3.32 Flashcards
Coronaviruses characteristics (3)
+ strand RNA viruses
enveloped
• Cause up to 30% of common colds
— is agent of COVID-19
SARS-CoV-2
§ SARS outbreak:
late 2002 -
2003
§ SARS =
atypical pneumonia
§ SARS-CoV jumped from
— to humans and the same is
true for SARS-CoV-2
animals
middle east respiratory syndrome (MERS) is a
viral respiratory illness
–% mortality rate for MERS-CoV infection
30-40
clinical presentation of people with sars-cov-2 infection
Asymptomatic or Presymptomatic Infection
Mild Illness
Moderate Illness
skipped
Asymptomatic or Presymptomatic Infection
Individuals who test positive for SARS-CoV-2 using a virologic
test (i.e., a nucleic acid amplification test or an antigen test), but who have no symptoms that are
consistent with COVID-19.
skipped
Mild Illness
Individuals who have any of the various signs and symptoms of COVID-19 (e.g., fever, cough,
sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhea, loss of taste and smell) but who
do not have shortness of breath, dyspnea, or abnormal chest imaging
skipped
Moderate Illness
Individuals who show evidence of lower respiratory disease during clinical assessment or
imaging and who have saturation of oxygen (SpO2) 294% on room air at sea level.
Severe Illness:
Individuals who have SpO2 <94% on room air at sea level, a ratio of arterial partial pressure
of oxygen to fraction of inspired oxygen (PaO2/FiO2) <300 mmHg, respiratory frequency >30 breaths per
minute, or lung infiltrates >50%.
Critical Illness:
Individuals who have respiratory failure, septic shock, and/or multiple organ dysfunction.
SARS -
Severe acute respiratory syndrome in severe/critical illness
PaO,/FIO2 =
arterial partial pressure of oxygen/fraction of inspired oxygen
(PaO2/FIO2) ratio
at sea level, the normal Pa02/FiO2 ratio is ~ 400-500 mmHg
ACE2 –
angiotensin converting enzyme (cleaves angiotensin II (vasoconstrictor) to angiotensin 1-7 (vasodialator)
ACE2 activity lowers blood pressure
TMPRSS2 –
transmembrane protease, serine 2 (cleaves (“primes”) Spike protein)
RAAS –
renin angiotensin aldosterone system (blood pressure regulation)
— manifestations of COVID-19
Extrapulmonary
covid 19 is associated with — effects on many other organ systems
deleterious
Picornaviruses (Chapter 32)
— stranded RNA viruses
do not have —
+
envelope
enteroviruses
habitat =
include:
gastrointestinal tract
poliovirus and coxsackievirus
echoviruses - enteric cytopathic human orphan viruses
rhinoviruses
habitat =
respiratory epithelium
Rhinoviruses:
Sensitive to acidic pH
Replicate poorly above 33 C
Enteroviruses:
very stable in food and water
also stable at pH 3 (stomach)