Coronavirus: Difference between revisions

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==Background==
==Background==
*Coronaviruses were first discovered in the 1960s and named after the crown-like spikes on their surface seen on electron microscopy.
*Enveloped, positive-stranded RNA viruses with nucleocapsid
*They are enveloped, positive-stranded RNA viruses.
*Very common cause of [[upper respiratory infection]], especially during fall and winter, and some diarrhea in pediatric patients
*They have a nucleocapsid around them and are the largest RNA virus.
*[[MERS]]-CoV and [[SARS]]-CoV types of Coronavirus cause the most severe infections.  
*Four main subtypes of Coronavirus:  alpha, beta, gamma, delta.
*Coronavirus is very common and most people will get infected atleast once in their lifetime, esp children but route of infection is controversial.  Most common time of infection is fall or winter.
*The cause of Coronavirus is hard to assess since it cannot be grown in laboratories, the way Rhinovirus can be grown (another common cold virus). 
*Commonly cause up to one-third of upper respiratory tract infections in adults and children.
**Also thought to cause diarrhea in infants, children, and farm animals.
*MERS-CoV and SARS-CoV types of Coronavirus cause the most severe infections.
**SARS stands for severe acute respiratory syndrome.
**SARS began in 2002 in Asia.
***SARS started off in the Guangdong Province in southern China in November 2002. Finally it reached Hong Kong, then it rapidly spread around the world, infecting the people in 37 countries.
**Up till now there have been more than 700 cases of death due to SARS, but during the epidemic (many called it a pandemic), there were 8,098 confirmed cases of SARS.
*The following human coronaviruses are currently known to virologists:
**MERS-CoV
**SARS-CoV
**HCoV-229E
**HCoV-OC43
**HKU1-CoV
**NL63/NL/New Haven coronavirus
**MERS-CoV
 
==Method of Replication==
*Coronavirus enters the cell cytoplasm and viral particle is uncoated causing RNA genome to deposit into cytoplasm.
*RNA viral genome is transcribed into new RNA copies via replicase protein.  


==Clinical Features==
==Clinical Features==
*Coronavirus usually presents like the common cold with an upper respiratory tract infection:  
*Incubation period: 2-4 days
**runny nose
*Upper respiratory symptoms
**cough
**rhinorrhea, cough, sore throat, earache, fever, malaise
**fever
**Respiratory symptoms may be more severe in elderly/immunocompromised (e.g. [[pneumonia]], secondary bacterial pneumonia)
**sore throat
*GI symptoms - vomiting, diarrhea, [[Necrotizing enterocolitis]] (in neonates)
**asthma exacerbation
**fatigue
**sneezing
*Symptoms show two to four days after coronavirus infection.
*Pulmonary - coughing, dyspnea/wheezing, respiratory failure (seen in elderly/immunocompromised), pneumonia, secondary bacterial pneumonia.
*GI - vomiting, diarrhea, [[Necrotizing enterocolitis]] (in neonates)
*HEENT - otalgia, coryza, rhinorrhea, sneezing


==Differential Diagnosis==
==Differential Diagnosis==
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==Evaluation==
==Evaluation==
*Generally no evaluation indicated
*Generally no testing indicated
*If needed, nasal swabs can be sent for PCR and immunofluorescent antigen assay
*If needed, nasal swabs can be sent for PCR and immunofluorescent antigen assay


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==Management==
==Management==
*There is no specific treatment for Coronavirus, since most infections spontaneously resolve.   
*There is no specific treatment for Coronavirus, since most infections spontaneously resolve.   
*Supportive care
*Supportive care, no specific treatment
**Rest
**Rest, hydration, analgesia, antipyretics
**Hydrate patient (Drink adequate water)
*Hand hygiene to prevent spread
**Clean humidifier or Cool mist vaporizer
*Pain and fever medications can be taken (do not give aspirin to kids).
**Take acetaminophen, ibuprofen or naproxen.


==See Also==
==See Also==
 
*[[Upper respiratory infection]]
*[[Fever]]


==External Links==
==External Links==

Revision as of 23:09, 7 September 2016

Background

  • Enveloped, positive-stranded RNA viruses with nucleocapsid
  • Very common cause of upper respiratory infection, especially during fall and winter, and some diarrhea in pediatric patients
  • MERS-CoV and SARS-CoV types of Coronavirus cause the most severe infections.

Clinical Features

  • Incubation period: 2-4 days
  • Upper respiratory symptoms
    • rhinorrhea, cough, sore throat, earache, fever, malaise
    • Respiratory symptoms may be more severe in elderly/immunocompromised (e.g. pneumonia, secondary bacterial pneumonia)
  • GI symptoms - vomiting, diarrhea, Necrotizing enterocolitis (in neonates)

Differential Diagnosis

  • Rhinovirus: most common cold virus. Causes around 40% colds.
    • as opposed to Coronavirus, this causes cold in other seasons besides winter.
    • Rhinovirus is NOT encapsulated as opposed to Coronavirus.
  • respiratory syncytial virus (RSV)
  • influenza
  • parainfluenza

Evaluation

  • Generally no testing indicated
  • If needed, nasal swabs can be sent for PCR and immunofluorescent antigen assay

Prevention

  • No vaccines have been made thus far to prevent Coronavirus.
  • Measures to reduce risk of transmission: fully wash hands, do not touch face without washing hands, avoid close contact with sick contacts.

Management

  • There is no specific treatment for Coronavirus, since most infections spontaneously resolve.
  • Supportive care, no specific treatment
    • Rest, hydration, analgesia, antipyretics
  • Hand hygiene to prevent spread

See Also

External Links

http://www.cdc.gov/coronavirus/about/ https://en.wikipedia.org/wiki/Coronavirus

References