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UPDATED 2019 novel coronavirus wuhan, china 2 feb 2020

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EPIDEMIOLOGY, CLINICAL FEATURES, AND MANAGEMENT OF NOVEL CORONA VIRUS 2019( nCOV 2019)

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UPDATED 2019 novel coronavirus wuhan, china 2 feb 2020

  1. 1. Dr. Ahmed Sayeed,MD,MRCP(UK) Division of Pulmonology King Abdullah Medical city Makkah
  2. 2. THE PROPHET ‫ﷺ‬SAID, "IF YOU HEAR ABOUT IT (THE PLAGUE) IN A LAND THAT YOU ARE IN, DO NOT RUN AWAY FROM IT, AND IF YOU HEAR THAT IT BROKE OUT IN A CERTAIN LAND, DO NOT ENTER THAT LAND." (BUKHARI)
  3. 3. THE EPICENTER A series of pneumonia cases of unknown cause with shared history of exposure to Huanan sea food market in Wuhan,China were reported. An epidemiological alert was released by the local health authority on 31st December.
  4. 4. THE BUSTLING MARKET
  5. 5. THE MARKET WAS SHUT DOWN ON JAN 1, 2020.
  6. 6. THE SUSPICION The diagnosis of pneumonia of unknown cause in Wuhan was based on  Clinical characteristics,  Chest imaging  Ruling out of common infections  Suspected patients were isolated using airborne precautions in the designated hospital
  7. 7. THE CULPRIT DIAGNOSIS  Collected respiratory, blood, and faeces specimens  A novel coronavirus, which was named 2019-nCoV was isolated then from lower respiratory tract specimen  Diagnostic test for this virus was developed later
  8. 8. A NEW 1000 BED HOSPITAL WAS BUILT IN 10 DYAS
  9. 9. • Technical interim guidance for novel coronavirus, WHO: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  10. 10. As of 11:00 a.m. ET January 31, 2020
  11. 11. • Technical interim guidance for novel coronavirus, WHO: https://www.who.int/emergencies/disease s/novel-coronavirus-2019
  12. 12. OBJECTIVES Clinical, laboratory, Radiological characteristics Treatment Clinical outcomes of these patients.
  13. 13. METHODS  All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan.  The data was collected and analysed on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR  Researchers also directly communicated with patients or their families
  14. 14. OTHER INVESTIGATIONS Nasopharyngeal swabs BAL samples for most common virus including SARS and MERS-CoV using real-time RT-PCR assays approved
  15. 15. The Lancet DOI: (10.1016/S0140-6736(20)30183-5) Figure 1: Date of illness onset and age distribution of patients with laboratory-confirmed 2019-nCoV infection (A) Number of hospital admissions by age group. (B) Distribution of symptom onset date for laboratory-confirmed cases.
  16. 16. COMMON COMPLICATIONS  ARDS 29%  RNAaemia 15%  Acute cardiac injury 12%  Secondary infection 10%  Invasive mechanical ventilation 10%
  17. 17. .THE PROPHET ‫ﷺ‬SAID, ‘“THERE IS NO DISEASE THAT ALLAH HAS SENT DOWN EXCEPT THAT HE ALSO HAS SENT DOWN ITS TREATMENT.’ (BUKHARI).
  18. 18. WHENEVER THE MESSENGER OF ALLAH ‫ﷺ‬SNEEZED, HE WOULD COVER HIS MOUTH WITH HIS HAND OR A PIECE OF CLOTH...’ (AT-TIRMIDHI). WASHING HANDS, WUDHU, GHUSL PERSONAL HYGIENE ALL STRONG ASPECTS OF ISLAM.
  19. 19. PROTECT YOURSELF AND OTHERS  Frequently clean hands by using alcohol-based hand rub or soap and water;  When coughing and sneezing cover mouth and nose with flexed elbow or tissue – throw tissue away immediately and wash hands;  Avoid close contact with anyone with fever & cough  If you have fever, cough and difficulty breathing seek medical care early and share previous travel history with your health care provider;
  20. 20. PROTECT YOURSELF AND OTHERS  Avoid direct unprotected contact with live animals and surfaces in contact with animals.  The consumption of raw or undercooked animal products should be avoided.  Raw meat, milk or animal organs should be handled with care, to avoid cross-contamination with uncooked foods,
  21. 21. THE MANAGEMENT  Emperical antibiotics  Oral oseltamir  Methylprednisolone 40–120 mg per day
  22. 22. OUTCOME 28 (68%) of 41 patients have been discharged 6 (15%) patients have died.
  23. 23. FITNESS FOR DISCHARGE  Abatement of fever for at least 10 days,  Improvement of chest radiographic evidence  Viral clearance in respiratory samples from URT
  24. 24. DISCUSSION  Clinical presentations greatly resemble SARS-CoV  Patients with severe illness developed ARDS and required ICU admission  The time between hospital admission and ARDS was as short as 2 days.  As of Jan 24, 2020, 835 laboratory- confirmed 2019-nCoV
  25. 25. DISCUSSION  2019-nCoV could have acquired the ability for efficient human transmission.  Airborne precautions, such as a fit-tested N95 respirator, and PPE are strongly recommended.  Onset of fever and respiratory symptoms should be closely monitored among health-care workers.
  26. 26. SIMILARITIES BETWEEN 2019- NCOV AND PREVIOUS BETACORONAVIRUS Most patients presented with  Fever,  Dry cough,  Dyspnea,  Bilateral ground-glass opacities on chest CT scans.
  27. 27. THE DIFFERENCES BETWEEN 2019-NCOV & PREVIOUS BETACORONAVIRUS Few patients with 2019-nCoV infection had prominent upper respiratory tract signs and symptoms 2019-nCoV patients rarely developed intestinal signs and symptoms
  28. 28. Technical interim guidance for novel coronavirus, WHO: https://www.who.int/emergencie s/diseases/novel-coronavirus- 2019
  29. 29. CORTICOSTEROIDS Corticosteroids were given to very few non-ICU cases with 2019- nCoV infections Further evidence is urgently needed to assess risk and benefits
  30. 30. NOVEL TREATMENT Randomised controlled trial has been initiated quickly to assess the efficacy and safety of combined use of lopinavir and Ritonavir in patients hospitalised with 2019- nCoV infection.
  31. 31. STUDY LIMITATIONS  Diagnosis was confirmed with lower respiratory tract specimens and no paired nasopharyngeal swabs were obtained to investigate the difference in the viral RNA detection rate between upper and lower respiratory tract specimens.  With the limited number of cases, it is difficult to assess host risk factors
  32. 32.  Cough & sob are common symptoms  CT chest shows bilateral consolidation/GG.  BAL sample PCR is diagnostic  Supportive treatment  Strict isolation precautions and good hand hygiene
  33. 33. 1.Huang C Wang Y Li X et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.Lancet. 2020; (published online Jan 24)https://doi.org/10.1016/S0140–6736(20)30183–5 2. https://www.cdc.gov/coronavirus/2019-ncov/summary.html
  34. 34. AN AMERICAN MOVIE CONTAGION THAT WAS RELEASED IN 2011 SPEAKS OF A CORONAVIRUS-LIKE VIRUS THAT BEGINS SPREADING FROM CHINA TO SPREAD TO THE REST OF THE WORLD!
  • RohitKumarDhusia

    Mar. 16, 2020
  • JerardLloyd

    Feb. 23, 2020
  • drharoonmohd

    Feb. 7, 2020
  • msakrana

    Feb. 3, 2020

EPIDEMIOLOGY, CLINICAL FEATURES, AND MANAGEMENT OF NOVEL CORONA VIRUS 2019( nCOV 2019)

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