CORONAVIRUS DISEASE 2019 (COVID-19)

Novel Coronavirus (2019-nCoV) causing an outbreak of respiratory illness in the city of Wuhan, Hubei province, China. Despite Wuhan and other Chinese cities, the COVID-19 has spread to almost more than 70 locations internationally and more than 1.35 lakh were found positive and more than 3500 were die globally.

In INDIA, COVID-19 cases have been confirmed in Kerala, Delhi, U.P., Rajasthan, Tamil Nadu and Jammu & Kashmir State. Total 39 cases were confirmed till date out of that 3 were recovered from the state of Kerala and still no any deaths have been reported.

Coronavirus

Coronaviruses are a family of viruses that can cause illnesses such as the common cold.

This family having six broad classifications

1. Human coronavirus 229 E (HCoV-229E)
2. Human coronavirus NL63 (HCoV-NL63)
3. Human coronavirus O43 (HCoV-OC43)
4. Human coronavirus HKU1 (HCoV-HKU1)
5. Middle East Respiratory syndrome MERS coronavirus (MERS -CoV)
6. Severe acute respiratory syndrome SARS coronavirus (SARS-CoV)
7. Novel Coronavirus (2019-nCoV) now seventh new coronavirus reported on 2019.

Transmission

• It's unclear exactly how contagious the new coronavirus is.
• Commonly, it is found in the animals.
• Rarely, it can be transmitted from animals to humans.
• Once’s it transferred to human then it will spread person to person.
• It appears to be spreading from person to person among those in close contact.
• It may be spread by respiratory droplets released when someone with the virus coughs or sneezes.

Clinical Presentation

• Signs and symptoms of COVID-19 may appear 2 to 14 days after exposure.
• This is very similar with other respiratory illnesses, such as influenza and common cold.
• It includes-
• 90% case fever
• 80% case fatigue and dry cough
• 20% shortness of breath or difficulty breathing
• 15% respiratory distress
• The severity of COVID-19 symptoms can range from very mild to severe.
• People who are older age, and underlying chronic medical conditions such as lung disease, cancer, heart failure, cerebrovascular disease, renal disease, liver disease, diabetes, immunocompromising conditions, and pregnancy, may be at higher risk of serious illness.
• Risk factors for COVID-19 appear to include:
• Recent travel from or residence in an area with ongoing spread of COVID-19 as determined by CDC or WHO
• Close contact with someone who has COVID-19 — such as when a family member or health care worker takes care of an infected person
• if you've recently travelled internationally or in contact with any person who travelled internationally and have COVID-19 symptoms and you've possibly been exposed to the virus, contact to nearest health care facility right away to conform that.

Diagnostic Evaluation

• History collection
• Physical examination
• Vital signs (to find fever status)
• Chest x-ray (should take both lungs)
• Blood test (mostly white blood count low)
• laboratory testing for COVID-19 (for conformation)
• Real-Time RT-PCR Panel for Detection 2019-Novel Coronavirus.
• After initial confirmation of COVID-10, additional testing of clinical specimens can help inform clinical management, including discharge planning.

Prevention from Novel Coronavirus

• Currently, there is no vaccine to prevent coronavirus disease 2019 (COVID-19).
• To prevent illness, the best way is to avoid being exposed to this virus.
• Everyday preventive actions that can help us to prevent the spread of respiratory diseases and COVID-19, including:
• Avoid close contact with anyone who is sick.
• Avoid touching your eyes, nose and mouth if your hands aren't clean.
• Stay home from work, school and public areas if you're sick.
• Cover your mouth and nose with your elbow or use tissue paper when you cough or sneeze.
• Avoid sharing dishes, glasses, bedding and other household items if you're sick.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
• Always wash hands if hands are visibly dirty. Wash with soap and water, or use an alcohol-based hand sanitizer with at least 60% alcohol.
• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
• Wear facemask
• when you are sick.
• The use of facemasks is crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).
• CDC does not recommend the use of facemask to that people who are well to protect themselves from respiratory diseases, including COVID-19.
• Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others.
• WHO also recommends that -
• Avoid eating raw or undercooked meat or animal organs.
• Avoid contact with live animals and surfaces they may have touched if you're visiting live markets in areas that have recently had new coronavirus cases.

Management

• Currently, no specific treatment is available to treat COVID-19.
• Clinical management includes prompt implementation of recommended infection prevention and control measures and only can supportive symptomatic pharmacological management for complications, including advanced organ support if indicated.
• For recommendations on discontinuation of transmission-based precautions or home isolation for patients who have recovered from COVID-19 illness, please see: Interim Guidance for Discontinuation of Transmission-Based Precautions and Disposition of Hospitalized Patients with COVID-19 and Interim Guidance for Discontinuation of In-Home Isolation for Patients with COVID-19.

References

1. CDC. Coronavirus Disease 2019 (COVID-19) [Internet]. Centers for Disease Control and Prevention. 2020 [cited 2020 Mar 8]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html
2. CDC, CDC. Coronavirus Disease 2019 (COVID-19) – Prevention & Treatment [Internet]. Centers for Disease Control and Prevention. 2020 [cited 2020 Mar 8]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html
3. staff familydoctor org editorial. Coronavirus: Symptoms, Diagnosis, Treatment [Internet]. familydoctor.org. [cited 2020 Mar 8]. Available from: https://familydoctor.org/condition/coronavirus/
4. 2019 Coronavirus (COVID-19): Symptoms,Treatment, Prevention [Internet]. Healthline. [cited 2020 Mar 8]. Available from: https://www.healthline.com/health/coronavirus-covid-19
5. Coronavirus [Internet]. [cited 2020 Mar 8]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
6. Coronavirus disease 2019 (COVID-19) - Symptoms and causes [Internet]. Mayo Clinic. [cited 2020 Mar 8]. Available from: https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963
7. Coronavirus LIVE News: Kerala reports five cases, boy from US under observation in TN [Internet]. The Economic Times. [cited 2020 Mar 8]. Available from: https://economictimes.indiatimes.com/news/politics-and-nation/coronavirus-cases-in-india-live-news-latest-updates-march8/liveblog/74533917.cms
8. Myth busters [Internet]. [cited 2020 Mar 8]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters