Covid 19

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COVID 19

Ahmad dalashi
• The virus that causes COVID-19 is designated severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2)
• The structure of the receptor-binding gene region is very similar to that of
the SARS coronavirus, and the virus has been shown to use the same
receptor, the angiotensin-converting enzyme 2 (ACE2), for cell entry.
• In a phylogenetic analysis of 103 strains of SARS-CoV-2 from China, two
different types of SARS-CoV-2 were identified, designated type L (accounting
for 70 percent of the strains) and type S (accounting for 30 percent).
• The L type predominated during the early days of the epidemic in China, but
accounted for a lower proportion of strains outside of Wuhan than in
Wuhan. The clinical implications of these findings are uncertain.
Route of transmission
•  Understanding of the transmission risk is incomplete.
• Person-to-person spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
is thought to occur mainly via respiratory droplets, resembling the spread of influenza.
• With droplet transmission, virus released in the respiratory secretions when a person with
infection coughs, sneezes, or talks can infect another person if it makes direct contact with
the mucous membranes; infection can also occur if a person touches an infected surface
and then touches his or her eyes, nose, or mouth.
• Droplets typically do not travel more than six feet (about two meters) and do not linger in
the air. Although one letter to the editor described a study in which SARS-CoV-2 remained
viable in experimentally generated aerosols for at least three hours, the relevance of this
to the epidemiology of COVID-19 and its clinical implications are unclear
• Given the current uncertainty regarding transmission mechanisms, airborne precautions
are recommended in certain situations. 
• SARS-CoV-2 RNA has been detected in blood and stool specimens.
Live virus has been cultured from stool in some cases, but according
to a joint WHO-China report, fecal-oral transmission did not appear to
be a significant factor in the spread of infection
• Viral RNA levels appear to be higher soon after symptom onset
compared with later in the illness ; this raises the possibility that
transmission might be more likely in the earlier stage of infection, but
additional data are needed to confirm this hypothesis.
• Incubation period — The incubation period for COVID-19 is thought
to be within 14 days following exposure, with most cases occurring
approximately four to five days after exposure.
• In a study of 1099 patients with confirmed symptomatic COVID-19,
the median incubation period was four days (interquartile range two
to seven days)
Spectrum of illness severity
The spectrum of symptomatic infection ranges from mild to critical; most
infections are not severe . Specifically, in a report from the Chinese Center for
Disease Control and Prevention that included approximately 44,500 confirmed
infections with an estimation of disease severity:
●Mild (no or mild pneumonia) was reported in 81 percent.
●Severe disease (eg, with dyspnea, hypoxia, or >50 percent lung involvement on
imaging within 24 to 48 hours) was reported in 14 percent.
●Critical disease (eg, with respiratory failure, shock, or multiorgan dysfunction)
was reported in 5 percent.
●The overall case fatality rate was 4.6%; no deaths were reported among
noncritical cases.

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