FINAL - Covid-19 Virus notes Flashcards

1
Q

What kind of virus is covid?

A

A medium-sized enveloped positive stranded RNA virus.
The host-derived membrane of the virus is studded with glycoprotein spikes that surround the viral genome, which is encased in a nucleocapsid.

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2
Q

HOw does the infection of the host occur with coronavirus?

A

The Spike proteins mediate receptor binding and fusion with the host cell membrane. Infection of host cells occurs via binding of the viral spike protein to angiotensin-converting enzyme 2 (ACE2) receptors.

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3
Q

Describe the course of the infection with coronavirus?

A

When viral spike proteins enable host cell entry via binding to angiotensin-converting enzyme 2 (ACE2) receptors and viral replication begins, infection of nasal and bronchial epithelial cells and pneumocytes generally occur early in infection . Later in infection acceleration of viral replication and compromise of epithelial-endothelial barrier integrity results in a dysregulated inflammatory response and a hypercoagulable state. Dysregulation of the renin-angiotensin-aldosterone system may also contribute to infection-related tissue damage.

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4
Q

Describe the most commone variant of covid right now?

A

OMICRON

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5
Q

How many confirmed cases of covid have their been internationally? How many deaths?

A

776 million with over 7 million deaths

These numbers do not accurately reflect the actual total of COVID-19 cases worldwide. Only a fraction of acute infections are diagnosed and reported.

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6
Q

How is covid-19 transmitted?

A

The COVID-19 virus is transmitted primarily via person-to-person contact by both symptomatic and asymptomatic individuals. This occurs through close contact (within 6 feet or 2 metres) via respiratory droplets. Potential routes of transmission include respiratory secretions from coughing, sneezing, and talking if it is inhaled or makes direct contact with mucous membranes.

Transmission risk is greatest if contact is prolonged for 15 minutes or more.

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7
Q

What increases the risk of transmission of covid-19?

A

Transmission risk is greatest if contact is prolonged for 15 minutes or more. The risk of transmission after contact with an individual with COVID-19 increases with the closeness and duration of contact. It appears highest with prolonged contact in indoor settings. Transmissibility, incubation period and infectivity varies depending on the virus variants and the individual’s immunity. The viral attack rate among household contacts for Omicron variants is estimated at 43%.

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8
Q

Describe other transmission routes aside from person to person?

A

Further routes of transmission such as aerosols and via contact with fomites are possible; however, these are not the primary routes of transmission. Although not a primary route of transmission, SARS-CoV-2 can also be transmitted longer distances through the airborne route via inhalation of particles that remain in the air over time and distance. This risk is enhanced in small, poorly ventilated spaces.

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9
Q

How is Covid infection spread via asymptomatic individuals?

A

As previously mentioned, COVID infection via asymptomatic individuals is possible. Viral shedding in the upper respiratory tract begins about 2-3 days prior to symptom onset. Asymptomatic carriers can transmit virus 1-3 days before developing symptoms. Peak viral load occurs around the time of symptom onset. The infectivity period can be affected by disease severity, pre-existing immunity through vaccination, or prior infection.

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10
Q

Is covid-19 seasonal yet?

A

The seasonality of COVID infections has not been established but COVID-19 activity is expected to be elevated in fall and winter months (associated with more indoor congregation for activities in colder months). Immunization programs have been targeted for fall, with release of updated vaccines each year, to coincide with influenza vaccination campaigns for ease of program administration and in hopes of optimizing vaccine uptake, which has waned over recent years.

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11
Q

What is the clinical presentation of Covid-19

A

Infection with SARS-CoV-2 often presents quite similarly to other viral influenza-like illnesses. It is also possible that those who are infected may present with little to no symptoms at all. For this reason, testing is encouraged to determine whether or not symptoms are due to COVID-19 infection and to guide further management. Criteria for testing and isolation vary from jurisdiction to jurisdiction.

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12
Q

What is the gold standard testing for Covid-19?

A

Molecular testing

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13
Q

Is a reactive result on a RAT considered diagnostic of Covid?

A

Yes!

A reactive result on a rapid antigen test should be considered a positive diagnosis; a negative result may mean that the person has tested too soon or insufficient sample, and retesting daily for 3-5 consecutive days when symptoms are present can be helpful. Swabbing the cheeks and back of the throat before the nasopharynx is recommended for rapid self-testing.

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14
Q

When do patients become symptomatic after exposure to covid?

A

Patients may become symptomatic anywhere from 1-14 days after exposure to the virus, but typically symptoms appear between 3-7 days

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15
Q

What symptoms can Covid-19 show?

A

-Sore throat
- Runny nose
- Sneezing
- New or worsening cough
- shortness of breath or difficulty breathing
- Temperature equal to or more than 38degree C
- Feeling feverish
- Chills
- Fatigue or weakenss
- Muscle or body aches
- New loss of smell or taste
- Headache
- Abdominal pain, diarrhea, nausea, and vomiting
- Feeling very unwell

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16
Q

What are other manifestations of severe disease of covid?

A
  • myocarditis
  • HEart failure
  • Myocardial infarction, stroke, other thromboembolic events
  • Acute kidney injury
  • ARDS
  • Mutiple organ failure
17
Q

Describe the difference between:
1. Asymptomatic or pre-symptomatic
2. Mild illness
3. Moderate illness
4. Severe illness
5. Critical illness

A
18
Q

For patients with non-severe disease, how does WHO stratify treatment decisions according to their risk for requiring hospitalization admissions?

A
19
Q

What % of patients wil mild covid-19 not admitted to hospital have symptoms lasting more than 4 weeks?

A

10% may have “long covid” symptoms

20
Q

What are the most commonly reported long-covid symptoms?

A
  • Respiratory: cough, shortness of breath
  • Cardiac: chest pain, palpitations
  • ENT: anosmia, dysgeusia
  • Musculoskeletal: arthralgia
  • Neurologic: fatigue, headache, memory loss, cognitive difficulty
  • Psychiatric: depression, insomnia
  • Other: physical limitations of normal activity
21
Q

What types of symptoms do elderly individuals experience if having long covid?

A

Of note is that elderly, frail individuals may experience gradual or ongoing decline in function, persistent deconditioning, worsening frailty, new or worsening dementia, and loss of interest in eating or drinking.

22
Q

What can be done to manage symptoms for patients with acute covid (mild)?

A

Stay well hydrated
Reliably report worsening symptoms (e.g., evaluate language barriers, cognitive status) and carry out their usual activities of daily living
Have access to appropriate resources and social support for self-isolation
Be able to manage any comorbidities at home
Have stable vitals and no signs of respiratory distress or persistent tachypnea
(If pulse oximetry is available) have an SpO2 >93% on room air; an SpO2 of 90–93% on room air may be acceptable if a patient has a pre-existing chronic lung disease

23
Q

What are red flag symptoms that warrant assessment by healthcare provider and consideration for admission to hospital?

A

Trouble breathing
Persistent pain or pressure in the chest
New confusion
Inability to wake or stay awake
Bluish lips or face

Patients with mild symptoms can generally be managed as outpatients. Those with moderate illness may be hospitalized based on risk factors for clinical progression to more severe infection. Severe illness requiring hospitalization may include symptoms of pneumonia, hypoxemia and acute respiratory distress syndrome (ARDS), sepsis and septic shock, cardiomyopathy, arrhythmia, or acute kidney injury.

Patient assessment and treatment should always be conducted with consideration to patient preference and values. These are important tools in clinical decision making and should guide treatment location and complexity/invasiveness of intervention.

24
Q
A