All you need to know about COVID-2019. Associate Professor Dmytro Oliinyk reports

Due to the spread of COVID-2019 coronavirus infection worldwide, the Internet and the media are fuul of information about the new virus. Today, it is very important not to succumb to the general panic, perceive information critically and not to neglect media hygiene. Odessa National Medical University once again calls for adherence to the general recommendations for prevention and quarantine, which has been introduced throughout Ukraine on March 17, 2020. Why everyone should take the topic of coronavirus seriously, tells Associate Professor of ONMedU, Candidate of Medical Sciences, doctor of the highest category Dmytro Oliinyk.

1. What is a coronavirus?

First of all, it’s not the flu. Coronavirus has a completely different origin, structure and belongs to another group of viruses. The SARS-Cov-2 coronavirus causes Covid-19 disease, unlike its SARS precursors, has a hybrid structure that partly carries a mutation that has HIV, and partly from a previously known SARS. It makes it more susceptible to mutations and more active toward human cells.

2. What is the current situation with the coronavirus in the world and in Ukraine today?

As of March 18, 2020, 179 111 people are considered sick in the world. Most of them are recorded directly in China – 81 116 cases. But also, today we have a large number of cases in Europe – 64188 people. The main epicenter for the coronavirus today is Italy – 27,980 confirmed cases of SOVID-2019. Concerning mortality, in the world today there are 7426 deaths from SOVID-2019, of which 3108 deaths occur in Europe. As for Ukraine, as of the morning of March 19, 16 cases of COVID-19 were confirmed in the laboratory in Ukraine: Chernivtsi region – 10 (1 lethal), Zhytomyr 1 (lethal), Kiev region – 2, Donetsk – 1, Kyiv – 2 cases.

3. Who can get sick with COVID-2019?

First of all, it should be understood that COVID-19 has several differences from its predecessors: a long incubation period, which can last up to 14 days (but on average of no more than 5 days); higher contagiousness – the tendency to contraction sometimes even without symptoms, and a high likelihood of developing severe viral pneumonia.

This is due to the predisposition of COVID-2019 to ACE2 receptors, which are mostly located in the alveolar cells of the human lungs. In children, the number and activity of such receptors is small, which is why children have the coronavirus not so often and in a milder form. The main risk group is the elderly people, especially the ones with various concomitant pathologies – with hypertension, kidney disease, and diabetes. They have a severe course and mortality due to the development of respiratory distress syndrome and other complications.

Determinants of the risk of death are:

• Age: Mortality rises to 8% in patients aged 70-79 years and can reach 14.8% in patients aged ≥ 80 years.
• Concomitant pathology: mortality increases to 10.5% in patients with cardiovascular disease, 7.3% in diabetics, 6.3% in patients with chronic respiratory diseases, 6% in hypertension and, finally, 5.6% in cancer patients.

4. How is COVID-2019 transmitted?

To date, the coronavirus transmission routes are confirmed to be airborne and fecal-oral (contact-household). But there must be some conditions for this. The virus is considered to be capable of being transmitted by close contact with a patient if he has been breathing, sneezing or coughing into your face, and if you have touched your face, mouth and eyes after contact with the patient, or objects or surfaces on which the  coronavirus may be stored for some time. The most common way to get infected is to touch people, so you need to wash your hands frequently. The virus can live on your hands for 5-10 minutes. But anything can happen in these 5-10 minutes (you can rub your eyes or touch your nose).

5. What are the first symptoms of COVID-2019?

The symptoms of coronavirus are very nonspecific and similar to those of other respiratory diseases, especially common influenza. But there are some differences:

1. Congestion of the nose. It is not like normal stuffiness. There is a feeling that you are sinking in the water.
2. Coronavirus is a dry cough without runny nose. If your first symptoms are a runny nose and phlegm like a cold, there is a chance it’s not the coronavirus.
3. Upon penetration of the coronavirus, there may occur dry mouth, dry throat, which is characteristic for quinsy. This will last for 3-4 days.
4. High fever and shortness of breath.

There are other symptoms as well, but they are primarily described as the overall picture of a viral infection: such as muscle pain, diarrhea, nausea, fever, etc., and are not specific.

6. What if you have a suspected conovirus disease?

First of all, do not panic. If you have symptoms that are similar to those of the coronavirus, the most important thing to do is to stay home, avoid contact with other people, and tell your local doctor about your case. Today, the only way to confirm the diagnosis of the coronavirus disease is to have a sufficient number of COVID-2019 tests available in hospitals of Odessa and Ukraine.

7. How is COVID-2019 treated? Is there a vaccine?

To date, there are no vaccines and no specific antiviral medicines for the coronavirus. However, according to the latest guidelines for the treatment of coronavirus disease in Italy, patients are treated with the combination of Lopinavir / Ritonavir with Chloroquine, although this drug is for malaria but has a high antiviral activity in vitro for both SARS virus and bird flu. In fact, chloroquine can exert its antiviral efficacy by increasing the endosomal Ph required to fuse the virus / host cell. In addition, chloroquine apparently interferes with glycosylation of SARS COVID-2019 cell receptors.

Another drug that seems to be working is Remdesivir, designed for Ebola patients. Some doctors in southern Italy in Naples use Tocilizumab (tocilizumab), which also seems to work. It is a protein that stops interleukin. He is against arthritis, but it also seems to work. But it should be noted that all of these drugs in Ukraine are quite rare and expensive.

8. What kind of coronavirus prevention is there and how not to get sick with COVID-2019?
9. The most effective method of prevention today is quarantine or preventing infection by eliminating contact with infected people. Avoid visiting large crowds and avoiding contact with patients, keeping a distance of at least 3 meters when possible.
10. Respiratory and eye protection methods. It is important to understand that a standard mask will not save you from contracting the virus, but if you are sick you should use a mask to protect others from infection.
11. Coronavirus has a protein structure, so anything that can affect it – mouthwash with alcohol, hot drinks or saline solutions should be used;
12. Hygiene of hands and common objects. Do not touch your face with hands.
13. If possible, spend more time outdoors and in the sun, as the virus is sensitive to ultraviolet light.
14. What are the COVID-2019 epidemic projections?

Taking into consideration the speed with which the situation changes every day, it is very difficult to make forecasts. But, according to international forecasts of the World Health Organization and the Center for Disease Control and Prevention, it is projected to reduce the activity of the virus closer to May-June 2020. But much depends on trends in the development of this epidemic in the near future and unconditional implementation of quarantine restrictions in all regions of the world, including Ukraine.