Professional Documents
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Covid 19
Covid 19
• Swab Test – In this case, a special swab is used to take a sample from your
nose or throat
• Nasal aspirate – In this case, a saline solution will be injected into your nose
and, then a sample is taken with a light suction
• Tracheal aspirate – In this case, a thin tube with a torch, also known as a
bronchoscope, is put into your mouth to reach your lungs from where a
sample is collected.
• Sputum Test – Sputum is thick mucus that gets accumulated in the lungs and
comes out with a cough. During this test, you’re required to cough up sputum
in a special cup or a swab is used to take a sample from your nose.
• Blood test – In this case, a blood sample is taken from a vein in the arm.
Diagnostic tests
• viral tests
• antibody tests.
• A viral test indicates a current infection.
• SARS-CoV-2 antibodies' potency and protective period have not been established. [ A
positive antibody test may not imply immunity to a future infection
• The most notable antibodies are IgM and IgG. IgM antibodies are generally detectable
several days after initial infection. IgG antibodies generally become detectable 10–14
days after infection and normally peak around 28 days after infection.
• Generally, however, median IgM detection occurs 5 days after symptom onset,
whereas IgG is detected a median 14 days after symptom onset. IgG levels
significantly decline after two or three months.
How the sample Nasal or throat swab (most tests) Nasal or throat swab Finger stick or blood draw
is taken...
Saliva (a few tests)
How long it takes Same day (some locations) One hour or less Same day (many locations)
to get results...
or up to a week or 1-3 days
Is another test This test is typically highly Positive results are usually Sometimes a second antibody
needed... accurate and usually does not highly accurate but negative test is needed for accurate
need to be repeated. results may need to be results.
confirmed with a molecular
test.
What it shows... Diagnoses active coronavirus Diagnoses active Shows if you’ve been infected by
infection coronavirus infection coronavirus in the past
What it can't do... Show if you ever had COVID-19 Rule out active coronavirus Diagnose active coronavirus
or were infected with the infection. Antigen tests are infection at the time of the test
coronavirus in the past more likely to miss an active or show that you do not have
coronavirus infection COVID-19. IgM 5 days after
compared to molecular symptom onset, IgG 14 days
tests. after symptom onset. IgG
decline after two or three
months.
Imaging
• Typical visible features on CT initially include bilateral multilobar
ground-glass opacities with a peripheral or posterior distribution.
• COVID-19 can be identified with higher precision using CT than with RT-PCR
• Chest CT scans and chest x-rays are not recommended for diagnosing
COVID-19.
• Radiologic findings in COVID-19 lack specificity
Virology
Coronaviruses are positive-sense,
single-stranded enveloped RNA
viruses with helical capsids that infect
a wide range of hosts including
humans, bats, other mammals, and
birds
• The S surface protein plays key roles in the viral life cycle and in host
defense: it is responsible for receptor binding, host range, membrane
fusion, hemagglutinin activity, and is a target for eliciting host
neutralizing antibodies
Pathogenesis
Pathogenesis
• SARS-CoV-2 enters host cells through interacting with ACE2,
an interferon-induced gene expressed on type 2
pneumocytes, intestinal epithelial cells, nasal goblet
secretory cells olfactory epithelial support cells and stem
cells, and nasal respiratory epithelium
Like pulmonary epithelial cells, vascular endothelial cells express ACE2, and SARS-
COV-2 has been found inside of endothelial cells in pulmonary capillaries, leading to
inflammatory cytokine production, endothelial cell death, and endothelial barrier
disruption.
This endotheliitis is associated with diffuse thickening of the alveolar wall and
infiltration of mononuclear cells and macrophages into the airspaces, which
collectively are seen as ground-glass opacities in the lungs on CT imaging As the
inflammation progresses, pulmonary edema and hyaline membrane formation
occur and cause acute respiratory distress syndrome (ARDS), which interferes with
oxygen diffusion.
Transmission
Transmission
• Intermediate host
• Wuhan Fish market
• Aerosol
• Fomites
• Gastrointestinal tract
• Conjunctiva
• Vertical transmission
Immunology
• Like pulmonary epithelial cells, vascular endothelial cells express ACE2, and
SARS-COV-2 has been found inside of endothelial cells in pulmonary
capillaries, leading to inflammatory cytokine production, endothelial cell
death, and endothelial barrier disruption.
• This endotheliitis is associated with diffuse thickening of the alveolar wall
and infiltration of mononuclear cells and macrophages into the airspaces,
which collectively are seen as ground-glass opacities in the lungs on CT
imaging As the inflammation progresses, pulmonary edema and hyaline
membrane formation occur and cause acute respiratory distress syndrome
(ARDS), which interferes with oxygen diffusion.
Immunology
• In one study, 71% of patients who died of COVID-19 met criteria for
disseminated intravascular coagulation (DIC)
Cytokine storm