Coronavirus Disease [nCOV-19], a pandemic disease, 2020. Get the latest information regarding COVID-19 https://www.mohfw.gov.in/

1. Coronavirus Disease
[nCOV-19]
Dr. Divya Sharma
Assistant Professor

2. Coronavirus
 Coronavirus constitute the subfamily Orthocoronavirinae in the
family Coronavividae.
 They are enveloped virus with a positive sense single-stranded RNA
genome.

3. The name corona virus defines in Latin,
Corona ------- crown or halo
which refers to the characteristic
appearance reminiscent of a crown when
viewed under electron microscopy, due to
the surface covering in club-shaped
protein spikes.

4.  Coronaviruses (CoV) belongs a large family of viruses which causes
disease ranging from the common cold to more severe diseases such as
Severe Acute Respiratory Syndrome (SARS-CoV) and Middle East
Respiratory Syndrome (MERS-CoV).
 A novel coronaviruse (nCoV) is a new strain that has not been previously
identified in humans.
 nCoV ---- Zoonotic (transmitted between animals and people)
SARS-CoV was transmitted from civet cats to humans; and
MERS-CoV from dromedary camels to humans
 Several known coronaviruses are circulating in animals that have not yet
infected humans.

5. Outbreaks of Coronavirus types of
relatively high mortality
Year Outbreak Virus type Death case
2002 Reported Severe acute respiratory
syndrome (SARS) virus in Hong-kong
SARS -
2003 SARS outbreak (in Avian – Bird Flu) SARS 77
2006 SARS-CoV outbreak SARS-CoV 774
2012 Middle east respiratory syndrome
(MERS) virus outbreak
MERS Over 400
2015 MERS outbreak in South-Korea MERS-nCoV 36
2018 MERS-CoV outbreak MERS-nCoV 41
2019-20 Coronavirus epidemic
SARS-CoV-2 announced by ICTV
[International Committee on Taxonomy of
Viruses] in 11 February 2020
SARS-nCoV-2 Approx. 5,833
2020 COVID-19, new disease announced by 11
February 2020, following guidelines World
Organisation for Animal Health (OIE) and
Food and Agriculture Organisation
(FAO),United Nations
COVID-19 Approx. 5,833
2020 nCoV-19 outbreak pandemic (worldwide) nCoV-19 Upto 7,201,136

6. COVID – 19 [nCoV-19]
 In December 2019, a pneumonia outbreak was reported in Wuhan,
China.
 On 31 December 2019, the outbreak was traced to a novel strain of
coronavirus, which was given the interim name 2019-nCoV by the
World Health Organization (WHO), later renamed as SARS-CoV-2 by
the International Committee on Taxonomy of Viruses.
 As of 15 March 2020, there have been atleast 5,833 confirmed deaths
and more than 156,396 confirmed cases (worldwide) in the
coronavirus pneumonia pandemic.

7. nCoV-19 - Clinical Features
Way of Transmission
Person to Person
 Close contact (surface)
 Randomly touch eyes,
nose, mouth etc.
 Coughs and sneezes
Symptoms
 Fever (77-98%)
 Cough (46-82%)
 Sore throat
 Shortness of Breath (3-31%)
 Myalgia or Fatigue (11-52%)
 Similar to Flu symptoms
Incubation Period : 1- 14 days
Recovery time : 3 - 6 weeks
Frequently reported Signs and Symptoms
Less commonly reported respiratory symptoms include sore throat,
headache, cough with sputum production and/or hemoptysis.

8. Infographics

9. nCoV-19 Symptoms compared to other
common diseases symptoms
*Sometimes for children Sources: CDC, WHO, American College of Allergy, Asthma and Immunology
Symptoms COVID-19
Common
Cold
Flu Allergies
Fever Common Rare Common Sometimes
Dry cough Common Mild Common Sometimes
Shortness of
breath
Common No No Common
Headaches Sometimes Rare Common Sometimes
Aches and
Pains
Sometimes Common Common No
Sore throat Sometimes Common Common No
Fatigue Sometimes Sometimes Common Sometimes
Diarrhea Rare No Sometimes* No
Runny nose Rare Common Sometimes Common
Sneezing No Common No Common

10. Mortality Rate by Age

11. nCoV-19 - Diagnosis
•To endemic countries like China, Iran & ItalyTravel history
•Leukopenia - seen in 30-45% of the patients
•Lymphocytopenia - seen in 85% of the patientsCBC
•Cheaper and easier with 60% sensitivityChest X-Ray
•30-70% sensitivityPCR
•95% sensitivity
•Low specificityChest CT Scan
•For COVID-19
IgM/IgG combo
test

12. Specimen Collection
 Combined nasopharyngeal/oropharyngeal swab
 If positive repeat every 3 days till negative
 If negative repeat second test after 24 hrs
 If 2 consecutive negative isolation can be discontinued:
 Lower respiratory specimen is preferred (if applicable)
 Airborne and contact isolation is recommended for
further information contact your infection control
practitioner

13. nCoV-19 treated Hospitals
 In close communication with Public Health Officials
 Infection Prevention Daily Rounds and Daily
Monitoring of PPE Supplies
 Staff education
 Signage
 Screen patients with symptoms: emergency
department; urgent care; and clinics
 Isolation rooms
 Testing procedure following CDC Guidelines

14. Classification of Symptoms
Symptoms were categorized depend on cases as follows:
 Mild cases: Majority (81%) of these nCoV-19 disease
cases were mild cases [include all patients without
pneumonia or mild cases pneumonia]
 Severe cases: Includes patients who suffered from
shortness of breath, respiratory frequency ≥30/min, blood
oxygen saturation ≤93%, PaO2:FiO2 ratio <300:30 and/or
lung infiltrates >50% within 24-48 hrs.
 Critical cases: Includes patients who suffered respiratory
failure, septic shock, and/or multiple organ dysfunction or
failure.

15. Risk of Infection
 The Case Fertility Rate (CFR) was 0.9% for those without
a pre-existing health condition & for young ages.
 The CFR was 10% for those with underlying health
conditions & for old ages.
 Fulminant myocarditis has also been reported in patients
with COVID-19 that caused by virus. It arises quickly,
progresses rapidly, and may lead to severe heart failure
or circulatory failure presenting as rapid-onset
hypotension and cardiogenic shock, with mortality rates
as high as 50-70%.
 Physicians should pay attention not only to the
symptoms of respiratory dysfunction but also the
symptoms of cardiac injury.

16. Management
 No specific treatment for COVID-19 is currently
available. There are currently no antiviral drugs licensed
by the U.S. Food and Drug Administration (FDA) to treat
patients with COVID-19. Clinical management includes
prompt implementation of recommended infection
prevention and control measures and supportive
management of complications, including advanced organ
support if indicated.
 Corticosteroids should be avoided, because of the
potential for prolonging viral replication as observed in
MERS-CoV patients, unless indicated for others reasons.
Eg: For a COPD exacerbation or for septic chock per
Surviving Sepsis guidelines.

17. nCoV–19 - Treatment
Mild cases
•Supportive treatments (Antihistamine & Analgesics)
Moderate cases
•Oseltamivir (150 mg BID)  for 5 days
•Hydroxychloroquine, Chloroquine (500 mg BID)  for 14 days or Ribavirin  for
5 days
Severe cases
•Oseltamivir (150 mg BID)  for 5 days
•Kaletra (Lopinavir/Ritonavir)  for 5 days
•Hydroxychloroquine, Chloroquine (500 mg BID)  for 14 days or Ribavirin  for
5 days
Critical cases
•Oseltamivir (150 mg BID)  for 5 days
•Kaletra (Lopinavir/Ritonavir)  for 5 days
•Ribavirin  for 5 days
•Hydroxychloroquine, Chloroquine  for 14 days
Investigational therapies:
Favilavir [Favipiravir], Remdesivir, Teicoplanin, Tocilizumab

18. Prevention
 Frequently wash your hands with soap and water (approx. 20-40
seconds)
 Avoiding touching eyes, nose or mouth with unwashed hands
 Avoiding close contact with people who are sick (approx. 10 feet)
 Maintain social distance with other person (approx. 1.8 m)
 Staying away from work, school or other people if you become sick
with fever and cough
 Avoid touching any metal surface and fabric, it will live at least 12
hrs on metal and 6-12 hrs on fabric [After touching, must wash
your hands as soon as with a bacterial soap].
nCoV–19 - Precautions
If you have travelled to China and have become ill with
fever, cough, or shortness of breath
o Seek medical care
o Share your travel history
o Wash hands often with soap and warm water for atleast 20 seconds

20. How to use a mask
 Before wearing a mask, wash your hands with an alcohol-
based disinfectant or with soap and water.
 Cover your mouth and nose with the mask and make sure
the mask is firmly pressed against your face.
 Do not touch the mask while you are wearing it; if you
do, wash your hands with an alcohol-based disinfectant or
soap and water afterward.
 Replace the mask as soon as it gets wet and do reuse
disposable masks.
 Remove the mask from behind (do not touch its front
side); throw it away in a closed container and then wash
your hands with an alcohol-based disinfectant or with
soap and water.

21. How to stop the spread of nCOV-19
 Social distancing or physical distancing, keeping
space between yourself and other people when you have
to go out.
 Quarantine, keeping someone home and separated from
the other people if they might have been exposed to the
virus.
 Isolation, keeping sick people away from healthy people,
including using a separate “sick” bedroom and bathroom
when possible.

22. Recovery rate for nCOV-19
Recovery rate ---- Between 97 – 99.75%
Scientists and researchers are constantly tracking COVID-
19 infections and recoveries. But they don’t have
information about the outcome of every infection. Early
estimates predict that the overall COVID-19 recovery rate
will be between 97 – 99.75%.

23. Thank-you
Sharma’s Classes - Dr. Divya Sharma