What is Coronavirus (COVID-19)?
Coronaviruses are RNA viruses that can infect humans and a wide variety of animal species. They cause a wide variety of respiratory infections in humans, ranging from the common cold to pneumonia. Coronaviruses cause cold with sore throat, dry cough, runny nose, weakness, and fatigue every year in autumn and winter. The incubation period is 3-5 days, in such Coronavirus infections, the disease limits itself within 4-6 days and patients recover rapidly. Pneumonia may develop in very few cases, especially in the risk group.
New Coronavirus strains, which have been seen since 2002, have started to appear with a more severe flu-like respiratory tract infection, which is different from the common cold. The first one of these is SARS-CoV (Severe Acute Respiratory Syndrome Coronavirus). In February 2003, the disease is thought to be transmitted first from bats to civet cats and from there to humans in the Guangdong region of China. It affected 8000 people in 33 countries from 5 continents, most of them from China, and approximately 800 people died due to this disease. After 2004, no new case related to SARS has been reported.
Another new Coronavirus strain is MERS-CoV (Middle East Respiratory Syndrome). It was first seen in Saudi Arabia in 2012 and is thought to be transmitted from camel to human. In this different MERS-CoV epidemic that continued until June 2018, 2229 cases were reported in 5 continents and 27 different countries. 791 of the cases were lost. In both SARS-CoV and MERS-CoV infections, while the incubation period can be 3-5 days, it can also extend up to 10-14 days. This means that an infected person can infect others with the disease for up to 10-14 days before the symptoms appear. After the incubation period, the disease continues with symptoms of fever, sore throat, dry cough, respiratory failure, muscle and joint pain and headache. Pneumonia is more common in this strain since the disease mostly causes damage to the lower respiratory tract. This situation reaches a life-threatening level, especially in elderly patients who are accepted as a risk group, or those with an underlying chronic heart, lung, or kidney disease. The recovery period may take 7-10 days for those who recover from the disease.
In Coronavirus infections that progress as a common cold, the virus infects the ciliated epithelial cells in the nasopharynx through aminopeptidase N receptors or sialic acid receptors. As the virus reproduces, damage occurs in the ciliated squamous epithelial cells. Secreted chemokines and interleukins cause local symptoms to appear. SARS-CoV and MERS-CoV attach to respiratory tract cells via angiotensin-converting enzyme 2. This situation causes systemic infectious disease. The virus can spread to pneumocytes, blood, urine (up to 2 months) and feces. The virus can remain in the respiratory tract for 2-3 weeks.
The case, which was reported from Wuhan city with a population of 11 million in Hubei province in China on December 31, 2019, was also found to be infected with a new Coronavirus strain that has never been seen before. This virus, called 2019-nCoV, is also thought to be a zoonotic infection, in other words, transmitted from animals to humans, like SARS-CoV and MERS-CoV. Nowadays, the disease is rapidly spreading among people, and on January 30, 2020, the number of cases reached 8000, most of them in Hubei province and especially in Wuhan and also in 19 other countries outside China. Unfortunately, 170 people died, all in China. When the deceased people were examined, it was found that the majority of them were elderly patients or people diagnosed with Parkinson's, Diabetes, chronic heart, lung or kidney diseases.
How Does 2019-NcoV Spread?
This infection, which started in the city of Wuhan, is thought to be transmitted to humans from the market, where seafood and various wild animal meat products are also sold. It has been proven that the disease is transmitted from person to person. Contagion has so far been mostly seen in those who are in the same family or environment with the infected person and in healthcare workers who do not take droplet precautions. Contagion is usually caused by the droplets formed during the coughing and sneezing of the sick person entering the respiratory tract of unprotected people in close contact up to 1m.
Does 2019-nCoV Survive in the External Environment?
According to current information, it is considered that the possibility of 2019-nCoV to be transmitted by hands after contact with inanimate surfaces in the external environment is weak. However, after touching live or inanimate surfaces with hands, it should not be neglected to wash hands or clean with alcohol-based hand disinfectants as well as to clean the inanimate surfaces.
What are the Symptoms of 2019-nCoV?
According to what is currently known, infected patients have symptoms of cough, fever and respiratory distress. On the other hand, respiratory failure, kidney failure and life-threatening multi-organ failure may develop in severe cases.
Who Gets Severely Ill from 2019-nCoV Disease?
As with seasonal influenza, 2019-nCoV infection tends to be more severe and life-threatening in elderly patients or those with an underlying chronic heart, lung, kidney, or liver disease, regardless of age.
How Does 2019-nCoV Disease Progress?
It is not possible to reach a definite conclusion about how and at what speed the disease can progress, based on current information. However, there are studies being carried out on this issue. The disease may start to appear in regions or countries where the disease has not been seen before. Even the number of patients may increase significantly, but this does not mean that the disease will progress more severely or with a higher mortality rate.
How to Approach a Probable or a Confirmed Case?
People who have been in Hubei province of China, especially Wuhan City where the disease started, in the last 14 days and who have fever, dry cough and breathing difficulties are called probable cases. On the other hand, people who have these symptoms and who have the agent detected in their respiratory tract samples by microbiological methods are called confirmed cases. In order to prevent the spread of the infection in the society, it is important that such cases should not directly go to a health institution themselves but report their situation to a health institution by phone and have preliminary evaluations made by the healthcare workers at home. People to be evaluated at home should wear a mask to cover their mouth and nose, and the healthcare workers should evaluate the case by wearing high-protective masks, gloves, and other protective equipment.
Patients who require hospitalization should be brought to the healthcare institution with a mask. The patients with probable and/or confirmed 2019 nCoV infection should be hospitalized in negative pressure rooms and the healthcare workers should be assigned to serve in these rooms. All of these can be considered among the necessary approaches.
Is There a Treatment for 2019-nCoV Disease?
There is currently no antiviral drug to treat the disease. Antiviral drugs used in the treatment of other viral infections have also been tried in the treatment of Coronovirus infections, but an effective result has not been achieved. Currently, the treatment is symptomatic, bed rest, plenty of fluid consumption and daily calorie intake are necessary for body resistance. Because it is the body resistance that will overcome the disease.
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