This document provides an epidemiological profile and overview of diagnostic methodologies for SARS-CoV-2. It discusses the first reported case in Wuhan, China in December 2019, describes the virus's transmission and stability on surfaces. Clinical features include fever, cough and shortness of breath, with severe cases progressing to pneumonia and ARDS. At risk groups are the elderly and those with pre-existing conditions. Diagnosis involves RT-PCR testing of nasopharyngeal or oropharyngeal swabs, with chest CT also useful. The document outlines sample collection, storage, and testing procedures.
This is a kind of seminar presentation that covers the basic information about COVID 19 including virus origin, the molecular structure of the virus. It also presents adequate information on the outbreak happened all over the world and the mathematical model for prediction of what will happen later. The other part of the presentation contains a cellular mechanism of how the virus invades our body. Finally, treatment strategies are clarified.
Rekha Dehariya (M.Sc nursing 1st year) Bhopal Nursing College, Bhopal
Covid -19 has effected broud number of people all over the world. the health education is necessary to aware people about it.
Corona virus disease-2019 (Covid-19 outbreak) epidemiology prevention and con...Arun Singh
This PPT is created and updated on 14 February 2020 and it is about the epidemiology of Corona Virus Disease-19, Its preventive measures were also given, useful for department of Community Medicine
This is a kind of seminar presentation that covers the basic information about COVID 19 including virus origin, the molecular structure of the virus. It also presents adequate information on the outbreak happened all over the world and the mathematical model for prediction of what will happen later. The other part of the presentation contains a cellular mechanism of how the virus invades our body. Finally, treatment strategies are clarified.
Rekha Dehariya (M.Sc nursing 1st year) Bhopal Nursing College, Bhopal
Covid -19 has effected broud number of people all over the world. the health education is necessary to aware people about it.
Corona virus disease-2019 (Covid-19 outbreak) epidemiology prevention and con...Arun Singh
This PPT is created and updated on 14 February 2020 and it is about the epidemiology of Corona Virus Disease-19, Its preventive measures were also given, useful for department of Community Medicine
COVID-19 (coronavirus disease 2019) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), previously known as 2019 novel coronavirus (2019-nCoV), a strain of coronavirus. The first cases were seen in Wuhan, China in December 2019 before spreading globally. The current outbreak was recognized as a pandemic on 11 March 2020.
The non-specific imaging findings are most commonly of atypical or organizing pneumonia, often with a bilateral, peripheral, and basal predominant distribution. No effective treatment or vaccine exists currently (March 2020).
Corona Virus and Reinfection(Second Time Infection)Apurv Charles
You may think that the one “positive” of testing positive for the COVID-19 causing coronavirus (SARS-CoV2) and surviving would be that you won’t get infected by that virus again.
At least not during this pandemic.
Ah, but is this assumption really true? Will you indeed be immune to the SARS-CoV2 after you’ve recovered from a COVID-19 infection?
Some reports out of Japan and China seem to suggest otherwise.
The February 14 article from Caixin, a Beijing, China-based media group, that was entitled “14% of Recovered Covid-19 Patients in Guangdong Tested Positive Again.” Umm, 14% would seem more like an “ooop” than an “ooops.”
"Remember though, these are news reports and not scientific studies yet. "
In COVID-19 any antiviral is more effective when used early in first week of illness.
What should not be used in covid-19 is also discussed in presentation.
COVID-19 (coronavirus disease 2019) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), previously known as 2019 novel coronavirus (2019-nCoV), a strain of coronavirus. The first cases were seen in Wuhan, China in December 2019 before spreading globally. The current outbreak was recognized as a pandemic on 11 March 2020.
The non-specific imaging findings are most commonly of atypical or organizing pneumonia, often with a bilateral, peripheral, and basal predominant distribution. No effective treatment or vaccine exists currently (March 2020).
Corona Virus and Reinfection(Second Time Infection)Apurv Charles
You may think that the one “positive” of testing positive for the COVID-19 causing coronavirus (SARS-CoV2) and surviving would be that you won’t get infected by that virus again.
At least not during this pandemic.
Ah, but is this assumption really true? Will you indeed be immune to the SARS-CoV2 after you’ve recovered from a COVID-19 infection?
Some reports out of Japan and China seem to suggest otherwise.
The February 14 article from Caixin, a Beijing, China-based media group, that was entitled “14% of Recovered Covid-19 Patients in Guangdong Tested Positive Again.” Umm, 14% would seem more like an “ooop” than an “ooops.”
"Remember though, these are news reports and not scientific studies yet. "
In COVID-19 any antiviral is more effective when used early in first week of illness.
What should not be used in covid-19 is also discussed in presentation.
This presentation discusses COVID-19. It covers etiology, epidemiology, pathophysiology, clinical features, diagnosis, clinical management and treatment of COVID-19. It also discusses the effects of COVID-19 on pregnancy,how it manifests and how it is diagnosed and how it is managed. Hope this will help you.
Covid 19--EMERGING AND FUTURE CHALLENGES FOR DENTAL SURGEONSOUMENDU KARAK
CORONAVIRUS (COVID-19)-EMERGING AND FUTURE CHALLENGES FOR DENTAL SURGEON.THE SLIDE DESCRIBE BRIEFLY ABOUT VIRUS,ITS CLINICAL MANIFESTATION,FATALITY RATE, MANAGMENT AND HOW WE OVERCOME FROM PRESENT SITUATION.
Coronavirus disease caused by severe acute respiratory syndrome coronavirus2 is an infectious disease was firstly reported in Wuhan, Hubei province china in December 2019. More than 2.7 million cases have been testified in 185 countries and territories resulting more than 206000 deaths and 865000 people have recovered. Since 2019 this disease has spread globally, resulting in the ongoing 2019-20 corona virus disease.
CORONA UPDATE 6
Compiled by Dr. Narendra Malhotra, Dr. Neharika Malhotra, Dr. Jaideep Malhotra, Dr. Keshav Malhotra
Special Inputs
CORONA INDIA IN JULY
by Prof. K. K. Aggarwal
Corona viruses are a group of viruses that infect human & birds. Human corona virus is enveloped, single stranded, positive sense RNA virus. Only seven strain of corona virus are infect man, in which four are circulating in human population.
Novel corona virus 2019 (nCoV2019) is a newly identified human corona virus that has 94% similarity of SARS corona virus. The outbreak of this virus was reported to on 31 December, 2019. The WHO declared the outbreak as a public health emergence of international concern on 23 January. prevention is better than cure.
No vaccine is available.
There is no vaccine available to prevent this infection,
Covid-19 is an infectious disease caused by SARS-CoV-2. mechsnism, pathogenesis and causes, transmission,symptoms and therapeutic strategies
Published by karuna raghuwanshi,M.pharma II semester (pharmaceutics),Pharmacy department.
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Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
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2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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3. ZERO CASE
57 years old female, Wei Guixian.
Shrimp seller in Wuhan city of China.
On 10 December 2019 she developed cold, lethargy
Fully recovered in January month
4. SARS-COV-2
It’s a zoonotic virus.
Bats appear to be the reservoir of COVID-19 virus.
It belongs to large family of enveloped , positive strand of RNA viruses.
Divided into 4 genera: alpha, beta, delta, and gamma
alpha and beta CoVs infect humans
It is betacorona virus which has RNA dependant RNA polymerase.
It enters human cells through ACE 2 receptors.
7. COVID DATES
12 December 2019: 1st case of COVID-19 reported in Wuhan city, Hubei province of China
31 Dec’ 2019: Chinese authorities alerted WHO about cases of Pneumonia of unknown
etiology.
01 Jan’ 2020: Wuhan Seafood Market closed by Chinese authorities.
03 Jan’ 202: India notified by WHO regarding the outbreak
07 Jan, nCoV identified as the causative organism
12 Jan Wuhan’s First death due to Novel Corona Virus
11 February 2020, WHO announced a name for the new coronavirus disease: COVID-19.
11 March, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic.
As on 27 April, 213 countries affected. 2,810,325 confirmed cases, 193,825 deaths
8. Mortality increases with age, with the highest mortality among people over 80 years of age (CFR 21.9%).
The CFR is higher among males compared to females (4.7% vs. 2.8%). By occupation, patients who
reported being retirees had the highest CFR at 8.9%. While patients who reported no comorbid
conditions had a CFR of 1.4%, patients with comorbid conditions had much higher rates: 13.2% for those
with cardiovascular disease, 9.2% for diabetes, 8.4% for hypertension, 8.0% for chronic respiratory
disease, and 7.6% for cancer.
9. FOUR EPIDEMIOLOGICAL AREAS
In areas without cases,
the strategy in these areas is to "strictly prevent introduction". This includes quarantine arrangements in
transportation hubs, monitoring for temperature changes, strengthening of triage arrangements, use of fever
clinics, and ensuring normal economic and social operations.
In areas with sporadic cases,
the strategy is focused on "reducing importation, stopping transmission and providing appropriate treatment".
In areas with community clusters,
the strategy is focussed on "stopping transmission, preventing exportation, and strengthening treatment".
In areas with community transmission,
the strictest prevention and control strategies are being implemented, the entry and exit of people from these
areas has been stopped and public health and medical treatment measures are comprehensively strengthened.
11. CONFIRMED CASE
A person with laboratory confirmation of COVID-19
infection, irrespective of clinical signs & symptoms.
12. CONTACT
A contact is a person who experienced any one of the following
exposures during the 2days before and the 14days after the onset
of symptoms of a probable or confirmed case :
1. Face to face contact with a probable / confirmed case within
1meter and for more than 15mins;
2. Direct physical contact with a probable / confirmed case;
3. Direct care for a patient with a probable / confirmed COVID-19
disease without using proper personal protective equipments;
17. CYTOKINE STORM
Cytokine storm (CS) refers to excessive and uncontrolled release of pro-inflammatory cytokines.
Clinically, it commonly presents as systemic inflammation, multiple organ failure, and high inflammatory
parameters.
In infectious diseases, CS usually originates from the focal infected area, spreading all over the body
through circulation.
In COVID-19,accompanied by rapid virus replication, a large number of inflammatory cell infiltration and
CS led to acute lung injury, acute respiratory distress syndrome (ARDS) and death.
In a study by immunologist in China, they measured cytokine levels in 41 inpatients (including 13 ICU
patients and 28 non ICU patients), IL-1B, IL-1RA, IL-7, IL-8, IL-9, IL-10, fibroblast growth factor (FGF),
granulocyte-macrophage colony stimulating factor (GM-CSF), IFNγ, granulocyte-colony stimulating
factor (G-CSF), interferon-γ-inducible protein (IP10), monocyte chemoattractant protein (MCP1),
macrophage inflammatory protein 1 alpha (MIP1A), platelet derived growth factor (PDGF), tumor
necrosis factor (TNFα), vascular endothelial growth factor (VEGF) were increased.
18. CONTD…
Most of severe COVID-19 patients in our ICU ward had persistent very high
level of erythematosus sedimentation rate (ESR), CRP, and high level of IL-
6,TNFα, IL-1β, IL-8, IL2R, etc., and were associated with ARDS,
hypercoagulation and disseminated intravascular coagulation (DIC),
manifested as thrombosis, thrombocytopenia, gangrene of extremities.
Autopsy findings revealed destruction of secondary lymphoid organs, spleen
atrophy, the number of lymph nodes decreased, diffuse alveolar damage in
lung.
As we know that 2019-nCoV infects target cells through angiotensin
converting enzyme 2 (ACE2), while there was no ACE2 expression on
lymphocytes, we speculate that lymphocytes were probably destroyed by CS.
20. CONTD…
Presymptomatic people are infectious.
Patients may be infectious 1 to 3 days before symptom onset and that up
to 40 to 50% of cases may be attributable to transmission from asymptomatic
or presymptomatic people.
Just before or soon after symptom onset, patients have high nasopharyngeal
viral levels, which then fall over the course of approximately 1 week.
Patients with severe disease may shed the virus for longer periods
(Ref: nejm/corona)
21.
22. AEROSOL & SURFACE STABILITY OF SARS COV 2
Aerosol - 3hours
Plastic - 72hrs
Stainless steel - 48hrs
Copper - 4hrs
Cardboard - 24hrs
(Ref: nejm/corona)
Survivability outside body:
• 1-2 days on nonporous surfaces
• 8-12 hours on porous surfaces
• Currently this information on 2019-
nCoV not clear
Incubation period:
Current estimates of the incubation period of
SARS-CoV-2 range from 2-14 days.
23. RISK FACTORS
Older age ( > 65 yrs)
Chronic lung disease
Cardiovascular disease
Hypertension
Diabetes mellitus
Obesity
End stage renal disease
Immunocompromised state
Liver disease
Male gender*
24. AGE DISTRIBUTION OF CASES IN CHINA (N=72,314)
0-9
=0.9%
10-29 =9.3%
30-39 =17.0%
40-49 =19.2%
50-59 =22.4%
>60=31.2%
• Median age: 51 years
• Range= 2 days-100 years
• Males: 51%
• Health care workers: 3.8%
88% reported from Hubei
30. CANDIDATES FOR SAMPLE COLLECTION
All symptomatic individuals who have undertaken international travel in the
last 14 days .
All symptomatic contacts of laboratory confirmed cases .
All symptomatic health care workers .
All patients with Severe Acute Respiratory lllness (fever AND cough and/or
shortness of breath) .
Asymptomatic direct and high-risk contacts of a confirmed case should be
tested once between day 5 and day 14 of coming in his/her contact.
31. SAMPLE COLLECTION
Most important step in lab diagnosis
A. Upper respiratory tract
Nasopharyngeal (NP) swab/oropharyngeal (OP) swab
B. Lower respiratory tract
Bronchoalveolar lavage, tracheal aspirate, pleural fluid, lung biopsy
32. CONTD…
Nasopharyngeal swab:
Insert flexible wire shaft minitip swab through the nares parallel to the palate (not upwards)
Swab should reach depth equal to distance from nostrils to
outer opening of the ear
Gently rub and roll the swab.
Leave swab in place for several seconds to absorb secretions.
Slowly remove swab while rotating it.
33. CONTD…
Oropharyngeal swab (e.g., throat swab):
Insert swab into the posterior pharynx and tonsillar areas.
Rub swab over both tonsillar pillars and posterior oropharynx and avoid touching the
tongue, teeth, and gums.
Combined nasal & throat swab:
Tilt patient’s head back 70 degrees. While gently rotating the swab, insert swab less than
one inch into nostril (until resistance is met at turbinates). Rotate the swab several times against
nasal wall and repeat in other nostril using the same swab. Place tip of the swab into sterile viral
transport media tube and cut off the applicator stick. For throat swab, take a second dry
polyester swab, insert into mouth, and swab the posterior pharynx and tonsillar areas (avoid the
tongue). Place tip of swab into the same tube and cut off the applicator tip.
34. STORAGE
Store specimens at 2-8°C for up to 72 hours after collection.
If a delay in testing or shipping is expected, store specimens at -
70°C or below.
35. RT-PCR DIAGNOSTIC PANEL
2019-nCoV_N1, 2019-nCoV_N2 and 2019-nCoV_N3 primers and
probes that target the nucleocapsid (N) gene and are designed for
both universal detection of SARS-like coronaviruses as well as
specific detection of the 2019-nCoV;
RP primers and probes that target the Human RNase P gene; and
nCoVPC, the 2019-nCoV positive control used in the assay.
36. SENSITIVITY & SPECIFICITY
SENSITIVITY
For the nCoV_IP and E_Sarbeco real-timeRT-PCR Sensitivity, in terms of 95% hit
rateis about 100 copies of RNAgenome equivalent per reaction (thisamount of target
sequences is always detected), the probability to detect lower amountsof virus
decreases, but samples containing 10 copies could be detectedwithmultiplex assay.
SPECIFICITY
Cross-reactivity with other respiratory viruses was tested withspecimens known to be positive for
a panel of respiratory viruses (influenza A(H1N1)pdm09, A(H3N2), B-Victoria, B-
Yamagata; influenzaC; RSV A, B; hBoV; hPIV; hMPV; HRV/enterovirus; adenovirus; hCoV
(HKU1, OC43, 229E and NL63); MERS-CoV. None of the tested viruses showed reactivity
with PCR2 and PCR4.
37. ROLE OF CT CHEST
Chest CT has been suggested to possess the potential to diagnose COVID-19
with significant sensitivity & even screen asymptomatic patient.
Sensitivity – 97%
Specificity – 25%
Chest CT is necessary even if RT PCR is negative