SARS vs.

COVID-19
Agojo, Mark Dave
Loyogoy, Roseller Jake
Objectives:
1. Differentiate SARS from COVID-19
2. Etiology and epidemiology
3. Clinical features
4. Complications
5. Management
 01
SARS
 what is

SARS?
Severe Acute Respiratory
Syndrome A zoonotic disease.

Caused by coronavirus, called

SARS-associated coronavirus First reported in China in
(SARS-CoV) February 2003

They get their name, “corona,” According to WHO, a total of 8,098

from the many crown-like people became sick with SARS .
spikes on the surface of the 774 total deaths
virus.
 Causative Agent
SARS-CoV
Susceptible Host
Immuno- Reservoir
Compromised Humans
People
(e.g. elders)
CHAIN OF
INFECTION
Portal of Entry Portal of Exit
Mouth and Nose Mouth and Nose
Mode of Transmission
Droplet transmission, Direct contact
CLINICAL SIGNS AND SYMPTOMS
of patient infected with SARS

Headache
Overall feeling of discomfort

High fever

Body ache

Less common symptoms:

Diarrhea and dry cough
MANAGEMENT
Diagnostic Molecular test (PCR)

Antibody test

Cell culture

Medication Oxygen therapy

Tracheal intubation

Mechanical intubation
 PREVENTION

Always wear face

Wash hands Disinfect regularly
mask

Avoid goin on
Avoid close contact Bring alcohol
crowded areas
TAKEAWAY
● SARS outbreak occurred in 2003

● It resulted from SARS-CoV

● There is no cure for SARS and no vaccine against

SARS-CoV

● It was eradicated in 2004. Since 2004, there have been no

recorded cases of SARS anywhere in the world.
 02
COVID-19
 What is COVID - 19?

Caused by the severe

acute respiratory Highly contagious
syndrome coronavirus 2 in human
(SARS-CoV-2)

Successor to
SARS-CoV-1
First recognized in
Wuhan, Hubei province,
China, in December 2019

R0= 2.24 to 3.58

They get their name, “corona,”

Positive-sense
from the many crown-like
single-stranded RNA
spikes on the surface of the
virus
virus.
 Prevalence of COVID - 19
Cases Deaths Recovered
154, 212, 688 3,227,828 131,645,735

33.2M Cases US
 Modes of Transmission

Respiratory droplets when an

infected person coughs,
sneezes, talks, sings or
breathes near you
From close contact
with an infected person

Virus travels in small

respiratory droplets that linger
in the air for minutes to hours
By touching surfaces that the
virus has landed on, then
touching your eyes, mouth, or
nose before washing your
hands
Pathophysiology
Diagnostic
Tests for
COVID-19
 CLINICAL SIGNS AND SYMPTOMS OF PATIENT WITH
COVID-19 INFECTION

Fever
Cough
Shortness of breath
Myalgia
Headache
Diarrhea
Loss of taste (ageusia)
Loss of smell (anosmia)
 EPIDEMIOLOGIC RISK FACTORS
HIGH RISK (severe or
critically ill)
- Pneumonia with
SpO2 < 92, RR >30,
MODERATE RISK
LOW RISK (mild disease) SBP <90
- With pneumonia but
- Mild symptoms, no - Age >60 years
not oxygen requiring
pneumonia, no - Preexisting
hypoxia pulmonary disease
- CKD
- DM
- HTN or CVD
transplant
 MANAGEMENT
No definitive treatment, mainly
supportive
Initiate Oxygen therapy
● Target: SpO2 >92%
Pharmacologic Anti-virals (Remdesivir, Lopinavir, Rotinavir)
Dexamethasone
Antimicrobials for Pneumonia
Interferon
Convalescent plasma
Tocilizumab
Hemoperfusion
Vitamin C + Zinc

Non-pharmacologic Diet as tolerated

 DIAGNOSTIC TESTS FOR SUSPECTED, PROBABLE, OR CONFIRMED
COVID -19 DISEASE (Baseline diagnostics)

HIGH RISK (severe or critically ill)

- CBC
- Complete metabolic panel
LOW RISK (mild disease)
- Procalcitonin
- None needed
- CRP
- D dimer
- LDH
- PT/INR
 DIAGNOSTIC TESTS FOR SUSPECTED, PROBABLE, OR CONFIRMED
COVID -19 DISEASE (Baseline diagnostics)

HIGH RISK (severe or critically ill)

- Ferritin
- Creatinine Kinase
- Sputum or ETA GS/CS*
- Influenza A/B
- Respiratory viral panel*
- Blood and urine culture*
- CXR PA/LAT
- CT Chest

*If indicated or available

Criteria for Discontinuation of Transmission-based
precautions including isolation
● Mild to moderate case
○ At least 10 days have passed since symptoms first appeared and
○ At least 24 hours have passed since last fever without the use of fever-reducing medications
and
○ Symptoms (e.g., cough, shortness of breath) have improved
● For asymptomatic cases
○ clinically recovered and no symptoms presented within 10 days.
● For severe and critical,immunocompromised patients
○ At least 10 days and up to 20 days have passed since symptoms first appeared and
○ At least 24 hours have passed since last fever without the use of fever-reducing medications
and
○ Symptoms (e.g., cough, shortness of breath) have improved
○ Consider consultation with infection control experts
Long Term effects of covid
● Tiredness or fatigue
● Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
● Headache
● Loss of smell or taste
● Dizziness on standing
● Fast-beating or pounding heart (also known as heart palpitations)
● Chest pain
● Difficulty breathing or shortness of breath
● Cough
● Joint or muscle pain
● Depression or anxiety
● Fever
● Symptoms that get worse after physical or mental activities
Complications
● ARDS
● Septic shock
● Invasive ventilation
● ECMO
● Death
 Prevention

1 2

Wash your Hands Use hand sanitizers Wear a Mask

often with soap and water. Use or Alcohol that covers your nose and mouth
hand sanitizer if soap and water to help protect yourself and
aren’t available others

3 4

Avoid crowds and Avoid close contact

poorly ventilated from a suspected or
Disinfect
indoor spaces infected person
Will vaccines render useless to previously infected person?

● Even if you have already had COVID-19, you should be vaccinated when it is offered to you. The protection that
someone gains from having COVID-19 will vary from person to person, and we also don’t know how long natural
immunity might last.
When can a recovered COVID-19 patient receive vaccine?

● Vaccination of people with known current SARS-CoV-2 infection should be deferred until the
person has recovered from the acute illness (if the person had symptoms) and they have met
criteria to discontinue isolation.

● For patients who received convalescent plasma, vaccination should be deferred at least 90 days.
Must know
 Isolate
Vs.
Quarantine
Nice to know…
Chloroquine or Hydroxychloroquine as post exposure prophylaxis
for COVID-19
Chloroquine or Hydroxychloroquine as treatment for COVID-19?
Lianhua as treatment for COVID-19?
Ivermectin as prophylaxis for COVID-19?
References
Cevik M, Kuppalli K, Kindrachuk J, Peiris M. Virology, transmission, and pathogenesis of SARS-CoV-2 BMJ 2020;
371:m3862 doi:10.1136/bmj.m3862
Zhu, Z., Lian, X., Su, X. et al. From SARS and MERS to COVID-19: a brief summary and comparison of severe acute
respiratory infections caused by three highly pathogenic human coronaviruses. Respir Res 21, 224 (2020).
https://doi.org/10.1186/s12931-020-01479-w
Caldaria, A., Conforti, C., Di Meo, N., Dianzani, C., Jafferany, M., Lotti, T., Zalaudek, I., & Giuffrida, R. (2020).
COVID-19 and SARS: Differences and similarities. Dermatologic therapy, 33(4), e13395.
https://doi.org/10.1111/dth.13395
Philippine Society for Microbiology and Infectious Disease. (2020). Interim Guidelines on the Clinical Management of
Adult Patients with Suspected or Confirmed COVID-19 Infection 2.0

Philippine College of Physicians COVID-19 Treatment Guidance March 2021 Coronavirus Disease 2019 (COVID-19)
Treatment Guidelines
https://files.covid19treatmentguidelines.nih.gov/guidelines/section/section_94.pdf
Thank you!