On February 19, 2020, the China National Health Council released Guidelines for Diagnosis and Treatment of New Coronavirus (Trial Sixth Edition). Here I select some of the information on the coronavirus (2019-nCoV, or COVID-19) that may help you know more about the virus to share with you.
Features of the new coronavirus
The gene of the new coronavirus obviously differentiates from that of SARS-CoV or MERSr-CoV. Current research shows that the coronavirus shares more than 85% similarity in gene sequence with bat SARS-like coronavirus (bat-SL-CoVZC45).
The coronavirus is sensitive to ultraviolet rays and heat, and can be inactivated when exposed to 56 ℃ environment for 30 minutes, lipid solvent like diethyl ether, 75% alcohol, chlorine-based disinfector, peracetic acid, and chloroform. Chlorhexidine cannot inactivate the coronavirus effectively.
Source of infection
At present, the main sources of infection seen are patients infected by the new coronavirus. Asymptomatic infected individuals can also be a source of infection.
Route of transmission
Transmission through respiratory droplets and close contact is the main route of transmission. There is a possibility of aerosol propagation in a relatively closed environment exposed to high concentrations of aerosols for a long period of time.
Susceptibility are presented among the general population.
Based on the current epidemiological study, the incubation period is 1-14 days, mostly 3-7 days.
Fever, dry cough, fatigue are the main performances. A small number of patients have symptoms such as nasal congestion, runny nose, sore throat, myalgia and diarrhea. Most of the severe patients develop difficulties in breathing and/or hypoxemia after one week of the onset of the disease; very seriously ill patients can quickly develop into acute respiratory distress syndrome, sepsis shock, metabolic acidosis and blood clotting dysfunction, and multi-organ failure that are hard to treat. It is worth noting that heavy and critical patients can have low to medium fever in the course of the disease, or even no obvious fever.
Mild patients show only low fever and mild fatigue, with no pneumonia symptoms.
From the analysis of current cases, most patients have a good prognosis, while a few patients are in critical conditions. Older people and people with chronic diseases have a poorer prognosis. The symptoms in children are relatively mild.
The total number of peripheral white blood cells in the early stages of the disease is normal or decreased. The lymphocyte count is reduced, and some patients can show increased liver enzymes, lactic acid dehydrogenase (LDH), muscle enzyme and myoglobin. For most patients, the C-reactive protein (CRP) and ESR (erythrocyte sedimentation rate) increase, while procalcitonin remains normal. In severe cases, D-dipolymer rises and peripheral blood lymphocytes progressively reduces. Heavily and critically ill patients often have elevated inflammatory factors.
New coronavirus nucleic acids can be detected in nasopharyngeal swabs, sputum and other lower respiratory secretions, blood, and feces of patients.
Early stages patients show multiple small patch shadow and interstitial changes, more obvious in the lung periphery, which then develop into ground-glass shadow and infiltration in both lungs. Severely ill patients can have lung consolidation, but pleural effusion is rare.
The guideline also offers diagnosis standard, clinical types, differential diagnosis, treatment, and case reporting, which are mainly guidelines and suggestions for doctors, so I decide not to upload all those treatment methods here because treatments are different among different countries.
If you have symptoms or test results that look like the new coronavirus, and have been to public locations or had close contact with coronavirus patients, visit your doctor as soon as possible.