Coronavirus & COVID-19

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-08-25 11:04

Coronavirus & COVID-19

The group of coronaviruses includes a large number of viruses that can cause different diseases. At the end of 2019, a new member of the virus family was discovered that had never been detected in humans before. It bears the name SARS-CoV-2, mostly of the "new type of coronavirus".

The disease that the virus causes is known as COVID-19. The symptoms were originally seen mainly in the respiratory tract. With increasing knowledge, however, it turned out that the spectrum of complaints is very broad and varies with age and concomitant diseases. Mild courses, similar to a cold, up to the most severe illnesses with a fatal outcome are possible. In order to protect yourself from infection, as with other infectious diseases, hygiene measures are essential.

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What is the coronavirus?

Coronaviruses are a large family of viruses that can cause various diseases in humans as well as mammals, birds, and fish. They were first identified in the 1960s. The virus family includes the so-called SARS coronavirus (SARS-CoV), which first appeared in humans in 2002, and the MERS coronavirus (MERS-CoV), which has been known worldwide since 2012. In late 2019, a novel strain of the virus was identified that had never been previously detected in humans. The official name for the pathogen is SARS-CoV-2, the abbreviation SARS stands for Severe Acute Respiratory Syndrome. The disease caused by the virus is called COVID-19 (Corona Virus Disease 2019).

The novel coronavirus and the disease associated with it was first described in the metropolis of Wuhan (Hubei Province, China) and spread into a global pandemic. The exact source of the outbreak is currently unknown.

There are still many unanswered questions about the properties of the novel coronavirus, e.g. transmission, duration of illness, course, etc. The current state of knowledge relates on the one hand to the observations made in the last few weeks and months. On the other hand, knowledge of the coronaviruses known to date can be used to draw conclusions about the new virus strain.

Experts around the world are constantly monitoring and analyzing the situation and examining the virus in various laboratories. They exchange knowledge in order to derive protective measures and recommendations.

How is the virus transmitted?

The novel coronavirus can be transmitted from person to person. It is mainly transmitted via the respiratory tract, ie the viruses are spread by those affected when they breathe out, sneeze, cough, especially when they speak out loudly and singly, and are absorbed by others with their breath.

The virus particles can be transmitted with so-called aerosols (tiny droplets suspended in the air) or droplets. Aerosols are excreted when speaking and breathing, and even more when screaming or singing. Especially in closed rooms, the aerosols can float in the air for a long time and spread. Virus-containing droplets are mainly released when coughing or sneezing (droplet infection). The transition between the two transmission paths is fluid.

The actual risk of infection depends on various factors, such as

• Amount of virus particles excreted by the infected person,
• Location and duration of contact with the infected person: the risk is higher in closed rooms than outdoors, especially if there is poor or no ventilation and longer stays,
• Proximity to the infected person: the risk of infection exists above all within a radius of one to two meters from an infected person.

The novel coronavirus can also stick to the skin and objects (e.g. door handles, telephone) and be transmitted via hands (smear infection) - especially if hands with virus particles come into contact with the eyes, nasal or oral mucosa.

How long the virus can survive on surfaces is currently not fully understood. A transmission via objects that do not come from the immediate environment of a person concerned, such as goods imported from risk areas, however, seems very unlikely. As with other coronaviruses, no cases of transmission via food or drinking water have yet been known for the novel coronavirus.

In general, stool, urine, blood and other body fluids can also contain particles of the novel coronavirus. However, it has not been sufficiently clarified whether they play a role as transmission routes. Strict regulations apply to blood donations. In the selection of donors for canned food and the testing of blood products, special measures are recommended and implemented so that they can be regarded as safe.

Pregnancy & breastfeeding

In the majority of documented COVID-19 infections in pregnant women, the virus was not transmitted to the unborn child. However, individual cases of illness in newborns that may be due to an infection in the womb have been reported. The data situation on possible transmissions of COVID-19 to the unborn child is currently insufficient to be able to make reliable statements. The same applies to possible transmissions during breastfeeding or through breast milk. According to the WHO, there is currently no reason to give up breastfeeding, even if the mother has confirmed COVID-19 disease.

More information on the transmission of COVID-19: FAQ Coronavirus (AGES)

incubation period

According to current knowledge, the incubation period of COVID-19 - i.e. the period from infection to the appearance of the first symptoms - seems to be between one and 14 days, with an average of five to six days.

The novel coronavirus can be transmitted to others two days before the signs of illness appear. The risk of this seems to be particularly high in the 24 hours before symptoms begin. Infection is generally also possible through those affected who show no or only mild symptoms.

What are the symptoms?

The spectrum of possible complaints with a COVID-19 illness is very broad. The following symptoms can occur, among others:

Common (more than 50 percent of the time):

• Disorder of the sense of smell or taste
• fever
• (dry cough
• Shortness of breath, shortness of breath
• fatigue
• Lack of appetite

Less often (up to 50 percent of the time):

• Expectoration
• Muscle aches
• Chest pain
• diarrhea
• Nausea, vomiting
• a headache
• dizziness
• Sore throat

Rarely (less than ten percent of the time):

• confusion
• runny nose
• Circulatory collapse, fainting
• Skin manifestations

The symptoms can change in the course of the disease. Initially, symptoms such as headaches and a blocked nose may be more in the foreground and only after a few days do other signs such as cough and fever appear. Often a course is observed in two phases, ie after the initial symptoms have already improved, there is a renewed deterioration in the state of health. In severe cases, the initial symptoms can turn into pneumonia, which is usually bilateral.

In addition, COVID-19 infections were also observed, in which those affected were almost symptom-free.

Note There is no standardized, typical symptom of COVID-19. In some cases, the illness may be similar to the flu (influenza). The symptoms and the course of COVID-19 are diverse and vary greatly.

Complications

Possible life-threatening complications of a COVID-19 illness include:

• acute respiratory distress syndrome,
• pathological activation of the blood coagulation system, as a result of which clots form in the blood vessels; as a result, the risk of thromboembolism and strokes is greatly increased,
• Cardiac arrhythmias, serious disorders of the heart muscle function and acute coronary syndrome,
• Kidney failure,
• Super infections caused by bacterial germs and fungal infections,
• Shock, sepsis and multiple organ failure.

Note It is noticeable that massively reduced oxygen levels in the blood (due to pneumonia and the formation of clots in the blood vessels of the lungs) are sometimes unusually well tolerated by the patients ("happy hypoxia"). However, within a very short time (minutes!), Life-threatening lung failure with the need for ventilation can develop.

How is the disease going?

In around 80 percent of those affected, COVID-19 takes a mild or moderate course, which means that the symptoms are rather mild and subside on their own without special treatment and without hospitalization. Diseases with a severe or fatal course occur more frequently in elderly and immunocompromised people, as well as in people with previous illnesses.

The risk group therefore includes older people aged 50 or 60 and over and people with the following diseases:

• advanced, chronic lung diseases that require permanent treatment,
• chronic heart disease with consequential damage to organs (e.g. heart failure),
• active cancers with associated treatment within the last six months or cancer at an advanced stage,
• Diseases treated with immunosuppression (suppressing the immune system)
• advanced chronic kidney disease,
• chronic liver disease,
• Obesity from grade III with a BMI> 40,
• diabetes mellitus not adjusted accordingly as well
• Chronic high blood pressure not properly adjusted.

In the risk group, the mortality from COVID-19 is sometimes significantly higher.

Note Even in healthy and young people without risk factors, severe disease can occur.

More on the topic: FAQ: Risk groups (Ministry of Social Affairs)

mortality

A mortality rate of around three percent is currently assumed for COVID-19. According to the WHO, there are around 28.6 million confirmed cases of COVID-19 and around 917,000 associated deaths worldwide (as of September 14, 2020). The current data can be found on the WHO website.

Note The information on death rates from COVID-19 is sometimes very different; comparisons with death rates from other diseases (e.g. influenza) are very difficult. Various factors play a role (e.g. different types of data collection and evaluation, number of tests carried out, groups of people tested, inclusion of an estimated number of unreported cases, etc.).

The increases in the mortality of certain groups of people (eg cancer patients, patients with advanced diseases) are in some cases clearly pronounced.

Children, adolescents & pregnant women

According to the current state of knowledge, children and adolescents do not have an increased risk of a severe course of the disease. This does not apply to babies under one year of age as well as children and adolescents with certain chronic diseases, such as asthma, obesity, diabetes, etc. In these cases, the risk of a severe course is increased - as is the case with adults with previous illnesses.

A dreaded complication that has been observed in children and adolescents in connection with COVID-19 infections is the so-called pediatric multi-system inflammation syndrome: This leads to massive overreactions of the immune system, with severe skin and mucous membrane symptoms, cardiac involvement and even shock (similar to Kawasaki syndrome, an inflammation of the blood vessels that can affect the arteries of various organs). The clinical picture is generally rare and is usually found after a SARS-COV-2 infection, so that the PCR test can already be negative.

Overall, however, COVID-19 affects comparatively few children and adolescents and is largely mild in this group in the event of illness.

Even pregnant women do not seem to have an increased risk of a severe course compared to non-pregnant women.

Long term effects & immunity

It is currently not possible to make any reliable statements about the possible long-term consequences of a COVID-19 illness. However, it is increasingly observed that those affected can still show symptoms weeks and months after the infection and that these symptoms persist much longer than with classic bacterial pneumonia. This applies in particular to the following complaints:

• Feeling weak,
• Breathlessness,
• Voice changes,
• Anxiety and depression,
• Sleep disorders,
• Memory disorders and
• Hair loss.

In addition, there is increasing evidence that SARS-CoV-2 viruses also damage the brain and nerve cells directly and can cause meningitis or encephalitis, for example. Severe encephalopathies (diseases or damage that affect the brain as a whole) or autoimmune diseases of the brain and nerves can also be a possible long-term consequence of the infection.

Complications from treatments (e.g. long-term ventilation) are also possible.

In very rare cases, a COVID-19 disease can occur again after an infection. The infection usually leads to the development of special antibodies that are directed against components of the virus (immunity). These antibodies are detectable from about the second week after the onset of symptoms, but not in all patients. It has not been sufficiently clarified whether or for how long these antibodies can offer adequate protection against re-infection. It is currently assumed that there is only a very low risk of repeated infection, at least for a certain period of time.

How is the diagnosis of COVID-19 disease made?

The diagnosis of COVID-19 disease is made through direct detection of the novel coronavirus, usually using a so-called PCR test. To do the test, a smear is taken from your nose or throat; Saliva samples or throat rinsing fluid are used occasionally (RT-LAMP test). The sample is then examined for the presence of the virus in special laboratories. The evaluation time of the test is only a few hours. However, depending on the number of tests, a few days may pass after the sample has been taken before the result is available.

Whether such a PCR test is carried out depends on various criteria. In principle, a test should be carried out as early as possible on all people who are suspected of having COVID-19 based on clinical symptoms.

As a suspected case

• any form of infection of the respiratory tract (respiratory infection),
• with or without fever,

• having at least one of the following symptoms for which there is no other plausible cause:

  • To cough,
  • Sore throat,
  • Shortness of breath,
  • Catarrh of the upper respiratory tract,
  • sudden loss of smell / taste.

More on the topic: Currently valid suspected case definition (Ministry of Social Affairs)

In addition, other reasons, such as previous contact with an infected person, high regional number of cases of illness, etc., may also make PCR testing for COVID-19 necessary. The clarification of a suspicion or the decision to carry out a test is made by a doctor according to defined criteria and recommendations.

A confirmed case is a person with laboratory diagnostic evidence (PCR) of SARS-CoV-2, regardless of the symptoms. The diagnosis is subject to official reporting.

Antibody tests

Antibody tests are based on the detection of antibodies, but not on the direct detection of the virus itself. Since it can take up to three weeks for the immune system to produce antibodies after an infection with the novel coronavirus, these tests are not used to diagnose an active disease suitable. This is especially true for tests that are carried out alone at home. In any case, medical expertise is required for the interpretation.

However, antibody tests can provide clues as to whether a person has had COVID-19 in the past. They can be used to draw conclusions about the contamination of the population or the spread of symptom-free / undetected infections. According to the current state of knowledge, however, a reliable statement about the immune status of the individual is not possible even through the detection of virus antibodies, nor about whether there is adequate protection against renewed infection.

What should I do if I suspect I have COVID-19?

If you fear you might be ill:

• Stay at home.
• Call the health counseling service on the phone at 1450 or your family doctor. Testing can be initiated in both ways.
• Follow the advice given over the phone.

If an infection is suspected, special safety criteria are followed that are recommended by the Ministry of Health according to international criteria.

How is COVID-19 treated?

People who have been diagnosed with the novel coronavirus can be quarantined at home if their symptoms are mild. The therapy is based on the symptoms and aims to alleviate symptoms. The doctor can, for example, prescribe antipyretic drugs, medication for sore throats, etc.

Serious cases are treated in the hospital, if necessary also with intensive care. Sometimes mechanical ventilation aids can also be used (e.g. in the case of ARDS symptoms). If further complications such as sepsis or acute kidney failure occur, these are treated accordingly in intensive care.

A causal treatment of the virus with a special drug is currently not possible and is currently the subject of research. Clinical trials are also currently underway and research is being carried out into the extent to which known antiviral drugs (virus-inhibiting drugs) or other known active ingredients could support the treatment.

Research is being carried out on the development of a vaccine. There is currently no approved vaccine against the novel coronavirus in Austria.

Segregation (quarantine and isolation)

Persons with a positive test result are officially segregated for 10 days by a notification from the medical officer (quarantine notification). If the state of health allows, the quarantine can be spent at home, in more severe cases in the hospital. Isolation is also required if a disease is suspected.

In addition, contact persons may be identified, informed and, depending on the situation, also placed in quarantine. The decision about segregation is made by the district administrative authority. All of the measures mentioned are aimed at preventing the virus from spreading further.

In the case of an officially ordered home quarantine, the apartment may not be left and no private visit may be received. The district administrative authority determines the precise regulations and informs those affected.

More on the topic: FAQ: Tests and quarantine (Ministry of Social Affairs)

How to prevent SARS-CoV-2 infection

As long as there is no vaccination to prevent a COVID-19 disease, the implementation of various protective measures has top priority to prevent the virus from spreading further. There are a number of recommended measures you can take to protect not only yourself but other people as well.

Important preventive measures

• Maintain a minimum distance of one meter from people who do not live with you in the same household. It has been shown that this significantly reduces the risk of transmission; a distance of two meters is even more effective.

• Wear mouth and nose protection, especially in situations in which you will meet many people or when the minimum distance cannot always be maintained. Studies show a significantly reduced risk of transmission if the mouth and nose protection is used correctly. Especially in a normal (non-medical) environment, mouth and nose protection always offers more protection than if no mouth and nose protection is worn. Additional eye protection (glasses, face shield) seems to reinforce the effect.

  Note At the moment, it is mandatory to wear a face mask in Austria in certain areas. More on the subject: FAQ: Mechanical protection device (MNS) (Ministry of Social Affairs)

• Maintain proper hand hygiene: wash your hands regularly with soap and water or use a disinfectant that contains alcohol.

• Sneeze and cough into a tissue (not your hands!) And throw the tissue away immediately. Or cover your mouth and nose with your bent elbow.

  Tip Videos on correct cell phone hygiene (Medical University of Vienna) and correct coughing and sneezing (Federal Center for Health Education) can be found on the Ministry of Social Affairs' homepage.

• Avoid shaking hands and hugs.
• Do not touch your eyes, nose or mouth ! Hands can pick up viruses and transfer them to the face.
• Avoid busy places.
• Regularly ventilate the rooms you are in (if possible once an hour).
• As soon as you feel sick, stay home and contact the health advice telephone 1450.

Note Take travel warnings seriously. Current travel recommendations and warnings can be found on the website of the Foreign Ministry.

How do I deal with the situation?

It is normal that the events related to the novel coronavirus outbreak can lead to feelings such as fear and stress. It is important not to fall into excessive fear and panic - these are not appropriate given the current situation and make sensible actions more difficult.

Finding out about facts and measures from trustworthy sources helps to deal with the situation objectively, e.g. to minimize the risk of infection. How to recognize trustworthy information can be found in the guide "Practical Guide: Where can I find reliable information on the Internet?" (Patient advocacy)

The WHO has also made recommendations on the effects of stress related to the coronavirus outbreak.

More on the topic: Corona crisis: Tips for dealing with the situation & the psyche

Where can I find more information?

• Coronavirus - Frequently Asked Questions (Ministry of Social Affairs)
• Coronavirus: Legal (Ministry of Social Affairs)
• FAQ Coronavirus with detailed explanatory videos (AGES)
• Together against the coronavirus (oesterreich.gv.at)
• Coronavirus: How can we take precautions? (Austrian red cross)