CORONA VIRUS DISEASE ( COVID - 19 ) - Clinical profile, investigations, treatment, prevention and myths as per WHO/CDC guidelines as on FEBRUARY 2020

1. Prof.(Dr.)A.J.Dhumale.
HOD Medicine, SSIMS. Bhilai (C.G)
drajdhumale@gmail.com
ClinicalProfileOf
Corona Virus Disease

2. COVID-19
• The WHO on 10th February 2020 proposed an official name for the illness caused by new corona virus as
COVID-19
• The goal was to avoid the stigma to any of the places, people or animals associated with the corona virus.
• ‘CO’ stands for CORONA
• ‘VI’ stands for VIRUS
• ‘D’ stands for DISEASE

3. What is Novel Corona Virus (nCoV)
• nCoV is a new strain
of Corona Virus that
has not been
previously identified
in humans.
• The ‘New or Novel’
corona virus ,now
called 2019-
nCoV,had not been
detected before the
outbreak reported
in Wuhan, China in
December 2019.

4. Why New Viral Infections
Emerging?
• New viral diseases typically
emerge because of human
activity that brings people into
contact with wildlife, such as:
➢ road building,
➢hunting and
➢agriculture expansion.
2/12/2020 44

5. The source of nCoV
• The animal source of the outbreak:
• SARS-CoV - cats and
• MERS-CoV – camels
• nCoV-most cases were handlers and
frequent visitors to the Wuhan
(Seafood Wholesale Market)
• Two recent research papers have
pointed to bats and snakes as the
possible culprits.
• Recently PANGOLINS !

10. How n-CoV spreads
• Air Droplets
(Coughing,
Sneezing)
• Touching an object
with the virus on it ,
then touching
mouth, eyes or nose
before washing
hands
• Close personal
contacts (Touching,
shaking hands)
• Rarely faecal
contamination

11. Incubation
period
• Time between infection & the
onset of clinical symptoms of
disease.
• WHO: 2-14 days

12. How quickly it spreads…
• Since the outbreak in mid-December, cases have escalated at
pace.
• Within a month, two people in China had died while about 40
cases were identified.
• As on today, the Feb 12th , the death toll stood at 1113 with
more than 15000 cases.
• A ONLINE agency reported: (ZEE NEWS…4days back)
o 24650 –Died so far
o 75000-Cases suffering
o 200000 people are receiving treatment….

16. WHO declares the new coronavirus
outbreak a Public Health Emergency of
International Concern
2/12/2020 1
6

17. -COVID19

18. -COVID19

19. -COVID19

20. -COVID19
-COVID19

21. 2/12/2020 2
1

22. Creationof isolation unitsin dangerous viral infections
2/12/2020 2
2

23. TRAINING THE HEALTH CARE WORKERS A
TOPIC PRIORITY
2/12/2020 2
3

24. HUMAN COORDINATION A
GREAT PRIORITY
2/12/2020
2
4

25. WHO says vaccine
could be ready in 18
months

45. Investigationstoconfirm2019-nCoV
• China shared the genetic sequence of the
novel coronavirus on 12 January.
• Specific diagnostic kits used in patients
withlaboratory-confirmed 2019-nCoV
infection:
1. ByReal-time RT-PCR
2. Next-generationsequencing.

56. Management of COVID-19
• Thereisnospecificantiviraltreatmentrecommended for2019-
nCoV infection.
• Peopleinfected with2019-nCoVshouldreceivesupportivecare
tohelp relievesymptoms.Forseverecases,treatmentshould
includecare to supportvitalorganfunctions.
• Peopleexposedto2019-nCoV,should contacthealthcare
providerimmediately.

58. Infection Prevention and Control practices

64. ? Oseltamivir /Tamiflu
? Iopinavir-Ritonavir
? Alfa Interferon-neubilisation BID

66. TheLancet..on 2019-nCoV
• The Lancet, researchers report on a genomic analysis of 2019-
nCoV from nine patients in Wuhan, China, all of whom had a
connection to the Huanan seafood market.
• Genetic sequences from the patients' samples were almost
identical, which indicates that the virus emerged in humans
very recently, the researchers note.
• Additionally, the virus appears most similar to two SARS-like
coronaviruses that originated in bats. The researchers say that
taken together, their findings suggest that bats are the original
host and an animal sold at the market might have served as an
intermediate host that facilitated transmission to humans.

67. New EnglandJournalofMedicine study
• New England Journal of Medicine study offers more
evidence supporting person-to- person transmission
of the virus.
• Of 425 cases studied, over half of those with onset in
December were linked to the market, while just 9% of
those occurring in January were thus linked.
• Overall, the mean incubation period was 5.2 days.

68. WHO
CORONAVIRUS
PUBLIC
INFORMATION

69. MYTHS

74. The following
measures ARE
NOT specifically
recommended
as 2019-nCoV
remedies as
they are not
effective to
protect yourself
and can be even
harmful:
• Taking vitamin C
• Smoking
• Drinking traditional herbal
teas
• Wearing multiple masks to
maximize protection
• Taking self-medication such
as antibiotics

75. PREVENTION

91. 1/31/2
020
Dr.T.V.RaO MD @ CORONA VIRUS
2019 -2010
5
0
2/12/2020
9
1

97. Fast Five Quiz:
“novel Corona Virus-An Update”
COVID19 (2019-nCoV)
SSIMS Bhilai (C.G)

98. 1.Which of the following most accurately
reflects the estimated incubation period of
COVID-19 ( 2019-nCoV)?
A. Within 24 hours
B. 2 days to 2 weeks
C. 3-4 weeks
D. Longer than a month

99. 1.Which of the following most accurately
reflects the estimated incubation period of
COVID-19 ( 2019-nCoV)?
A. Within 24 hours
B. 2 days to 2 weeks
C. 3-4 weeks
D. Longer than a month

100. 2. Which of the following is most accurate
regarding the presentation of
COVID-19 ( 2019-nCoV)?
A. Women have demonstrated a higher incidence of severe
2019-nCoV infection than men
B. Unlike similar viruses, 2019-nCoV has a higher incidence
among younger populations (< 40 years)
C. Early estimates suggest that the mortality rate of 2019-
nCoV infection is around 3%
D. Early reports suggest that 2019-nCoV is substantially more
clinically severe than MERS or SARS

101. 2. Which of the following is most accurate
regarding the presentation of
COVID-19 ( 2019-nCoV)?
A. Women have demonstrated a higher incidence of severe
2019-nCoV infection than men
B. Unlike similar viruses, 2019-nCoV has a higher incidence
among younger populations (< 40 years)
C. Early estimates suggest that the mortality rate of 2019-
nCoV infection is around 3%
D. Early reports suggest that 2019-nCoV is substantially more
clinically severe than MERS or SARS

102. 3.Which of the following is the most
commonly reported clinical finding in
patients with COVID-19 ( 2019-nCoV)?
A. Headache
B. Excess sputum production
C. Diarrhea
D. Fever

103. 3.Which of the following is the most
commonly reported clinical finding in
patients with COVID-19 ( 2019-nCoV)?
A. Headache
B. Excess sputum production
C. Diarrhea
D. Fever

104. 4. Which of the following diagnostic tests
is currently used by the CDC to diagnose
COVID-19 (2019-nCoV)?
• A. Enzyme-linked immunosorbent assay (ELISA)
• B. Real-time reverse transcription polymerase
chain reaction (rRT-PCR) assay
• C. Virus isolation in cell culture
• D. Viral antigen detection test

105. 4. Which of the following diagnostic tests
is currently used by the CDC to diagnose
2019-nCoV?
• A. Enzyme-linked immunosorbent assay (ELISA)
• B. Real-time reverse transcription polymerase
chain reaction (rRT-PCR) assay
• C. Virus isolation in cell culture
• D. Viral antigen detection test

106. 5.Which of the following is most accurate
regarding the treatment and prevention of
COVID-19 (2019-nCoV)?
• A. All individuals should use contact, airborne, and droplet
precautions before entering a room with a patient who has
confirmed or suspected 2019-nCoV
• B. Oseltamivir phosphate is recommended for all patients with
2019-nCoV
• C. Alcohol-based sanitizers have been found to be wholly ineffective
in the prevention of 2019-nCoV transmission
• D. A combination of zanamivir and peramivir is recommended to
help shorten symptom duration in older patients with 2019-nCoV

107. 5.Which of the following is most accurate
regarding the treatment and prevention of
COVID-19 (2019-nCoV)?
• A. All individuals should use contact, airborne, and droplet
precautions before entering a room with a patient who has
confirmed or suspected 2019-nCoV
• B. Oseltamivir phosphate is recommended for all patients with
2019-nCoV
• C. Alcohol-based sanitizers have been found to be wholly ineffective
in the prevention of 2019-nCoV transmission
• D. A combination of zanamivir and peramivir is recommended to
help shorten symptom duration in older patients with 2019-nCoV

108. References
• WHO
• CDC
• Medscape
• Media-Newspaper/Television