Covid 19

Question 1

Coronavirus

Answer 1

Single stranded RNA virus
Causes colds, lower respiratory infections and gastroenteritis

SARS (severe acute respiratory syndrome)
MERS (middle east respiratory syndrome)

Covid doesn’t culture well —> difficult to study

Enveloped virus with a spiked proteins look like a crown ( S protein)

Viral replication occurs in the cytoplasm of infected cell high frequency of genetic mutation

SARS- 2003
MERS- 2012
SARS 2- 2019

Originated from Bats from China

Question 2

Incubation period and immunity

Answer 2

SARS 6 days cytokine storm
MERS 2-13 days
SARS 2 14 days

No such thing as absolute immunity…. Since it is a respiratory virus

Immunity only last 3-5 months

Vaccines should NOT be mixed

30% of covid causes colds

Question 3

Mode of transmission

Answer 3

Respiratory droplet

Survives on surfaces 6 - 9 days

Person to person within 6 ft

Viral shedding: 2 days prior to symptoms and 10 days after symptoms

Viral detection up to 6 weeks but not infectious

Question 4

Method of infection

Answer 4

COVID attaches to ACE 2 enzymes which is attached to cells in the lungs, arteries, kidneys, and intestines (viruses entry point into a cell)

ACE 2 also found in cerebral cortex, striatum, hypothalamus, and brainstem

Angiotensin Converting Enzyme

Question 5

Risk factors

Answer 5

Age
CV disease
DM
HTN
Chronic lung disease
CA
CKD
Obesity
Smoking
African Americans and Hispanics

Question 6

Lab abnormalities

Answer 6

Lymphopenia
Thrombocytopenia
Elevated liver, LDH, CRP, ferritin, inflammatory cytokines, TNF (inflammatory markers)
Elevated D-dimer, PT, troponin, CPK
AKI

CXR ground glass opacities

Question 7

Signs and symptoms

Answer 7

Cough fever myalgia
Headache dyspnea sore throat
N/V/D
Loss of smell (anosmia)
Loss of taste (Dysgeusia)
AB pain
Rhinorrhea

Question 8

Complications

Answer 8

ARDS PNA
Acute cardiac injury/shock
Arrhythmias
VTE stroke
Encephalopathy
Cytokine storm (massive systemic inflammation)

Severe infection might be due to lack of interferons (Fx to fight viral infections)

SARS CoV 2 —> anti-interferon gene

Question 9

Children and covid

Answer 9

Some kids have neutropenia or lymphocytopenia

RF: obesity, severe genetic disorder, inheritied metabolism disorder, sickle cell anemia, congenital heart disease, DM, CKD, asthma, chronic pulmonary disease, less than 1 year of age

Complications:
Pediatric multisystem inflammatory syndrome

SS:
Fever, N/V/D, rash, ab pain, conjunctivitis, mucous membrane involvement
Neuro, resp, lymphadenopathy