COVID-19 Insights: COVID-19 (by SARS-COV-2/Coronavirus) Signs, Symptoms and Management

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  • Published on:  Wednesday, March 18, 2020
  • Diseases lasts 2 weeks on average in 81% of the population
    In 14% that become serious it can go on from 2 weeks to 6 weeks
    in 5% critical cases it can go from 2 to 8 weeks

    Asymptomatic
    Youngsters
    And, incubation time
    Median incubation time is 5.1 days

    Symptoms at onset*:
    Fever (98%),
    Dry cough (76%)
    Fatigue & myalgia (44%)
    Sputum production (28%)
    Headache (8%)
    Haemoptysis (5%)
    Diarrhoea (3%)
    Subsequent symptoms: dyspnoea (25%)

    Mild cases: The majority (81%) of these coronavirus disease cases were mild cases. 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 lesser than 300, and/or lung infiltrates greater than 50% within 24–48 hours. 

    PaO2 (partial pressure of oxygen)
    FiO2 (fraction of inspired oxygen)
    PaO2/FiO2 is called Horowitz index, or Carrico index and the PF ratio


    Critical cases: Critical cases include patients who suffered respiratory failure, septic shock, and/or multiple organ dysfunction or failure.



    Management
    Supportive management

    Antivirals for COVID-19
    According to the WHO
    There are no known effective antivirals for coronavirus infections.
    • Various candidates with potential anti-nCoV activity are being evaluated for clinical trial protocols (see module 15).
    • Use of unregistered or unproven therapeutics for nCoV should be done under strict monitoring and ethical approval.
    – Use WHO Monitored Emergency Use of Unregistered Interventions (MEURI) framework (see module 15)

    Remdesivir
    https://www.sciencemag.org/news/2020/...

    https://www.drugtargetreview.com/news...

    Remdesivir cripples an enzyme called RNA polymerase that is used by many viruses to copy themselves; it does not specifically target SARS-CoV-2, the virus that causes COVID-19.

    Article being critical of the remdesivir efficacy
    https://www.statnews.com/pharmalot/20...


    Chloroquine
    Antimalarial and HIV medicine
    Makes the cell organelle less acidic (raises their pH which interferes with the virus replication.)
    It also interferes with the terminal glycosylation of the ACE2 receptor negatively influencing the virus receptor binding
    https://virologyj.biomedcentral.com/a...
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