COVID-19 and RSV Flashcards
outbreak
-illness happens in unexpected high numbers
-may stay in one area or extend more widely
-can last days or years
-if disease is unknown, new to population, or absent for long time 1 single case is considered an outbreak
epidemic / pandemic
-infectious disease spreads quickly to more people expected
-affects a larger area than outbreak
-pandemicis outbreak that spreads across countries or continents
-affects more people and takes more lives than epidemic
of lives lost in pandemic depends on
-How many people are infected
-How severe of an illness the virus causes (its virulence)
-How vulnerable certain groups of people are
-Prevention efforts and how effective they are
flu pandemic: spanish flu 1918
-Death Toll: 20 -50 million
-Cause: Influenza
-1918-1920
-deadly outbreak
-global 1/3+ of world’s population
-ending the lives of 675,000 in U.S, 50 million people worldwide
-mortality rate- 10%-20%, with up to 25 million deaths in the first 25 weeks alone
-What separated the 1918 flu pandemic from other influenza -> killed healthy young adults, while leaving children and those with weaker immune systems alive
the black death (1346-1353)
-Death Toll: 75 – 200 million
-Cause: Bubonic Plague
-From 1346 to 1353
-outbreak in Europe, Africa, and Asia,
-death toll- 75 - 200 million
-originated in Asia, spread via fleas living on rats that lived on merchant ships
-bacteria
COVID-19 as of 2024
-global #- 702,529,440
-global death- 6,974,972
-US confirmed- 110,791,717
-US deaths- 1,193,867
Coronaviruses (CoV)
-large family of viruses
-can cause illness in animals or humans
-humans- respiratory infections
from common cold to more severe like severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and coronavirus disease 2019 (COVID-19)
COVID-19 emergence
-Identified in Wuhan, China in December 2019
-COVID-19 is caused by the virus SARS-CoV-2
-Early in the outbreak, many patients were reported to have a link to a large seafood and live animal market
-Later, no link to the market indicating person-to-person spread of the disease
-Travel-related exportation of cases reported
COVID-19 transmission
-aerosols- <5um diameter
-suspended in air- >1m distance
-contact/droplet- >5um diameter direct contact OR <1m distance
-fomites?
-points of entry- eyes, nose, mouth
-Person-to-person considered predominant mode of transmission, likely via respiratory droplets from coughing, sneezing, singing, talking, or breathing
-High-level viral shedding evident in upper respiratory tract
-Airborne transmission suggested by multiple studies, but frequency unclear in absence of aerosol-generating procedures in healthcare settings
-virus rarely cultured in respiratory samples > 9 days after symptom onset, especially in patients with mild disease
-Multiple studies describe a correlation between reduced infectivity with decreases in viral loads and rises in neutralizing antibodies
-ACOG: “Data indicate that vertical transmission appears to be uncommon”
nonpharmacologic preventative intervention: COVID-19
-Inactivation of SARS-CoV, MERS-CoV, and other endemic human coronaviruses readily accomplished with 62% to 71% ethanol, 0.5% hydrogen peroxide, or 0.1% sodium hypochlorite (in 1 min)[5]
-0.05% to 0.2% benzalkonium chloride, 0.02% chlorhexidine digluconate less effective
COVID-19 symptoms
-symptoms may appear 2-14 days after exposure to virus
-congestion or runny nose
-new loss of taste or smell
-fatigue, muscle or body aches
-fever or chills
-headache
-cough sore throat
-SOB or difficulty breathing
-nausea or vomiting, diarrhea
COVID-19 extrapulmonary manifestations
-derm- petechiae, liveido reticularis, erythematous rash, urticaria, vesicles, pernio-like lesions
-cardiac- takotsubo cardiomyopathy, myocardial injury/myocarditis, cardiac arrhythmias, cardiogenic shock, myocardial ischemia, acute cor pulmonale
-endocrine- hyperglycemia, diabetic ketoacidosis
-GI- diarrhea, nausea/vomiting, abdominal pain, anorexia
-neurologic- headaches, dizziness, encephalopathy, guillain barre, ageusia, myalgia, anosmia, stroke
-thromboembolism- DVT, pulmonary embolism, catheter related thrombosis
-hepatic- elevated ALT/AST, elevated bilirubin
-renal- acute kidney injury, proteinuria, hematuria
stages of COVID-19
-asymptomatic or presymptomatic infection- + test but no symptoms
-mild illness- varied symptoms but NO SOB, dyspnea, abnormal imaging
-moderate illness- SpO2 > 94% and lower respiratory disease evidenced by clinical assessment or imaging
-severe illness- SpO2 < 94%, PaO2/FiO2 <300, respiratory rate > 30, or lung infiltrates > 50%
-critical illness- respiratory failure, septic shock, and/or multiorgan dysfunction
stages and tx: COVID
-stage 1 (early stage)- mild constitution symptoms, dry cough, lymphopenia
-stage 2 (pulmonary phase)- SOB without hypoxia, abnormal chest imaging, transaminitis, low normal procalcitonin
-stage 3 hyperinflammation phase- ARDS, SIRS/shock, cardiac failure, elevated inflammatory markers (CRP, LDH, IL-6, D-dimer, ferritin), troponin, NT-proBNP elevation
-tx for stage 2 and 3- remdesivir (not used for stage 3), dexamethasone, O2
COVID-19 people at higher risk for severe illness
-In some cases seriously illness -> develop difficulty breathing -> death
-risk factors:
-age
-underlying medical conditions
