Patients presenting late or deteriorating hospitalized patients usually suffer from acute respiratory distress syndrome (ARDS), acute respiratory failure, acute renal injury, and multi-organ failure ( 15– 17). Signs of pneumonia include decreased oxygen saturation, deterioration of blood gas, multi-focal glass ground opacities, or patchy/segmental consolidation in chest X-ray or CT. Progression to pneumonia is documented by radiological findings and usually occurs 1–2 weeks after the beginning of the symptoms. Less common symptoms include sore throat, confusion, productive cough, hemoptysis, diarrhea, nausea, and chest pain ( 15). Patients usually present with fever, dry cough, shortness of breath, headache, malaise, muscle, and bony aches. Adults with pre-existing cardiovascular diseases, respiratory diseases, endocrine diseases, diabetics, or immunocompromised adults remain the most exposed to serious complication of COVID-19 ( 14).Īlthough many patients of COVID-19 remain asymptomatic, some patients get pneumonia and 10% of cases require mechanical ventilation and ICU admission. Studies are now also proposing the possible feco-oral transmission of the virus ( 11).ĬOVID-19 patients are mainly adults older than 18 years old with a male predominance, the preconceived notion that pediatrics are not subjected to infection later changed with confirmed cases occurring in pediatrics in China and worldwide ( 12, 13), however, mortality is still much more in the adult group above the age of 65 years. The virus was confirmed to spread through respiratory droplets from coughs or sneezes ( 7– 9) with the ability of the host to shed the infection while asymptomatic ( 10).
Although the first data available about COVID-19 indicates possible animal-to-human transmission via wild animals in Huanan seafood Market in Wuhan ( 5, 6), epidemiological data and studies, after that, have increasingly demonstrated that the virus transmits human-to-human, through droplets or direct contact, with the reporting that individuals who did not have direct contact with the Huanan seafood market were diagnosed with COVID-19 and with secondary cases occurring at hospitals among health care workers who had extensive contact with COVID-19 patients. Coronaviruses are enveloped, positive single stranded large RNA viruses. Transmission and Clinical Manifestations of COVID-19ĬOVID-19 is caused by the SARS-CoV-2 that belongs to the beta-coronaviruses subfamily. As of, COVID-19 has been confirmed in 5,404,512 individuals globally with deaths reaching 343,514 with a morality of 6.4%, The United States had the highest number of confirmed cases (1,618,757 cases) ( 4). On 11 February 2020, the WHO has named the disease COVID-19, short for “coronavirus disease 2019” ( 2) and on 12 March 2020 the total number of COVID-19 confirmed cases reached 125,260 globally with 80,981 cases in China and 44,279 outside of China and the COVID-19 was declared to be a pandemic by the WHO ( 3). The 2019-nCoV virus rapidly spread across China and many other countries and caused a rapidly growing global outbreak. The new virus, 2019-nCoV, so called then, was isolated on 7 January 2020 and identified as the cause of the outbreak ( 1). The outbreak was linked to the Huanan food Market. In December 2019, an outbreak of pneumonia cases was reported in Wuhan, China. Targeting cytokines during the management of COVID-19 patients could improve survival rates and reduce mortality. Excessive production of proinflammatory cytokines leads to ARDS aggravation and widespread tissue damage resulting in multi-organ failure and death. Mortality in COVID-19 patients has been linked to the presence of the so-called “cytokine storm” induced by the virus. COVID-19 is transmitted via droplets or direct contact and infects the respiratory tract resulting in pneumonia in most of the cases and acute respiratory distress syndrome (ARDS) in about 15 % of the cases.
1Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.Dina Ragab 1 *, Haitham Salah Eldin 2, Mohamed Taeimah 3, Rasha Khattab 4 and Ramy Salem 1
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