This document summarizes the presentation given by Mukesh Pandit on the Coronavirus. It discusses the phylogeny and taxonomy of coronaviruses, noting that they are RNA viruses in the order Nidovirales. It describes the seven known human coronavirus species and mentions SARS-CoV, MERS-CoV, and the novel 2019-nCoV. It then summarizes the first known case of 2019-nCoV in the United States, which occurred in Washington in January 2020 in a man who had traveled from Wuhan, China.
3. VIRUSES :-
• Viruses are known to infect unicellular
organisms such as Mycoplasma, bacteria,
algae and all other higher plants and animals.
• Virion is the complete virus particle. It
includes nucleocapsid plus a surrounding
envelope.
4. DNA Viruses : -
• All are ds except Parvovirus : ss { @ part – of – a – virus}
• All have liner genomes except Papilloma, Polyoma and
Hepadna : circular.
• All are icosahedral except Pox virus : complex.
• All replicate in the nucleus except Pox virus : carries
own DNA - dependent RNA polymerase. { @ out - of - the
– box}
13. CORONA VIRUS : Reservoirs
Zoonoti Disease ( Animal's Human)
SARS 2003 China ( Civat Cats)
MERS 2012 Saudi Arabia ( Camels)
Noval nCov 2019 December Wuhan, Hubei
Province of China ( ? Animal ) Seafood and wild
Animal market.
14. CORONA
VIRUS : - nCoV
• Although, sea foods and wild animal's markets
were thought to be the epicenter of the outbreak.
• Now there is a school of thought
regarding Pangolins could have transmitted these
disease. Genetic analysis showed almost 99%
similarity of the viral genome in human to that of
the Pangolins.
• Pangolins are considere of medicinal value in
treatment of skin diseases, menstrul abhormalities
and joint diseases. The trading of these valuable
animal could subject to imprisonment for 10 years in
China.
15. CORONA VIRUS : Pathogenesis
Highly species – secific
Display tropis for epithelial cells. However , SARS had also predilection
for salivary glands is monkeys.
Virus can also be detected in Kidneys, live and small intestine and, and
in stool.
Corona virus are suspected of causing some gestroentritis in humans.
16. CORONA VIRUS : Clinical Features
Mostly : Common cold usually afelorille as caused by
rhinovirus.
SARS and MARS : Severe Respiratory illnesses
Diarrhea as caused by rotavirus
17. CORONA VIRUS
: - Immunity
• As with other respiratory virus, immunity
develops but is not absolute.
• Immunity against the surface projection
antigen is probably most important for
protection.
18. CORONA VIRUS : Lab Diagnosis
1. Antigen and nucleic acid detection.
ELISA if high – quality antiserum is available
Electron microscopy of stool specimen
PCR assays
2. Isolation and Identification of virus.
Difficult to culture in-vitro
SARS was recovered from oropharyngeal specimens using vero monkey
Kidney cells.
3. Serology
ELISA – Indirect IF
27. CORONA VIRUS : nCoV : Nepal : 3 cases
A 31yr. old student returned from Wuhan was found corona positive
when his throat swab was sent and examined in the who regional
headquarter, Hongkong.
Later a men and women were also suspected. However, 28yr. Old men
who had transit in china was positive for the corona virus.
48yr. Old women who went for an event was found negative for the virus.
28.
29. CORONA VIRUS : nCoV : 1st case in US
• December 31st 2019 -----> Clusters of cases of pneumonia in Wuhan,
Hubei Province of -------> Huanan seafood wholesale market -------> On
Jan 7th Chinese authorities confirmed these cases were associated
with novel corona virus.
• First case reported in US was in 20th January 2020.
30. CORONA VIRUS : nCoV : 1st case in US
On January 19, 35-years-old man presented to an urgent care clinic in
Snohomish County, Washington with 4 day h/o cough and subjective
fever
He disclosed he has returned to Washington on January 15 after
traveling to visit family in Wuhan.
He said he had seen the health alert systems from CDC regarding
symptoms of the disease.
31. CORONA VIRUS : nCoV : 1st case in US
He has h/o hypertriglyceridemia. Otherwise healthy non-smoker.
Temp: 37.2 celcius
BP: 134/87 mmHg
Pulse: 110 bpm
RR: 16 bpm
Spo2 @ ambient air: 96%
32. CORONA VIRUS : nCoV : 1st case in US
A rapid nucleic acid amplification test (NAAT) for influenza A and B was
negative.
A nasopharyngeal swab specimen was obtained and sent for detection of viral
respiratory pathogens by NAAT; this was reported back within 48 hours as
negative for all pathogens tested, including influenza A and B, parainfluenza,
respiratory syncytial virus, rhinovirus, adenovirus, and four common
coronavirus strains known to cause illness in humans (HKU1, NL63, 229E, and
OC43).
33. CORONA VIRUS : nCoV : 1st case in US
Although the patient reported that he had not spent time at the Huanan
seafood market and reported no known contact with ill persons during his
travel to China, CDC staff concurred with the need to test the patient for 2019-
nCoV on the basis of current CDC “persons under investigation” case
definitions.
After specimen collection, the patient was discharged to home isolation with
active monitoring by the local health department.
35. CORONA VIRUS : nCoV : 1st case in US
On January 20, 2020, the CDC confirmed that the patient’s nasopharyngeal and
oropharyngeal swabs tested positive for 2019-nCoV by real-time reverse-
transcriptase–polymerase-chain-reaction (rRT-PCR) assay.
On admission, the patient reported persistent dry cough and a 2-day history of
nausea and vomiting; he reported that he had no shortness of breath or chest pain.
Vital signs were within normal ranges
36. CORONA VIRUS : nCoV : 1st case in US
After admission, the patient received supportive care, including 2 liters of normal saline and
ondansetron for nausea.
The patient continued to report a nonproductive cough and appeared fatigued.
On the afternoon of hospital day 2, the patient passed a loose bowel movement and reported
abdominal discomfort. A second episode of loose stool was reported overnight
A sample of this stool was collected for rRT-PCR testing, along with additional respiratory
specimens (nasopharyngeal and oropharyngeal) and serum.
The stool and both respiratory specimens later tested positive by rRT-PCR for 2019-nCoV,
whereas the serum remained negative.
37. CORONA VIRUS : nCoV : 1st case in US
Treatment during this time was largely supportive. For symptom
management, the patient received, as needed,
antipyretic therapy consisting of 650 mg of acetaminophen every 4 hours
and
600 mg of ibuprofen every 6 hours
600 mg of guaifenesin for his continued cough
approximately 6 liters of normal saline over the first 6 days of
hospitalization.
41. CORONA VIRUS : nCoV : 1st case in US
Laboratory results on hospital days 3 and 5 (illness days 7 and 9) reflected
leukopenia, mild thrombocytopenia, and elevated levels of creatine kinase.
In addition, there were alterations in hepatic function measures on day 5 of
hospitalization:
alkaline phosphatase (68 U per liter),
alanine aminotransferase (105 U per liter),
aspartate aminotransferase (77 U per liter),
lactate dehydrogenase (465 U per liter)
43. CORONA VIRUS : nCoV : 1st case in US
Change in respiratory status was noticed starting on the evening of
hospital day 5, when the patient’s oxygen saturation values as
measured by pulse oximetry dropped to as low as 90% while he
was breathing ambient air
Given the changing clinical presentation and concern about
hospital-acquired pneumonia, treatment with vancomycin (a 1750-
mg loading dose followed by 1 g administered intravenously every
8 hours) and cefepime (administered intravenously every 8 hours)
was initiated.
45. CORONA VIRUS : nCoV : 1st case in US
Given the radiographic findings, the decision to
administer oxygen supplementation, the patient’s
ongoing fevers, the persistent positive 2019-nCoV RNA at
multiple sites, and published reports of the development
of severe pneumonia at a period consistent with the
development of radiographic pneumonia in this patient,
clinicians pursued compassionate use of an
investigational antiviral therapy
46. CORONA VIRUS : nCoV : 1st case in US
Treatment with intravenous remdesivir (a novel nucleotide
analogue prodrug in development) was initiated on the
evening of day 7, and no adverse events were observed in
association with the infusion.
Vancomycin was discontinued on the evening of day 7, and
cefepime was discontinued on the following day, after serial
negative procalcitonin levels and negative nasal PCR testing
for methicillin-resistant Staphylococcus aureus.
47. CORONA VIRUS : nCoV : 1st case in US
On hospital day 8 (illness day 12), the patient’s clinical
condition improved. Supplemental oxygen was discontinued,
and his oxygen saturation values improved to 94 to 96% while
he was breathing ambient air.
The previous bilateral lower-lobe rales were no longer present.
His appetite improved, and he was asymptomatic aside from
intermittent dry cough and rhinorrhea.
48. CORONA VIRUS : nCoV : 1st
case in US
• As of January 30, 2020, the
patient remains hospitalized.
He is afebrile, and all
symptoms have resolved with
the exception of his cough,
which is decreasing in severity.
49.
50. • PRESENTED BY – MUKESH PANDIT
• CLASS --- XI – D
• SCHOOL – SD PUBLIC SCHOOL
