Coronavirus

This was written on 4/5/20, and discussing a rapidly evolving subject.

Coronavirus is a member of the family of viruses that causes common cold, SARS and MERS infection. It looks like crown with spikes, hence the name coronavirus.

These viruses are more prevalent in the winter months, but can circulate year-round.

It enters the body mainly through respiratory tract and affects lung. It can also affect heart, kidney and other organs. In the lung it causes diffuse widespread pneumonia called ARDS. As a result patient cannot breathe and requires ventilator support in ICU.

This virus spread by tiny respiratory particles (droplets, aerosols) when infected or carrier patients coughs or sneezes, and can affect healthy individuals within 2-14 days (incubation period). This particles can travel up to 6 feet and can last up to 72 hours on certain surfaces. Protective mask can prevent inhalation in healthy individuals, but N-95 mask is the most effective.

Initial common symptoms include fever, cough, and shortness of breath. Other less common symptoms include extreme fatigue/weaknesses, loss of taste, loss of smell, loss of appetite, and sometimes diarrhea.

Blood picture shows decreased lymphocyte and platelet counts, increasing reactive markers such as CRP, D-dimer and ferritin level. Laboratory tests to diagnose are now available but due to short supply is being channeled through pre-screening.

Fortunately, 80% of the patients either develop minor symptoms requiring no medical care but needs isolation to prevent the spread or do not develop symptoms at all. 20% of the patients can develop severe symptoms requiring hospitalization, and approximately 1-4% the patient may die. Elderly patients or patients with other existing diseases such as diabetes, COPD, heart or kidney failure do poorly.

Unfortunately there is no specific treatment for COVID-19 infection at this time. Medical specialists and hospitals only provide supportive care while the patient’s body takes care of it itself. Some non-established anecdotal drugs such as antimalarial and other antiviral are being used on compassionate basis with variable results. There has been question of harmful effects off anti-inflammatory drugs such as ibuprofen and blood pressure medication such as lisinopril / losartan but it has not been established. One should not stop using any existing medications without consulting physicians.