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Covid 19
1. COVID-19
B I L A L M A N Z O O R
P H A R M - DBILAL MANZOOR (PHARM-D) billskhan786@gmail.com
2. CONTENTS;
• INTRODUCTION
• GENERAL HUMAN
RESPIRATORY SYSTEM
• GENERAL PHYSIOLOGY OF
COVID-19
• PATHOGENESIS OF COVID-19
• SIGN AND SYMPTOMS
• MANAGEMENT
• PHARMACOTHERAPY PLAN
• PREVENTION
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3. INTRODUCTION:
Coronavirus disease (COVID-19) is an infectious disease
caused by a new virus. The disease causes respiratory
illness (like the flu) with symptoms such as a cough, fever,
and in more severe cases, difficulty breathing. It is mainly
found in avian and mammalian species. Coronavirus
disease spreads primarily through contact with an
infected person when they cough or sneeze. It also
spreads when a person touches a surface or object that
has the virus on it, then touches their eyes, nose, or
mouth.
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5. GENERAL PHYSIOLOGY OF COVID-19
Spherical or
pleomorphic(variation in
shape and size), enveloped
particles containing single-
stranded (positive-sense)
RNA associated with a
nucleoprotein within a
capsid comprised of
matrix protein. The
envelope bears club-
shaped glycoprotein
projections.
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6. PATHOGENESIS OF COVID-19
After the virus enters the body, it needs a special receptor to help it enter the
cell. This receptor is called (Angiotensin Converting Enzymes_2) Symbolized
by ACE_2. The ACE_2 is present on the surface of the alveolar cells in the
lung. We have 3 types of alveolar cells:
Type1: Responsible for gas exchange.
Type2: It is responsible for producing "surfactant" which is a mixture of
proteins and fats that reduce the surface tension of the alveoli.
Type3: Dust cell, which is macrophages.
The ACE_2 is found on type2 of these cells.
Corona virus envelope contains proteins called spikes and special (S_Spike)
that help the virus bind to ACE_2.
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7. When the association occurs, the genetic material of the
virus enters the cell and the cell is harnessed to produce
viral proteins, thus the virus multiplies and the cell dies.
When (type 2 alveolar cells) die, they release substances
called specific inflammatory mediators.
These substances stimulate the existing immune cells
"macrophages" and
when they stimulate the macrophages, they secrete 3
immune substances called "cytokines" which are:
• Interleukin_1 (IL_1)
• Interleukin_6 (IL_6)
• Tumor Necrosis Factor (TNF_α).
These three substances, when they reach the
bloodstream, cause the symptoms associated with
infection with Corona virus.BILAL MANZOOR (PHARM-D) billskhan786@gmail.com
8. SIGNS AND SYMPTOMS;
First - at the level of lungs:
1)These substances cause expansion of the blood vessels surrounding the
vesicle,
as well as increased permeability of the wall of these vessels
🔷Vasodilation
🔷Capillary permeability increased. and thus leads to "alveolar edema",
which leads to
hypoxia and shortness of breath.
2)The loss of surfactant leads to an increase in the surface tension of
the vesicle and consequently leads to Alveolar collapse. It also leads to
Hypoxia and shortness of breath.
3)These three substances also lead to an increase in the flow of
"neutrophils" cells to the place of
the viral infection as an immune response.
BILAL MANZOOR (PHARM-D) billskhan786@gmail.com
9. Neutrophils cells kill some viruses by secreting two substances such
as:
🔷Reactive Oxygen Species "ROS"
🔷Proteases.
But the above articles also destroy some of the alveolar cells
responsible for gaseous
exchange and cause a condition called consolidation that causes
cough symptoms.
Second: At the CNS level:
The three substances "IL_1, IL_6, TNF" go to the "hypothalamus" and
thus increase the body temperature and cause the symptoms of
"Fever".
Third: In the case of severe "SIRS" will occur
Systemic inflammatory response syndrome.
That lead to septic shock.
Also "MODS"
Multiple organ dysfunction syndrome.
Especially the kidney and kidney failure.BILAL MANZOOR (PHARM-D) billskhan786@gmail.com
10. MANAGEMENT AND PHARMACOTHERAPY
On January 28, 2020, the WHO released a document
summarizing WHO guidelines and scientific evidence
derived from the treatment of previous epidemics from
HCoVs.
• Treatment is symptomatic
• no specific antiviral treatment recommended for COVID-19, and no
vaccine is currently available.
• oxygen therapy represents the major treatment intervention for patients
with severe infection. Mechanical ventilation may be necessary in cases of
respiratory failure refractory to oxygen therapy, whereas hemodynamic
support is essential for managing septic shock.
• No corticosteroids or antibiotic approved yet prophylactically.
• several approaches have been proposed such as lopinavir/ritonavir
(400/100 mg every 12 hours), chloroquine (500 mg every 12 hours), and
hydroxychloroquine (200 mg every 12 hours). Alpha-interferon (e.g., 5
million units by aerosol inhalation twice per day) is also used.
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