This PowerPoint is made on 2020's November

1. Overview On
Covid19 Pandemic
Prepared By :
Rasan Hakeem
Diyar Dinar
Ilham
Parween Rasheed
University Of Duhok
College Of Medicine
2020/November

2. >Corona Viruses and Covid19
>Virology of Corona Virus
>Modes of transmission
>Epidemiology
>Pathogenesis
> Clinical Features
>Diagnosis
>Classification
>Risk of Infection
>Management & Treatment
>Prevention
>Deferential Diagnosis
>References
Objectives

3. ❑ COVID-19 pandemic is an ongoing pandemic of coronavirus
disease 2019 (COVID-19) caused by -SARS-CoV-2.
❑ COVID-19 is an infectious disease caused by the most recently
discovered coronavirus. This new virus and disease were unknown
before the outbreak began in Wuhan, China, in December 2019 as
pneumonia of unknown cause . Patients were epidemiologically
linked to a seafood and wet animal wholesale market in Wuhan,
Hubei Province, China
❑ In 7 th January COVID-19 as the causative virus
➢ Corona Viruses and Covid19

4. ❑ On January, 30th, 2020, The World Health Organization (WHO)
declared coronavirus disease 2019 (COVID-19) a public health
emergency of international concern
❑ On March 11th, WHO Director General referred to COVID-19
as a pandemic

5. Coronavirus disease in humans (Novel coronaviruses )
• Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) China- 2003
• Middle East Respiratory Syndrome Coronavirus (MERS-CoV) KSA - 2012
• Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) - 2019

6. ➢ VIROLOGY of Coronavirus
❑ Approximately 75 percent of the SARS-CoV2 genome is identical to the
SARS-CoV genome, and the amino acid residues required for receptor
binding are the same between these two viruses; both viruses use the
angiotensin converting enzyme 2 (ACE-2) receptor to infect airway
epithelial cells and endothelial cells.
The coronavirus genome encodes four major
proteins: spike (S), nucleocapsid (N),
membrane (M), and envelope (E).
Enveloped RNA virus
• Spike (S) protein – Mediates receptor binding
and fusion into target ACEII expressing cells of
the body – Major antigen
• Membrane (M) protein – Viral assembly
• Nucleocapsid (N) protein – Regulation of
RNA synthesis – Possible antigen
• Small envelope (E) protein – Viral assembly
and release ACE2 Receptor

7. ➢ Modes Of Transmission
❑ Direct person-to-person transmission is the primary means of
SARS-CoV-2 transmission. It is thought to occur through close-
range contact, mainly via respiratory droplets.

8. ❑ The virus is spread primarily via small droplets from coughing,
sneezing, and talking.
❑ The droplets are usually not airborne; however, those
standing in close proximity may inhale them and become
infected.
❑ People may also become infected by touching a
contaminated surface and then touching their face.
❑ The transmission may also occur through aerosols that can
stay suspended in the air for longer periods of time in
enclosed spaces.
❑ It is most contagious during the first three days after the onset
of symptoms, although spread is possible before symptoms
appear, and from people who are asymptomatic.

9. ➢Epidemiology
❑ Incubation time for COVID-19 between 2 and 14 days has
been recorded by the WHO
❑ As of 29 September 2020, more than 33.4 million cases have
been reported worldwide, although the true number of cases is
likely to be much higher.
❑ A better indicator for case spread is the more than 1 million
deaths attributed to COVID-19.
❑ The epidemiology report covers four areas: current
epidemiology situation and global confirmed cases, populations
at risk, case fatality rate, and data limitations.

13. ❑The pandemic has caused
global social and economic disruption, including the largest global
recession since the Great Depression. According to estimations, up
to 100 million people have fallen into extreme poverty and global
famines are affecting 130 million people. It has led to the
postponement or cancellation of sporting, religious, political,
and cultural events, widespread supply shortages exacerbated
by panic buying, and decreased emissions of pollutants and
greenhouse gases. Educational institutions have been partially or
fully closed, with many switching to online
schooling. Misinformation about the virus has circulated through
social media and mass media. There have been many incidents of
xenophobia and racism against Chinese people and against those
perceived as being Chinese or as being from areas with high
infection rates.

14. ➢ Covid19 Clinical features
❑ Most common symptoms:
fever
dry cough
tiredness
❑ Less common symptoms:
aches and pains
sore throat
diarrhoea
conjunctivitis
headache
loss of taste or smell
a rash on skin, or discoloration of fingers
Serious symptoms:
difficulty breathing or shortness of breath
chest pain or pressure
loss of speech or movement

15. ➢ High-Risk Populations
The virus that causes COVID-19 infects people of all ages.
However, evidence to date suggests that two groups of people are
at a higher risk of getting severe COVID-19 disease:
❑ Older people (people over 70 years of age)
❑ People with serious chronic illnesses such as:
• Diabetes
• Cardiovascular disease
• Chronic respiratory disease
• Cancer
• Hypertension
• Chronic liver disease

16. ➢ Diagnosis
Viral testing
Reverse transcription polymerase chain reaction
Isothermal amplification assays
Antigen
Imaging
Antibody tests
Rapid diagnostic test (RDT)
Enzyme-linked immunosorbent assay (ELISA)
Neutralization assay
Chemiluminescent immunoassay
Neutralizing vs. binding antibodies

17. Symptoms were categorized as follows:
❑ Mild cases: The majority (81%) of these coronavirus disease
cases were mild cases include all patients without pneumonia
or cases of mild pneumonia.
❑ Severe cases: This includes patients who suffered from
shortness of breath, respiratory frequency ≥ 30/minute, blood
oxygen saturation ≤93%, PaO2/FiO2 ratio <300,30 and/or lung
infiltrates >50% within 24–48 hours.
❑ Critical cases: Include patients who suffered respiratory failure,
septic shock, and/or multiple organ dysfunction or failure.
➢ Classification

18. ❑ The Case fertility rate (CFR) was 0.9% for those without a
preexisting health condition & for young ages.
❑ The CFR was 10% for those with underlying health conditions
& for old ages.
❑ Fulminant myocarditis has also been reported in patients with
Covid-19 which is caused by virus. It arises quickly, progresses
rapidly, and may lead to severe heart failure or circulatory
failure presenting as rapid-onset hypotension and cardiogenic
shock, with mortality rates as high as 50%–70%.
❑ Physicians should pay attention not only to the symptoms of
respiratory dysfunction but also the symptoms of cardiac
injury.
➢ Risk of Infection

19. ➢ Management & Treatment
❑ Currently, there is no drug that is recommended by
specialized organizations to treat Covid 19, and Antibiotics are
ineffective against viral infections, such as COVID-19.
❑ The US Food and Drug Administration (FDA) has authorized
the emergency use of the antiviral drug (remdesivir) to treat
Covid-19. also recommended the use of corticosteroid
(dexamethasone) for people with Covid-19 who need
additional oxygen, but only Under medical attention, it causes
a lot of side effects.

20. ❑ Plasma is collected from blood donated by people who have
recovered from Covid 19.
❑ A supportive care approach focuses on relieving symptoms and
may include:
❑ Pain relievers (ibuprofen, acetaminophen)
❑ Cough syrup
❑ Comforts
❑ Drink fluids
❑ In case of shortness of breath needs a ventilator
❑ If the symptoms are mild, does not need any medication, just
stay in isolation, avoid people, and take a lot of rest

21. ➢ Prevention

22. Vaccines
❑ There are currently no approved vaccines to treat
Covid-19
❑ The followings are the main list of candidate
vaccines .
❑ Inovio Vaccine, USA (Phase I / II)
❑ Moderna Vaccine, USA (Phase III)
❑ Curvac vaccine, Germany (phase 1)
❑ Pasteur Institute / Merck / Thymes Vaccine, France / USA / Austria (pre-
clinical trial)
❑ AstraZeneca Vaccine / University of Oxford, United Kingdom and Northern
Ireland (phase III)
❑ University of Hong Kong vaccine, China (pre-clinical trial)
❑ Novavax Vaccine, USA (Phase I / II)
❑ Clover Biopharma Vaccine, China (Phase 1)
❑ The University of Queensland Vaccine / CSL Laboratories, Australia (Phase
1)

23. ➢ Differential Diagnosis
Differential diagnosis should include the possibility of a wide range
of common respiratory disorders such as:
❑ Other Coronaviruses (SARS, MERS)
❑ Adenovirus
❑ Influenza
❑ Human metapneumovirus (HmPV)
❑ Parainfluenza
❑ Respiratory syncytial virus (RSV)
❑ Rhinovirus (common cold)
❑ Bacterial pneumonia, mycoplasma pneumonia (MPP) and
chlamydia pneumonia.
Differentiation should also be made from lung disease caused by other diseases. A
CT scan has great value in early screening and differential diagnosis for COVID-19 .

24. ➢ References
❑ Zhu N
, Zhang D
, Wang W
, et al; China Novel Coronavirus Investigating and
Research Team. A novel coronavirus from patients with pneumonia in China,
2019. N Engl J Med. 2020;382(8):727-733.
doi:10.1056/NEJMoa2001017PubMedGoogle ScholarCrossref
❑ "Q&A: How is COVID-19 transmitted?". World Health Organization (WHO). Retrieved 12
July 2020.
❑ Transmission of COVID-19". European Centre for Disease Prevention and Control. Retrieved 12
September 2020.
❑ "COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins
University (JHU)". ArcGIS. Johns Hopkins University.
❑ "Quarantine for coronavirus (COVID-19)". Australian Government Department of Health.
Retrieved 25 September2020.