SARS-CoV-2: Difference between revisions
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− | == |
+ | ==Background== |
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+ | ===Microbiology=== |
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+ | *Virion consists of: |
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+ | **Spike glycoprotein (S) |
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− | * Declared pandemic by WHO in 2020 |
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+ | **Membrane protein (M) |
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+ | **Nucleocapsid protein (N) |
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+ | **Hemagglutinin esterase (He) |
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+ | **Envelope protein (E) |
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+ | *Secondary household attack rate of 12-17% |
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− | * Primarily supportive |
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+ | |||
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+ | === Risk Factors for Mortality === |
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+ | |||
+ | * Greater age |
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+ | * Male sex |
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+ | * [[COPD]] |
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+ | * [[Dyslipidemia]] |
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+ | * [[Diabetes]] |
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+ | |||
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+ | *Lymphopenia is common, as is hypoalbuminemia, elevated D-dimer, CRP, LDH, AST/ALT |
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+ | *Viral load detectable before symptom onset and peaks around the time of symptom onset |
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+ | === Complications === |
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+ | * In critically ill patients: |
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+ | ** [[ARDS]] (75%) |
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+ | ** [[AKI]] (40%) |
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+ | ** [[Thrombosis]] (10%) |
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+ | == Diagnosis == |
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+ | * PCR from NP swab |
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+ | ** May be positive long after no longer infectious |
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+ | *Dexamethasone for patients requiring supplemental oxygen |
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+ | == Further Reading == |
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+ | * 10.1001/jama.2020.12839 |
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[[Category:Viruses]] |
[[Category:Viruses]] |
Revision as of 19:16, 30 July 2020
Background
Microbiology
- Coronavirus related to SARS-CoV
- Virion consists of:
- Spike glycoprotein (S)
- Membrane protein (M)
- Nucleocapsid protein (N)
- Hemagglutinin esterase (He)
- Envelope protein (E)
Epidemiology
- First cases detected Dec 2019 related to likely exposure in wet market in Wuhan, Hubei, China, and declared a pandemic in 2020
- Secondary household attack rate of 12-17%
Risk Factors for Mortality
- Greater age
- Male sex
- COPD
- Dyslipidemia
- Diabetes
Clinical Manifestations
- Incubation period 4-5 days (range 2 to 11), possibly as long as 14 days in some cases
- Main presenting symptoms were fever and cough, followed by myalgia, fatigue, headache, dyspnea
- Other symptoms include dyspnea, rhinorrhea, vomiting, diarrhea, anosmia/hyposmia
- Lymphopenia is common, as is hypoalbuminemia, elevated D-dimer, CRP, LDH, AST/ALT
- Viral load detectable before symptom onset and peaks around the time of symptom onset
Complications
- In critically ill patients:
- ARDS (75%)
- AKI (40%)
- Thrombosis (10%)
Diagnosis
- PCR from NP swab
- May be positive long after no longer infectious
Management
- Dexamethasone for patients requiring supplemental oxygen
- Investigational therapeutics include tocilizumab, lopinavir/ritonavir, and chloroquine
Further Reading
- 10.1001/jama.2020.12839
References
- ^ Louise Lansbury, Benjamin Lim, Vadsala Baskaran, Wei Shen Lim. Co-infections in people with COVID-19: a systematic review and meta-analysis. Journal of Infection. 2020;81(2):266-275. doi:10.1016/j.jinf.2020.05.046.