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Patho > COVID-19 > Flashcards

COVID-19 Flashcards

1
Q

What is SARS-COV2?

A

Severe Acute Respiratory Syndrome from the Coronavirus 2
Is the virus that causes the COVID-19 disease

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2
Q

What is the ethology of COVID-19? (3)

A
  • Started in Wuhan, China - traced back to a fish/meat market
  • Believed to have come from bats - 96.2% genetic similarity to bat coronavirus
  • Underwent antigenic shift from bat to human, unknown if intermediate carrier was involved
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3
Q

What is the name of the spike protein on coronavirus?

A

Glycoprotein-S

*spike proteins, membrane proteins, and envelope proteins essential for virus binding to host cell

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4
Q

What are the current variants of concern (VOC)?

A

None at present

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5
Q

What are the current variants under monitoring (VUM)?

A

Anything containing the F456L spike mutation

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6
Q

What are the current variants being monitored (VBM)?

A

Omicron
Beta
Alpha
Gamma

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7
Q

What is the reproductive rate (R0)?

A

How many individuals a virus can be passed on to from 1 infected individual

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8
Q

What is the series interval (Si)?

A

The time it takes (in days) to pass on a virus to another individual

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9
Q

What are the 4 modes of transmission for influenza?

A
  1. Respiratory droplet
  2. Fomite - depends on surface
  3. Fecal-oral
  4. Vertical transmission
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10
Q

How long can COVID last on surfaces (as fomites)?

A

Copper + latex = 8 hours
Wood + glass = 5 days

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11
Q

How long can COVID respiratory droplets stay in the air?

A

Up to 3 hours

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12
Q

What percent of COVID transmission occurs through vertical transmission?

A

~3% occurs during later stages of pregnancy and in breastfeeding

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13
Q

What are the 3 phases of COVIDs disease course?

A

Stage 1 - viral response
Stage 2 - pulmonary phase
Stage 3 - hyper inflammatory phase

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14
Q

Explain the viral response of COVIDs disease course.

A

The viral response includes the incubation and infectious periods
- person shows mild symptoms
- is contagious

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15
Q

Explain the pulmonary phase of COVIDs disease course.

A
  • when the adaptive immune response occurs
  • person experiences hypoxia and dyspnea
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16
Q

Explain the events of the hyper inflammation phase in COVIDs disease course.

A

DIC, cytokine storm, ARDS, multi-system organ failure

17
Q

What are the target cells and target tissue of COVID?

A

Target cells: any cells that have an ACE2 receptor
Lungs are the main target area - alveoli have type 2 pneumocytes with ACE2 receptors
**other cells also have ACE2 receptors, which is why COVID produces a variety of symptoms

18
Q

What is the co-receptor that COVID uses?

A

Transmembrane protease serine 2 (TMPRSS2)

19
Q

List factors that increase risk of mortality with COVID infection.

A

CV disease, lung disease, diabetes, cancer/immunosuppressed, age > 60yr

Elevated: D-dimer, ferritin, CK-MB, troponin

labwork hint: clotting problems, heart problems

20
Q

Explain the cytokine storm.

A

aka cytokine release syndrome – occurs when a large number of WBCs are activated via the AIR response, they release inflammatory cytokines, activates more immunity cells
– creates positive feedback loop

21
Q

List the WBCs involved in the cytokine storm.

A

Monocytes
Lymphocytes
Macrophages
Dendritic cells

MLMs are dicks

22
Q

What are the 4 effects of the cytokine storm?

A
  1. Act on vascular endothelium (VCAMS)
  2. Activate neutrophils
  3. Impaired coagulation
  4. Increase in chemical mediators
23
Q

Explain how cytokines act on VCAMs.

A

Cytokines:
interleukin-1, 6, 8
tumor necrosis factor A (TNFA)
interferon gamma

Increase function of vascular cellular adhesion molecules to pull WBCs out of vasculature and into lungs

24
Q

Explain the activated neutrophil step of the cytokine storm.

A

Increased neutrophil activity results in increased release of reactive oxygen species (ROS) and proteases = damages surrounding cells

25
Q

Explain the effects of damaged alveolar cells as a result of increased neutrophil activity.

A

Damage to type 1 alveolar cells = impaired gas exchange

Damage to type 2 alveolar cells = decreases surfactant = increases surface tension = alveolar collapse
*further impairs gas exchange

26
Q

Explain how coagulation activity is impaired due to the cytokine storm.

A

Increased pro-coagulant activity
Decreased anti-coagulant activity
= results in clot formation = possible pulmonary emboli

27
Q

What is the result of the increased chemical mediators?

A

Damaged alveolar cells release chemical mediators (leukotrienes, prostaglandins, bradykinins) which activate the vagus nerve and stimulates CNS
Triggers cough reflex and bronchial smooth muscle constriction

chemical mediator hint: licensed practical bitch

28
Q

What other body systems are affected by COVID?

A

Olfactory - loss of sense of taste + smell
Heart - damaged myocardial tissue
GI tract - N+V, diarrhea, abdominal pain
Kidneys - decreased function = decreased urine production
Liver - decreased function = metabolic disorders

29
Q

What are pulmonary complications that can occur due to COVID?

A
  • pneumonia
  • pulmonary edema
  • pulmonary emboli
  • ARDS
30
Q

What occurs with the lysis of cells with ACE2 receptors?

A

Increased angiotensin 2 production = affects blood pressure
Causes: pulm HTN, increased inflammation, increased vascular permeability
= results in acute lung injury

31
Q

What are two methods of diagnosing COVID?

A
  1. Nasopharyngeal swab
  2. Serology
32
Q

How does nasopharyngeal swabbing diagnose COVID?

A

Reverse Transcriptase Polymerase Chain Reaction Test (RT-PCR)
Tests for presence of viral RNA
**gold standard - 70% sensitivity

33
Q

How does serology diagnose COVID?

A

Tests for presence of antibodies in blood.
- IgM present = actively infected
- IgG present = recovered from infection
** 95% sensitivity when combines with RT-PCR test

34
Q

What are the treatments for mild-moderate COVID infection?

A
  • inhaled corticosteroids
  • antiretrovirals
35
Q

What are the treatments for severe COVID infection?

A
  • dexamethasone
  • antiretrovirals
    +/- supplemental O2
36
Q

What are treatments for critically ill COVID infection?

A
  • dexamethasone
  • LMW heparin
  • high-flow O2 or mechanical ventilation
    +/- immunosuppressants to prevent or lessen cytokine storm effects
37
Q

What is the preventative treatment for COVID?

A

VACCINE

Patho (9 decks)

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