the World Health Organization suggest that the case fatality rate is around 3%, and 2% in February 2020 Hubei. Other CFR numbers, which adjusts the time difference confirmation, death or remission but not peer reviewed, respectively 7% and 33% for people in Wuhan on 31 January. An unreviewed of 55 deaths noted that initial estimates may be too high because of the death of asymptomatic infections were missed. They estimate the average infection ratio fatality (IFR, the death rate among infected) ranging from 0.8% – 0.9%. outbreaks in 2019-2020 has led to at least 198 004 confirmed infections and 7948 deaths.
An observational study of nine people argue that there is no mother to newborn. Also, descriptive study in Wuhan found no evidence of transmission of the virus through unprotected vaginal sex (from a female to a partner), but the authors noted that transmission during sex may occur via another route.
announced on February 11, 2020 that “COVID-19” will be the official name of the disease. Head of the World Health Organization said the “co” stands for “corona”, “vi” for “virus” and “d” for “illness”, while “19” is for this year, since the outbreak was first identified on December 31, 2019. Tedros said the name was chosen to avoid reference to a specific geographic location (ie China), animal species or group of people in line with international recommendations for naming aimed at preventing.
While the disease is named COVID-19, the virus that causes it is called or SARS-CoV-2. This virus was originally referred to as the new coronavirus 2019 or 2019-nCoV. WHO also use “virus COVID-19” and “virus responsible for COVID-19” in public communications.
Korean Health Authorities and guidelines recommending the 7th edition of China including ,, chloroquine, and / or umifenovir.
Because of the key role in the transmission and progression of the disease, has become the focus of a significant proportion of research and various therapeutic approaches have been proposed.
There is no vaccine available, but research into developing a vaccine have been conducted by various agencies. Previous work on the medium used for SARS-CoV-2 and SARS-CoV using either the ACE2 receptor to enter human cells. There are three vaccination strategies are being investigated. First, the researchers aim to build a whole virus vaccine. The use of such viruses, either that or die, is to obtain a prompt from the human body to new infections with COVID-19. The second strategy, subunit vaccine, aiming to create a vaccine which sensitises the immune system to a particular subunit virus. In the case of SARS-CoV-2 research has focused on the S-spike protein that helps the virus to infiltrate the receptor. The third strategy is a vaccine nucleic acid (or, the new technique to create a vaccination). The experimental vaccine from one of these strategies must be tested for safety and efficacy.
On March 16, 2020, the first clinical trials of vaccines began with four volunteers in Seattle. The vaccine contains a harmless genetic code is copied from the virus that causes this disease.
Some of that is being repurposed to treat COVID-19 and the couple moved into clinical trials.
There is tentative evidence for per March 2020. Remdesivir inhibit SARS-CoV-2. is being conducted in the US, in China and in Italy.
, which was previously used to treat, are being tested in China in February 2020, with initial results appear to be positive. Chloroquine phosphate has a variety of antiviral effects and has been proposed as a treatment for SARS-CoV-2. Chloroquine and effectively inhibit the SARS-CoV-2 in vitro, with evidentiary hydroxychloroquine become stronger than chloroquine and with a more tolerable safety profile.
The initial results of a multicenter trial suggest that chloroquine is effective and safe in treating COVID-19 associated pneumonia, “improve lung imaging findings, promote the conversion of virus-negative, and shorten the course of illness”. In March 2020, a preliminary hearing in France found that chloroquine (600 mg hydroxychloroquine (brand name Plaquenil) every day for 10 days) may be effective.
Guangdong Provincial Department of Science and Technology and Health and Health Commission of Guangdong Province issued a report stating that chloroquine phosphate “improve the success rate of treatment and shorten the length of patient stay in the hospital” and is recommended for people diagnosed with a mild case, moderate and severe pneumonia novel coronavirus. On March 17, the Italian Pharmaceutical Agency including chloroquine and the list of drugs with the results of a positive start for the treatment COVID-19.
have been included in treatment guidelines by China after a little study has been completed. This was a non-randomized to undergo tests at a national level in Italy after showing positive results in people with severe illness. Combined with identified, it is intended to counter such DevelopmEnt, which is suspected to be the cause of death in some affected people. It was approved by the for the treatment of cytokine release syndrome induced by different causes ,, in 2017.
In 2020 was found not to work in COVID19. has been recommended for further study after demonstrating inhibition of low concentration.
Recent studies have shown that the initial priming spike protein by the transmembrane serine protease 2 () is important for the entry, and through interaction with the receptor. These findings indicate that TMPRSS2 inhibitor approved for clinical use in Japan for inhibiting fibrosis in the liver and kidney disease, postoperative reflux esophagitis and pancreatitis may be an effective treatment option off-label.
Use of healthy people who have recovered from COVID-19 are being investigated, a strategy that has also been tried for SARS, earlier cousin COVID-19. Is that is naturally produced in from those who have been cured transferred to the people who need them through the form of non vaccine. Another form of passive antibody therapy, such as monoclonal antibodies produced may also come later after the construction, but convalescent serum production can be increased for faster deployment.
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