A summary on COVID-19 disease and SARS-CoV-2 for non-medical personnel

Written by Dr Mariam Jow-Mbowe

Brief Summary on COVID 19

There are many types of coronaviruses found in animals and humans. 7 have been identified to cause infections in humans. Some give the common cold others pneumonia and even severe respiratory distress syndrome. Two Coronaviruses were responsible for outbreaks in the past SARS (2003 in China) and MERS (2012 in Saudi Arabia). The novel coronavirus responsible for the 2019-2020 pandemic causes an illness called COVID-19 and the virus is called SARS-CoV-2. The membrane of the virus (outer covering is made up of lipids (fats) which can be destroyed by soap and alcohol. When the membrane of the virus is destroyed it leads to eventually the death of the virus.

Viruses infect the body by latching onto and entering healthy cells. The cell is the basic unit of life. Once inside the cell, the virus makes copies of itself and multiplies throughout the cells in the body by making new proteins leading to the formation of new viruses. The coronavirus can gain entry into the body through the eyes, nose, or mouth. It then grabs onto the cells by latching its spikey surface proteins to receptors on normal cells, especially those in the airways. Specifically, the viral proteins of SARS-CoV-2 enter into cells through the ACE2 receptors. Once inside, the coronavirus hijacks the healthy cells and takes over command. Eventually, they kill some of the healthy cells and new viruses will infect other healthy cells.

COVID-19, the illness caused by the coronavirus, starts in the respiratory tract. That’s the airway between the mouth, nose, throat, and lungs. It’s the same place that the common cold attacks. But COVID-19 can become more serious than the common cold because it is more likely to get deeper into the respiratory tract, including into the lungs. That’s because the lower airways have more ACE2 receptors. Smoking cigarettes increases these receptors which might explain the increase in deaths in smokers reported by early researches on the disease. The way it spreads is through respiratory droplets from person to person when a person with the virus exhales or cough which can infect surfaces and also travel about 1 meter. This is the reason behind the advice for people to stay one meter apart and also to avoid handshakes and touching the face with unclean hands. There are reports from researchers that it can be transmitted through aerosols (tinier than droplets) but more scientific information is needed to prove it.

When the virus enters the body and it is spotted the immune system counterattack as a way of defense. One sign of that is a fever as the white blood cells produce a substance which causes it. There might also be a cough mostly reported to be dry as no sputum is produced. That is the body’s usual response to foreign bodies (something that’s in the airways that shouldn’t be). The mounted immune response causes damage to the organ systems. Symptoms reported by WHO and early findings from China include difficulty breathing, fatigue, sore throat and even diarrhoea which is not a very common presenting complaint.

More than 8 in 10 cases are mild. But for some, the infection gets more severe. The infection is reported to be worst in patients with underlying medical problems like diabetes, heart diseases like high blood pressure and heart attack, patients with previous lung problems like asthma, COPD (chronic pulmonary lung disease or smoker’s lung disease) cancers patients, immunosuppressed patients just to name some examples.

As the infection reaches the lower respiratory system, including the lungs, it can be hard to breathe. This is when more serious medical problems can crop up. Problems like pneumonia. This makes the airways swell and the lungs fill with fluid. In the most severe cases, this fluid in the lungs can lead to acute respiratory distress syndrome or ARDS. People who get this condition are usually already in the hospital for the illness. ARDS makes it difficult or impossible to breathe because the lungs are grossly inflamed making gas (oxygen and carbon dioxide) exchange difficult leading to suffocation of tissues.

As fluid collects in the lungs, they carry less oxygen to the blood. That means the blood may not supply organs with enough oxygen to survive. This can cause organs like the kidneys, lungs, and liver to fail down and stop working leading to multi-organ failure and eventually death.

Not everyone who has COVID-19 has these serious complications. And not everyone needs medical attention. However, patients not showing symptoms can continue infecting people who are healthy as carriers and transmitters of the infection. Death from COVID-19 in the young is not much reported as compared to the elderly and sick there are cases death in the young.
As there is no drugs or vaccine found to be effective against the virus. Research is ongoing in many countries to find definitive treatment. However, treatment is mainly supportive for example giving paracetamol for fever and giving oxygen and fluid to help the circulatory system. Precautions can be taken as the saying goes PREVENTION IS BETTER THAN CURE.

Let us continue washing hands with soap and water or use alcohol-based hand sanitizers. Cologne which has alcohol can also be used.
Whilst coughing or sneezing cover mouth with single-use tissue or use bend of the elbow. Clean frequently touch objects especially mobile phones.

Eating healthy (balanced diet and stay hydrated by drinking water and natural juices. Eat foods rich in vitamin C like oranges, grapefruit, pineapples, moringa to boost the immunity

Stay at home but also stay fit by becoming more active by doing indoor activities or by frequently moving in the house.

Do not share fake news only share information that is coming from official sources.

Do not cause panic as it will weaken the immune system further leading to worse outcomes and stress.

Keep educating your families and neighbours and the public about the COVID-19 and how to stay safe from infectious diseases.

If you think you are sick with the Virus call for help by using the emergency call numbers to seek help from health officials. Do not walk into the facility to seek care by doing you can infect thousands. Do not become a super spreader. Let us break the chain.

For Further Reading consult WHO and CDC websites.

By Dr Mariam Jaw Mbowe
MBChB (UTG)