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Medical Studies 1 > 8.1 Pathophysiology of SARS-CoV-2 > Flashcards

8.1 Pathophysiology of SARS-CoV-2 Flashcards

1
Q

Which receptor does COVID-19 use to attach to host cells?

A

ACE 2

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2
Q

Which receptor does COVID-19 use to fuse with the host cell?

A

TMPRSS2

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3
Q

How can people have asymptomatic/mild cases of COVID-19

A
  • Early innate immune response
  • Detection of PAMPs through PRRs
  • Rapid response controls infection
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4
Q

The lungs only have a medium density of ACE2 relative to other tissues in the body; why is the infection mostly in the lungs?

A
  • Because the mode of infection of the virus is respiratory
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5
Q

ACE vs ACE2

A

ACE: Turns Ang I to Ang II
ACE2: Hydrolyses Ang I, not making Ang II

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6
Q

What is the role of ACE2 in the lung?

A

To protect the lung from Ang II induced inflammation

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7
Q

What is PANoptosis?

A

Inflammatory cell death pathway

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8
Q

List two ways in which PANoptosis can damage tissue

A
  • Damages structure of tissue
  • Leads to release of DAMPs and inflammatory cytokines from dying cells, possibly triggering cytokine storms
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9
Q

What is a cytokine storm?

A

A life-threatening condition caused by inflammatory programmed cell death

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10
Q

Which cytokines trigger PANoptosome formation?

A
  • TNF
  • IFN gamma
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11
Q

Describe the positive feedback loop of a cytokine storm

A
  • Infection
  • Release of cytokines
  • Recruitment of cells
  • New cells released cytokines (including TNF and IFN gamma)
  • PANoptosome fomation
  • PANoptosis (more cell death)
  • PANoptosis causes further cytokine release (uh oh…)
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12
Q

Severe outcomes of cytokine storm

A

Systemic inflammation and organ failure

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13
Q

What happens to the alveoli during COVID-induced ARDS?

A
  • Increased fluid in alveoli
  • Surfactant breakdown
  • Decreased efficiency of gas exchange
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14
Q

ARDS symptoms/signs

A
  • Dyspnoea
  • Low O2 sat
  • Tahchypnoea
  • Rattling sounds when breathing
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15
Q

What happens to ACE2 levels as you age?

A

It decreases

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16
Q

How can COVID-19 infect multiple organs?

A

Because the ACE2 inhibitors are expressed in many organs of the lung, often in higher density than the lungs

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17
Q

Risk factors for severe illness in COVID-19

A
  • Age
  • Smoking
  • Pregnancy
  • Male gender
  • Chemotherapy
  • Childhood cancer
  • Diabetes
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18
Q

Symptoms of cytokine storm

A
  • Fever
  • Nausea/vomiting
  • Confusion
  • Chills
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19
Q

Is COVID-19 enveloped or non-enveloped? What does this mean?

A
  • It is enveloped
  • This means it has a protein capsid surrounding its RNA
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20
Q

List some organs with high levels of ACE2

A
  • Small intestine
  • Testis
  • Kidneys
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21
Q

List some organs with medium levels of ACE2

A
  • Lungs
  • Liver
  • Bladder
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22
Q

List some organs with low levels of ACE2

A
  • Blood
  • Brain
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23
Q

Main mechanism of transmission of SARS-CoV2

A

Close-contact droplet infection

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24
Q

Primary target cells for SARS-CoV2

A

Epithelium is respiratory and intestinal tract

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25
Why is COVID-19 prone to mutation?
RNA Dependent RNA Polymerase does not have a proofreading mechanism
26
Variant of interest vs variant of concern
Interest: consistent thorughout community/within clusters Concern: Increased transmissibility, virulence, or decreased effectiveness of treatment
27
Order of dominance of COVID variants
- Alpha - Beta - Gamma - Delta - Omicron
28
Change in case numbers and mortality of COVID over time
- Case numbers going up - Mortality going down
29
Define endemic
Health conditions that occurs at a predictable rate in a particular region
30
Define outbreak
Unpredicted increase in the number of people presenting a health condition of the occurrence of cases in a new area
31
Define epidemic
Outbreak that spreads to larger geographic areas
32
Define pandemic
Epidemic that's spread over multiple countries or continents
33
Early infection COVID symptoms
- Cold like symptoms - Smell/taste disorders - Lymphopaenia
34
Pulmonary phase (Stage 2) COVID symptoms
- Respiratory distress - Coughing/phlegm - Dyspnoea +/- hypoxia
35
Hyperinflammation phase COVID symptoms
- ARDS - Shock - Cardiac failure
36
Breathing support for COVID (with increasing severity)
Nothing -> Oxygen -> More O2/BiPAP -> ventilation
37
Describe the symptoms of COVID-related Kawasaki disease
- Inflammation of blood vessels, particularly in eyes, palms, soles of feet, tongue
38
List preventative measures for COVID-19
- Vaccination - Masks - Social distancing - Isolation/quarantine
39
How does an increased number of comorbidities change an individual's chance of death from COVID?
It increases it
40
What two medications are used during stage 1 of COVID-19 (viral replication; mild symptoms)?
- Antivirals - Anti-spike monoclonal antibodies
41
What two medications are used during stage 2 of COVID-19 (pulmonary phase)?
- Antivirals (remdesivir) - Corticosteroid (dexamethasone)
42
What two medications are given during stage 3 of COVID-19 (hyperinflammation phase)?
- Corticosteroid (dexamethasone) - Anti-Il 6 mAbs, JAK inhibitors
43
How do monoclonal antibodies limit the virulence of COVID-19?
Bind to spike protein
44
For whom are monoclonal antibodies indicated in COVID-19?
- Unvaccinated - Immunocompromised
45
How can oral antivirals reduce viral replication through amino acid insertion
Insert foreign amino acid into genetic material of virus, nullifying genetic code and preventing replication
46
How does remdesivir (IV antiviral) inhibit viral replication
Inhibits activity of RdRp
47
Broadly, how do JAK inhibitors work?
- Prevent activation of signal transducers - Prevents release of cytokines
48
Which patients should be considered for long-acting antibody combination against covid-19?
- Immunocompromised - Allergy; cannot be vaccinated
49
Risk factors for severe disease in COVID-19
- Age > 55 - Obesity - Pregnancy - CKD - Immunosuppressive disease - CVD - Diabetes
50
In what % of COVID-19 patients does ARDS occur?
5%
51
What % of patients require ventilation with COVID-19?
20-100%
52
List some complications of COVID-19
- ARDS - Persistent fever - Dehydration - Hypovolaemia
53
Cardiac complications of COVID-19
- MI - Arrhythmia - Cardiac arrest
54
Neurological complications of COVID-19
- Delirium - Nerve inflammation/paarlysis - Stroke
55
Liver and GI complications of COVID-19
- Liver dysfunction - Mesenteric ischaemia
56
Steroids can be used in treatment of COVID-19. Provide some complications that can arise from this
- Stress ulcers - Hyperglycaemia - Fungal pneumonia
57
How do steroids increase risk of fungal infection
Delay epithelial regeneration
58
Is long COVID more common in older or younger people?
Older
59
Risk factors for long COVID
- Women - Increasing age - Diabetes
60
Is there any correlation between disease severity and long COVID occurrence?
No
61
Complications of long COVID
- Organ damage - Altered immune status
62
List a bunch of possible symptoms of long covid
- Fatigue - Muscular weakness - Joint pain - Dyspnoea - Cough - Headaches - Palpitations
63

Medical Studies 1 (90 decks)

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