CORONA

VIRUS
PRESENTATION PREPARED BY PRAJWAL RAO K, FINAL MBBS, SRI DEVRAJ URS ACADEMY
OF HIGHER EDUCATION AND RESEARCH (SDUAHER), TAMAKA, KOLAR - 563101
 CORONAVIRUS
• Coronaviruses are a group of related viruses that cause diseases in mammals and birds.

• In humans, coronaviruses cause respiratory tract infections that can be mild, such as
some cases of the common cold (among other possible causes, predominantly
rhinoviruses), and others that can be lethal, such as SARS, MERS, and COVID-19.

• Symptoms in other species vary: in chickens, they cause an upper respiratory tract
disease, while in cows and pigs they cause diarrhea.

• There are yet to be vaccines or antiviral drugs to prevent or treat human coronavirus
infections.
 CLASSIFICATION

Unranked Virus
Realm Riboviria
Phylum incertae sedis
Order Nidovirales
Family Coronaviridae
Subfamily Orthocoronavirinae
• The name coronavirus is derived from the Latin corona, meaning "crown" or "halo",
which refers to the characteristic appearance reminiscent of a crown or a solar
corona around the virions (virus particles) when viewed under two-dimensional
transmission electron microscopy, due to the surface covering in club-shaped protein
spikes.

• Coronaviruses are enveloped viruses with a positive-sense single-stranded RNA

genome and a nucleocapsid of helical symmetry.

• The genome size of coronaviruses ranges from approximately 27 to 34 kilobases, the

largest among known RNA viruses.
 DISCOVERY OF VIRUS
• Human coronaviruses were first discovered in the late 1960s.

• The earliest ones discovered were an infectious bronchitis virus in chickens and two in
human patients with the common cold (later named human coronavirus 229E and human
coronavirus OC43).

• Other members of this family have since been identified, including SARS-CoV in 2003, HCoV
NL63 in 2004, HKU1 in 2005, MERS-CoV in 2012, and SARS-CoV-2 (formerly known as 2019-
nCoV) in 2019.

• Most of these have involved serious respiratory tract infections.

 MORPHOLOGY OF VIRUS
• Coronaviruses are large pleomorphic spherical particles with bulbous surface projections.

• The diameter of the virus particles is around 120 nm.

• The envelope of the virus in electron micrographs appears as a distinct pair of electron dense
shells.

• The viral envelope consists of a lipid bilayer where the membrane (M), envelope (E) and spike
(S) structural proteins are anchored.

• A subset of coronaviruses (specifically the members of betacoronavirus subgroup A) also have

a shorter spike-like surface protein called hemagglutinin esterase (HE).
• Inside the envelope, there is the nucleocapsid, which is formed from multiple
copies of the nucleocapsid (N) protein, which are bound to the positive-sense
single-stranded RNA genome in a continuous beads-on-a-string type
conformation.

• The genome size for coronaviruses ranges from approximately 27 to 34 kilobases.

• The lipid bilayer envelope, membrane proteins, and nucleocapsid protect the
virus when it is outside the host cell.
VIRAL REPLICATION
 TRANSMISSION

• Human to human transmission of coronaviruses is primarily thought to occur

among close contacts via respiratory droplets generated by sneezing and coughing.

• The interaction of the coronavirus spike protein with its complement host cell
receptor is central in determining the tissue tropism, infectivity, and species range
of the virus.

• The SARS coronavirus, for example, infects human cells by attaching to the
angiotensin-converting enzyme 2 (ACE2) receptor.
 HUMAN CORONAVIRUSES
• 7 strains of human coronaviruses are known.
4 produce the generally mild symptoms of 3 produce potentially severe symptoms
the common cold
1) Human coronavirus OC43 (HCoV-OC43) 1) Middle East respiratory syndrome-
related coronavirus (MERS-CoV), previously
known as novel coronavirus 2012 and
HCoV-EMC
2) Human coronavirus HKU1 2) Severe acute respiratory syndrome
coronavirus (SARS-CoV or "SARS-classic")
3) Human coronavirus NL63 (HCoV-NL63, 3) Severe acute respiratory syndrome
New Haven coronavirus) coronavirus 2 (SARS-CoV-2), previously
known as 2019-nCoV or "novel coronavirus
2019"
4) Human coronavirus 229E (HCoV-229E)
 Outbreaks of coronavirus-related diseases
OUTBREAK VIRUS TYPE DEATH
1) 2003 severe acute respiratory SARS-CoV 774
syndrome outbreak
2) 2012 middle east respiratory MERS-CoV > 400
syndrome outbreak
3) 2015 middle east respiratory MERS-CoV 36
syndrome outbreak in South Korea
4) 2018 middle east respiratory MERS-CoV 41
syndrome outbreak
5) 2019-2020 coronavirus SARS-CoV-2 > 11,400
pandemic

These are the outbreaks of coronavirus types of relatively high mortality

CORONAVIRUS
DISEASE-2019
(COVID-19)
• Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2).

• The disease was first identified in 2019 in Wuhan, China, and has since spread globally,
resulting in the 2019–20 coronavirus pandemic.

• While the majority of cases result in mild symptoms, some progress to severe pneumonia and
multi-organ failure.

• As of 20 March 2020, the rate of deaths per number of diagnosed cases is 4.1%.

• However, it ranges from 0.2% to 15% depending on age and other health problems.
• TRANSMISSION:

1. The infection is typically spread from one person to another via respiratory droplets
produced during coughing or sneezing.

2. It may also be spread from touching contaminated surfaces and then touching ones face.

• INCUBATION PERIOD:

 Time from exposure to onset of symptoms is generally between 2 and 14 days, with an
average of 5 days.

• DIAGNOSIS:

1. The standard method of diagnosis is by real-time reverse transcription polymerase chain

reaction (rRT-PCR) from a nasopharyngeal swab.

2. The infection can also be diagnosed from a combination of symptoms, risk factors and a
chest CT scan showing features of pneumonia.
 DIAGNOSIS
• The standard method of testing is real-time reverse transcription polymerase chain reaction (rRT-PCR).

• The test can be done on respiratory samples obtained by various methods, including a nasopharyngeal
swab or sputum sample.
• Results are generally available within a few hours to two days.

• A study published by a team at the Tongji Hospital in Wuhan on 26 February 2020 showed that a chest CT
scan for COVID-19 has greater sensitivity (98%) than the polymerase chain reaction (71%).

• False negative results may occur due to PCR kit failure, or due to either issues with the sample or issues
performing the test.
• False positive results are likely to be rare.
• Diagnostic guidelines released by Zhongnan Hospital of Wuhan University suggested methods for
detecting infections based upon clinical features and epidemiological risk.

• These involved identifying people who had at least two of the following symptoms in addition to a
history of travel to Wuhan or contact with other infected people:

1. fever,

2. imaging features of pneumonia,

3. normal or reduced white blood cell count, or

4. reduced lymphocyte count.

 RADIOLOGICAL FINDINGS

• One study in China found that CT scans showed ground-glass opacities

in 56%, but 18% had no radiological findings.

• Bilateral and peripheral ground glass opacities are the most typical CT
findings, though they are non-specific.

• Consolidation, linear opacities and reverse halo sign are other

radiological findings.
 CHEST
RADIOGRAPHICAL
APPEARANCE
Shown are chest radiographs
obtained :
1. at admission (Panel A)
2. on day 3 (Panel B),
3. day 5 (Panel C), and
4. day 6 (Panel D) after admission.
 CT SCANS &
CHEST X-RAY

• CT scans of a 71-years old male with the

novel coronavirus showing ground-glass
opacities with consolidation and reticular
and/or interlobular septal thickening
upon admission (a), 2 days later (b), and
4 days later (c).

• A chest X-ray obtained 6 days after

admission shows diffusely increased
opacities in both lungs (d).

COURTESY : RSNA
 MANAGEMENT
• People are managed with supportive care which may include fluid, oxygen support, and
supporting other affected vital organs.

• Steroids such as methylprednisolone are not recommended unless the disease is complicated by
acute respiratory distress syndrome.

• CDC recommends that those who suspect they carry the virus wear a simple face mask.

• While WHO does not oppose the use of non-steroidal anti-inflammatory drugs such as ibuprofen
for symptoms,

• some recommend paracetamol for first-line use.

• Extracorporeal membrane oxygenation (ECMO) has been used to address the issue of respiratory
failure, but its benefits are still under consideration.
 PERSONAL
PROTECTIVE
EQUIPMENT

CDC outlines the specific Personal

Protective Equipment (PPE) and the
order in which healthcare providers
should put it on when dealing with
someone who may have COVID-19:
1) gown,
2) mask or respirator,
3) goggles or a face shield,
4) medical gloves.
 PASSIVE ANTIBODY THERAPY
• Using blood donations from people who have recovered from COVID-19 is being
investigated, a strategy that was tried for SARS.

• The mechanism of action is that the antibodies produced by the immune systems of those
who have already recovered are transferred to people in need of them via a nonvaccine form
of immunization.

• Other forms of passive antibody therapy, such as with manufactured monoclonal antibodies,
are in development.

• Convalescent serum production could be increased for quicker deployment.

 VACCINES
• There is no available vaccine, but research into developing a vaccine has been undertaken by various
agencies.

• Previous work on SARS-CoV is being utilised because SARS-CoV-2 and SARS-CoV both use the ACE2 receptor
to enter human cells.

• There are three vaccination strategies being investigated.

1. First, researchers aim to build a whole virus vaccine. The use of such a virus, be it inactive or dead, aims to
elicit a prompt immune response of the human body to a new infection with COVID-19.

2. A second strategy, subunit vaccines, aims to create a vaccine that sensitises the immune system to certain
subunits of the virus. In the case of SARS-CoV-2 such research focuses on the S-spike protein that helps the
virus intrude the ACE2 enzyme receptor.

3. A third strategy is the nucleic acid vaccines (DNA or RNA vaccines, a novel technique for creating a
vaccination).

• Experimental vaccines from any of these strategies would have to be tested for safety and efficacy.
 ANTIVIRALS
• Several existing antiviral medications are being looked at to treat COVID-19 and some are moving
into clinical trials.

• There is tentative evidence for remdesivir as of March 2020.

• Remdesivir inhibits SARS-CoV-2 in vitro.

• Phase 3 clinical trials are being conducted in the US, in China, and in Italy.

• Chloroquine and hydroxychloroquine effectively inhibit SARS-CoV-2 in vitro, with

hydroxychloroquine proving to be more potent than chloroquine and with a more tolerable safety
profile.

• The Guangdong Provincial Department of Science and Technology and the Guangdong Provincial
Health and Health Commission issued a report stating that chloroquine phosphate "improves the
success rate of treatment and shortens the length of patient's hospital stay" and recommended it
for people diagnosed with mild, moderate and severe cases of novel coronavirus pneumonia.
• The Chinese 7th edition guidelines also include interferon, ribavirin, or umifenovir for use
against COVID-19.

• Teicoplanin appears to inhibit SARS-CoV-2 and the related MERS conaviruses and is viewed
as a potential treatment for COVID-19.

• Nitazoxanide has been recommended for further in vivo study after demonstrating low
concentration inhibition of SARS-CoV-2.

• The TMPRSS2 inhibitor camostat approved for use in Japan for inhibiting fibrosis in liver and
kidney disease might constitute an effective off-label treatment.
PROGNOSIS

Wuhan coronavirus.mp4
MYTHS & FACTS
REGAURDING COVID-19
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