Coronavirus

Question 1

Describe the structure of Coronavirus

Answer 1

-Coronaviruses are the only +ssRNA virus with a helical capsid
-They are all enveloped, and hand sanitizers work on coronavirus

Question 2

Unlike other RNA viruses, what can coronaviruses do when copying their RNA?

Answer 2

Can proofread when copying their RNA and have a lower mutation rate than other RNA viruses.

-However, they can still change by antigenic drift

Question 3

Coronaviruses often use ______ to make changes in their genome

Answer 3

recombination

Question 4

The ________ are known to cause the common cold

Answer 4

HCoV

-They are local infections with an incubation time of 2-4 days

Question 5

Human coronaviruses (HCoV) are 2nd in causing the common cold - what is 1st?

Answer 5

Rhinovirus

Question 6

Is immunity entirely protective against human coronavirus?

Answer 6

-Immunity is not entirely protective (wanes after time
-Reinfection with the HCoVs seems to be common

Question 7

When season are human coronaviruses common?

Answer 7

Winter months

Question 8

Is Severe Acute Respiratory Syndrome (SARS-Cov) (asymptomatic/symptomatic)?

Answer 8

Symptomatic

-Almost no asymptomatic infections
-Tends to have a higher fatality rate in older patients

Question 9

How did SARS-CoV emerge?

Answer 9

Emerged due to a bat CoV infecting the palm civet in China and probably adapting in this host for some time before jumping to humans

Question 10

What did SARS-CoV cause?

Answer 10

-A severe respiratory infection
-As a result, many people were hospitalized and required mechanical ventilation

Question 11

Why was the spread of SARS-CoV rapid and hard to control?

Answer 11

-Because of ‘super-spreaders’
-These people would infect a large number of people, probably due to high virus loads and aerosolization of the virus

Question 12

How was SARS-CoV controlled?

Answer 12

By a better diagnosis of the SARS-CoV patients, isolation of those patients, and isolation of all patient contact.

Question 13

What type of people did not spread SARS?

Answer 13

Asymptomatic or pre-symptomatic

Question 14

The Middle East Repertory Syndrome (MERS-Cov) has introductions to humans from what animals?

Answer 14

Camels

Question 15

Unlike SARS-CoV, MERS-CoV is what type of infection?

Answer 15

Mild and asymptomatic infection

Question 16

What can MERS-CoV cause?

Answer 16

Acute respiratory distress syndrome (ARDS) but also renal disease

Question 17

How does MERS-CoV infection spread?

Answer 17

-Person-to-person from respiratory secretions
-Most spreading tends to occur in a hospital setting or from household contacts of the infected. (Like SARS-CoV, there tended to be people who facilitate ‘super-spreader events’ which happen in hospital settings for MERS)

Question 18

The _____ for MERS-CoV is high

Answer 18

CFR

-Like all respiratory infections, there is a higher fatality rate in people with comorbidities, but otherwise, healthy people also die from MERS; this is more likely with increased age

Question 19

How was the MERS-CoV outbreak halted?

Answer 19

By better diagnosis, faster quarantine of MERS-CoV patients, and extensive quarantine of contacts

Question 20

SARS-CoV-2 most resembles a ______ coronavirus. The intermediate host _____

Answer 20

bat; unknown

Question 21

How does MERS-CoV-2 spread?

Answer 21

-Has sustained community spread
-Can spread from asymptomatic people and before people show symptoms
-There are ‘super-spreading events’

Question 22

What is the CFR for SARS-CoV-2?

Answer 22

-Hard to say
-It is higher the older the person and with the existence of comorbidities
-If hospitals are overrun, then CFR tends to go highr

Question 23

What is the incubation time of SARS-CoV-2?

Answer 23

2-5 days but can last as long as 12

Question 24

What are the symptoms of SARS-CoV-2?

Answer 24

There is a wide range of symptoms, but most people start with signs of respiratory tract infections or lack of taste or smell, but some people have GI symptoms

Question 25

Is SARS-CoV-2 local or systemic?

Answer 25

SARS-CoV-2 can be systemic but remains a local infection in some

Question 26

There are _____ licensed vaccines available for SARS-CoV-2 in the US

Answer 26

3

Question 27

The newest SARS-CoV-2 vaccine is a _______ vaccine from Novoxax. It contains….

Answer 27

subunit; it contains an adjuvant in addition to the spike protein and is from the original strain

Question 28

Two of the SARS-CoV-2 vaccines are mRNA-based vaccines. How do these work?

Answer 28

1) These use an mRNA encoding the spike protein, the receptor-binding protein on the viral surface of SARS-CoV-2. The mRNA enters a cell, and the spike protein is made.
2) The RNA is encoded in a lipid or nanoparticle. Some lipids can act as an adjuvant, as can the RNA itself.
3) The RNA vaccines give a neutralizing antibody response with two doses, but a regular booster will be needed. It will more than likely be like the influenza vaccine with regular boosters needed and change with the most prevalent strain.
4) If people have previously had SARS-CoV-2, it is recommended that they get the vaccine. It
will boost their neutralizing antibodies.

Question 29

All SARS-CoV-2 vaccines seem to work very well at preventing hospitalization and death. However, the more the virus changes, the less well the original vaccines prevent infection. What is this due to?

Answer 29

The virus mutating to escape neutralizing antibodies

Question 30

Currently, the ______ variants are the only detected variants in the world. However, subvariants of ________ occur fairly regularly, supplanting the old ______ subvariants

Answer 30

Omicron (for all blanks)

Question 31

Three antivirals and some monoclonal antibodies are used to treat SARS-CoV-2. ______ is only for non-hospitalized, and _______ is for mild to severe infections

Answer 31

Paxlovid; Remdesivir

Question 32

What is Paxlovid?

Answer 32

A combination pill with two components:
-A protease inhibitor against the main protease of SARS-CoV-2
-Component that keeps the level of inhibitor more steady

Question 33

When and how is Remdesivir given?

Answer 33

-Given via IV injection and in a nucleotide inhibitor of SARS-CoV-2’s RNA-dependent RNA polymerase
-It can be given early to prevent hospitalization or upon hospitalization

Question 34

Many different neutralizing monoclonal antibodies are given via IV. However, the monoclonal antibodies…..

Answer 34

do not work on all of the variants

Question 35

Tests for SARS-CoV-2 infection are _______ and _______

Answer 35

PCR based and antigen-based

-The at-home kits are antigen-based and work when there are high enough levels of the virus to be detected
-PCR tests are more sensitive and can detect lower amounts of the virus