This document provides an overview of Covid-19, including its structure, symptoms, treatments, and impact on cardiovascular patients and those with diabetes. Key points include: - Covid-19 is caused by a novel coronavirus that emerged in China in late 2019 and was declared a pandemic in March 2020. - It primarily spreads through respiratory droplets and can have an incubation period of 2-14 days. Common symptoms include fever, cough and fatigue. - While there is no specific treatment, supportive care is used. Risk of death increases with age and presence of comorbidities like cardiovascular disease and diabetes. - Proper hand hygiene and mask usage can help prevent transmission of the virus. Those over 60 and with

1. Prepared by: Chandrima Das

2. Table of Contents
Serial. Number Contents Slide No
1 Introduction 3-4
2 What is Covid-19? 5
3 Structure of Covid-19 6
4 Covid-19 Scenario Worldwide 7
5 Covid-19: 10 most affected Countries 8
6 Incubation Period/Mode of Transmission 9
7 Symptoms 10
8 Treatments Used 11
9 How to prevent yourself from getting infected? 12-13
10 Fatality Rate by Age and Sex 14
11 Risk Factors related to Covid-19 15
12 Cardiovascular patients and Covid-19 16
13 Diabetes and Covid-19 17-18
14 What is our learning? 19
15 Conclusion 20

3. Introduction
According to WHO; Covid-19 is a severe infectious disease caused by a newly
discovered coronavirus.
Coronaviruses are positive-sense RNA virus which are important pathogens of
birds and mammals.
They are classified into four types- Alphacoronavirus, Betacoronavirus,
Gammacoronavirus and Deltacoronavirus.
Alpha and Beta Coronaviruses are found exclusievly in mammals whereas
gamma and delta coronaviruses mainly infect birds.
Source: Wertheim et.al; A case for the Ancient Origin of Coronavirusess
Image Source: Shutterstock

4. Continued…
The identification of Severe Acute Respiratory Syndrome (SARS) coronovirus in 2003 led to the intense search of novel coronavirus in humans,
domesticated animals and wildlife.
Middle East Respiratory Syndrome (MERS) is another form of coronavirus that was first reported in Saudi Arabia in September 2012.
Source: Wertheim et.al; A case for the Ancient Origin of Coronaviruses.

5. What is Covid-19?
Covid-19 is a novel coronavirus which has recently been detected (December 2019) in Wuhan City, Hubei province, China.
World Health Organization declared Covid-19 as global pandemic on 11th March 2020.
It’s outbreak involved 230 countries with predominant disease load in Italy, Vietnam, Macau, South Korea, Iran and Hong Kong.
Severe Acute Respiratory Syndrome(SARS) coronavirus in 2003 and Middle East Respiratory Syndrome (MERS) in 2012 originated in bats and it is more
likely that Covid-19 did as well.
Source: Sahu et.al; COVID-2019: update on epidemiology, disease spread and management.

6. Structure of Covid-19
The virion of Covid-19 is approximately 50-200 nm in diameter.
It consists of atleast four known structural proteins: spike (S) protein, envelope (E)
protein, membrane (M) protein, and nucleocapsid (N) protein.
The S protein is responsible for promoting host attachment and virus-target cell
membrane fusion during virus infection.
The M protein is the most abundant one and interacts with all the major structural
proteins in the coronavirus.
The E protein is the smallest one and most important for viral replication.
Source: Yamamoto et. al; Covid-19: Review of a 21st Century Pandemic from Etiology to Neuro-psychiatric Implications.

7. Covid-19 Scenario Worldwide
Total Covid-19 cases
(Worldwide)
84,442,981
Active Cases
22,876,735
Closed Cases
61,566,246
Mild cases
22,770,309 (99.5%)
Critical Cases
106,621 (0.5%)
Recovered/Discharged
59,729,786 (97%)
Deaths
1,836,586 (3%)

8. Covid-19:Top 10 Most Affected Countries Worldwide
Country Cases Deaths Region
United States 20,617,346 356,445 North America
India 10,305,788 149,218 Asia
Brazil 7,700,578 195,441 South America
Russia 3,212,637 58,002 Europe
France 2,639,773 64,765 Europe
United Kingdom 2,542,065 74,125 Europe
Turkey 2,220,855 21,093 Asia
Italy 2,129,376 74,621 Europe
Spain 1,936,718 50,837 Europe
Germany 1,762,525 34,519 Europe

9. Incubation Period/Mode of Transmission
According to Centre of Disease Control and Prevention
(CDC), the mean incubation period for Covid-19 is 1.5
days (range 2-14 days).
Studies showed that 95% of patients had incubation
ranging from 2.1 to 14.7 days.
World Health Organization (WHO), thus set the
quarantine period for 14 days.
The major transmission of Covid-19 virus are through
close or direct contact with infected secretions or large
aerosol droplets
Source: Sahu et.al; COVID-2019: update on epidemiology, disease spread and management.

10. Symptoms
The symptoms of the virus appear after an average of 5.2 days.
The period between the onset of symptoms until death ranges from 6-41days , depending upon the age, underlying health complications and immune
system status.
Source: Sahu et.al; COVID-2019: update on epidemiology, disease spread and management
Respiratory
Symptoms:
Fever
Cough
Myalgia
Fatigue
Non –
Respiratory
Symptoms:
Nausea
Diarrhea
Vomiting
Arthralgia
Anosmia

11. Treatments Used
There is no specific antiviral agent approved for Covid-19 till now. However, supportive care to alleviate symptoms is the current approach followed by the
medical centers.
Supportive care includes-
Isolating the patient to a negative pressure isolation room, and providing adequate rest,
hydration,
nutritional support and
electrolyte balance.
However, complicated cases developing respiratory failure, heart failure and septic shock requires high level of care like invasive ventilation,
extracorporeal membrane oxygenation (ECMO), renal replacement therapy and so on.
Source: Sahu et.al; COVID-2019: update on epidemiology, disease spread and management.

12. How to prevent yourself from getting infected?
The importance of maintaining personal hygiene is the most effective solution to
avert the spread of the virus.
Centre for Disease Control and Prevention (CDC) recommends at least 20 seconds
of effective engagement in hand washing.
The washing of hands with soap and handwashes can thereby make it difficult for
the virus to infect human cells.
Use of sanitizers frequently is also equally important to get rid of the virus.
Source: Sahu et.al; COVID-2019: update on epidemiology, disease spread and management.
Image Source: Shutterstock

13. Continued…
Wearing a mask
Surgical Mask
Loose fitting, disposable device.
Prevents large droplets and splashes.
Acts as a physical barrier.
One way protection- catches bodily fluid leaving the wearer.
One time use. Not needed for general population who are healthy.
N95 Mask
Close facial fit.
Efficient filtration of airborne particles.
N95 means-95% of very small (0.3 micron) particles.
Two way protection- It filters the air breathed in.
One time use. Not needed for healthy population.
Source: Sahu et.al; COVID-2019: update on epidemiology, disease spread and management.

14. Fatality Rate by Age and Sex
Fatality rate by Age:
Older individuals are especially at higher risk of dying from COVID-19 as compared
to younger population.
The fatality rate significantly increases in the individuals of more than 60 yrs (3.6%)
as compared to individuals younger than 40 yrs (0.2%).
Fatality Rate by Sex:
According to World Health Organization(WHO)-China Joint Mission statement dated
28 February 2020, there has been a trend showing more males dying to COVID-19 than
females (4.7% vs. 2.8%).
Source: Sahu et.al; COVID-2019: update on epidemiology, disease spread and management.
Fatality Rate by Age
>60years
<40years
Fatality Rate by Sex
Male
Female

15. Fatality Rate by Co-morbidities
According to different studies, hypertension, diabetes mellitus, and
cardiovascular disorders are the most underlying co-morbidities of Covid-19.
As per the WHO-China Joint Mission statement (dated 28 February 2020), the
percentage risk of dying of a COVID-19 patient due to underlying co-morbidities
are-
 Cardiovascular disease (13.2%)
Diabetes mellitus (9.2%)
 Hypertension (8.4%)
 Chronic respiratory disease (8%)
Source: Sahu et.al; COVID-2019: update on epidemiology, disease spread and management.
Risk Percentage
Cardiovascular disease
Diabetes Mellitus
Hypertension
Chronic Respiratory Disease

16. Cardiovascular patients and Covid-19
According to the studies, patients with cardiovascular risk factors like advanced age, hypertension, diabetes, cardiovascular diseases, cerebrovascular
disease had worst clinical outcome.
Advanced age was associated with higher mortality. Studies reported case fatality of 12.8%, 20.2% in patients above age group of 70 and 80
simultaneously.
Cardiovascular risk factors like advanced age, hypertension, diabetes, coronary artery disease, heart failure, atrial fibrillation etc. have been reported to be
associated with increased mortality.
Source: Sahu et.al; COVID-2019: update on epidemiology, disease spread and management.

17. Diabetes And Covid-19
Diabetes may lead to increased risk of death in the covid-19 patients.
The patients with type I diabetes are at significantly higher risk of death than the patients with type II diabetes.
Diabetic patients suffer from low pulmonary function (lung dysfunction) which probably adds up to worsen their condition.
The diabetic patients have thickened lung basal lamina which may influence poor pulmonary function.
The patients suffer from persistent cough, dyspnea and severe breathing problems twice as more than non-diabetic patients.
Sources : 1. Yan et.al. Clinical characteristics and outcomes of patients with severe covid-19 with diabetes.
2. Barron et.al. Associations of type 1 and type 2 diabetes with COVID-19- related mortality in England: a whole population study.

18. Continued….
The death rate was higher in males as compared to females, while the patients who died were mostly of older age more than 65years.
The risk of developing pneumonia is twice as higher in type I diabetic patients than in type II patients.
The patients with diabetes have lower days of survival than non diabetic patients with the days of survival being 10- 13 days for the former and 19- 20 days
for the later.
The patients with severe Covid-19 with diabetes have higher inflammatory response than the others.
Sources: 1.Yan et.al. Clinical characteristics and outcomes of patients with severe covid-19 with diabetes.
2.Barron et.al. Associations of type 1 and type 2 diabetes with COVID-19- related mortality in England: a whole population study.

19. What is our learning?
Personal hygiene is if utmost importance in or without a pandemic. So keeping yourself clean and sanitized is the best way to keep away the virus and any
other disease.
Appreciating nature and keeping a healthy connection with it might help in overcoming such situation in future.
Anxiety and depression triggers bad health. People should try to maintain a stress free life.
Situations like these can be overcome through mutual co-operations, realizing one’s mistakes, shortcomings and deficiencies and respond to a crisis in the
best way possible.

20. Conclusion
The outbreak of Covid-19 has emerged as one of the grievous public health threat to the entire
world.
It has been affecting human lives and various industrial sectors leading to global economic
breakdown.
Rapid urbanization and invasion into forest habitats has created an interface among human
beings and other living organisms which exposed humans with many unfamiliar organisms
which also involves its consumption.
Covid-19 has reported greater incidence of panic disorder, anxiety, depression and other
psychosocial issues.

21. Thank You