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Corona Virus

Now, there’s quite a few things we don’t know about this virus. But, there’s quite a few things we do. So, I wanted to talk about that and I want to tell you about some practical implications as well.

How you can protect yourself, how you can protect your family and this will be interesting if you’re a healthcare provider, health care professional or if you want to be a better informed a member of the public who wants to protect themselves.

The Corona Virus are remarkably small. They say it’s called a corona virus because of this crown shaped appearance because of the outer; the outer protein coat on it.

There’s lots of these viruses and it’s a large family of viruses that cause illness ranging from the common cold to more severe respire to disease. This is in human now.

The corona virus as we’ll see comes from animals and in animals it causes a lot of different pathologies. About the disease state, as it affects humans and of course as it spreading from China at the moment, now we’ve known about quite a few corona viruses for a while. But, a new corona virus was identified in humans on the 29th of December 2019 and it was a novel virus. It is new; it hasn’t been seen before.

So, for that reason, this virus was assigned this name: 2019 novel coronavirus. What it does is it causes human respiratory viral infections. So, about infections of the respiratory system, now ofcourse, we can have upper respiratory infections in through the nose, the pharynx. It depends where you count upper.

Not normally upper would be above the level of the the larynx. So, upper respiratory infections and lower respiratory infections, bronchitis in the bronchial passages and infections lower down in the lung fields, in the alveoli, these are all respiratory infections and spine infections can be caused by bacteria or viruses and ofcourse these ones are caused by viruses like corona virus. But, there’s that, there’s a wide variety of viruses can cause human respiratory viral infections. So, the common cold for example is the different viruses can cause that a corona virus can cause common cold type symptoms.

But, the most common one is called a rhinovirus. For that, for the nose we get this characteristic; irritating runny nose and general malaise and the features of a common cold that you’re all familiar with well; influenza is another type of respiratory virus. This causes flu. So, it’s it an influenza virus. There’s different types. But, they say this is the main cause of seasonal flu.

The flu that we get more of every winter and there was a quite 9outrageous outbreak in 1918, 1919 in the West recorded the Spanish flu and it killed about 50 million people when a virus mutated and when the virus mutated, this effect caught so called genetic shift. The virus shifted; it was a new genetic form of the virus and what that meant was an expressed different proteins and these were proteins that our immune system was not familiar with. So, we didn’t have immunity to it and it caused severe illness, inflammatory reactions, killed young people and old people tragically.

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So, different viruses can cause human respire viral infections. But, thinking about the corona virus particularly is what we want to focus on because that’s what’s new. We’ve had these other viruses for a long time.

This novel coronavirus now; the throne of virus is single-stranded RNA, it’s a ribonucleic acid virus and it’s in a protein envelope and this is a protein shell or capsid. The protein envelope or the protein capsule is very important for spread later on because this can protect the virus when it’s outside of the body and egg. It can survive on surfaces for a few days because of this. This protein envelope that surrounds the RNA and they’re very smal.

Coronaviruses are zoonotic. It’s one of the zoo enosis illnesses. The zoo enosis illnesses as the name sort of implies are infections that we get from animals. So, this comes from animals and you might have remembered previous infections of coronavirus that have caused pandemics that have gone round the world infecting in the world.

So, an epidemic is a large global outbreak; an epidemic is a large local outbreak; a pandemic pan- all of the world is affected.

So, MERS was the Middle East respiratory syndrome that was a corona virus in 2012 and severe acute respiratory syndrome ;the SARS in 2013 were also corona viruses and now we have this novel previously unidentified one; the 2019 novel coronavirus which is currently causing illness.

What are the clinical features that this novel coronavirus will cause?

Well, the data from China is somewhat limited at the moment. But, this is the latest data as of a couple of days ago. So, the people that got this condition 98% of them had a fever. So, basically everyone who had this disease had a fever; they were pyrexi. So, what happens here is that toxins are released from the virus; that’s detected by the immune system.

The immune system facilitates prostaglandin mechanisms and the hypothalamus turns off the set point of the hypothalamus and then we feel cold and shivery. We can have these rykors.

Rykor’s is the cold shiver feeling because when your temperature’s going up you feel cold, that increases the body temperature and gives us the fever now. This is actually a good thing because the viruses are less comfortable in pyrexia environments and the viruses don’t replicate as well in a fevered patient.

The increase in body temperature increases the efficiency of the immune system, so we need to see fever as an adaptive defensive mechanism. That’s going to help us combat this infection but it’s a clinical feature that we can detect simply by taking the patient’s temperature- 76 percent of the patients so far analysed who’ve been affected with novel coronavirus of had a cough.

Myalgia is pain in the muscles. With the corona virus, I assumed these patients are feeling remarkably ill as well. 28% produced sputumas you might expect. With a respiratory virus, 8% had a headache, 5% had coughing up blood, 3% had diarrhea which is interesting.

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So, this virus seems to affect primarily the respiratory system. But, also the gastrointestinal system which is interesting and 55% developed dyspnea-difficulty in breathing, shortness of breath. So, thinking about the complications of this condition, so severe acute respiratory infection is pneumonia.

Now, pneumonia is infection at the level of the alveoli. So, bronchitis is going to be the larger bronchial passages. But the larger bronchial passages in the bronchial tree is bronchitis but pneumonia is actually affecting the lung at the level of the alveoli and we get consolidation, we get fluid collecting in there and of course if there’s fluid in there, the oxygen can’t get in, the carbon dioxide can’t get out.

So, that’s pneumonia, it is a complication of novel coronavirus. As with the other corona viruses that pneumonia is a complication severe acute respiratory infection which is pneumonia and also acute respired for distress syndrome. Acute respiratory distress syndrome a RDS occurs when the lungs become inflamed for any reason. It can be infection, it can be injury and the inflammation causes fluid from the nearby blood vessels to leak into the alveoli. So, the net result really is much the same as pneumonia. You get fluid in the alveoli because by acute respiratory distress syndrome and the patient will become very short of breath.

So far, from the Chinese data, two to three people have been getting infections for every year. Every infected case so that means it’s doubling and tripling in incidence. We don’t have any good antiviral treatments for the corona virus. But, I think that you get a temperature because the immune system wants your temperature to be high to improve the elimination of the virus and to improve the function of the immune system.

So, keeping warm and certainly in adults, I like to avoid giving air. Antipyretics in children is different, of course but avoid non-steroidal anti-inflammatories and paracetamol. That’s acetaminophen; the who you ask sometimes people will say take regular powerset. It’ll certainly make you feel better, but it will lower your temperature and therefore in my view lower the efficiency of the immune system.

Keep hydrated because there is a risk of renal failure with severe conditions. Should you eat or not well eat if you’re hungry, if you don’t feel like eating, don’t worry about it you’ll be fine as long as you’re a reasonably nourished before. You’ll be fine without eating for a few days. Don’t force yourself to eat if you don’t feel like it. It’s really quite normal for the body to go catabolic when it’s ill; no specific antiviral medications.

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