What is COVID-19?
The spread of the new coronavirus (COVID-19) is constantly evolving, the data overlap and are often a source of completely uncontrolled fake news and information. This article aims to provide clarity by using only evidence-based information. However, authoritative and updated sources are available online in real time to follow the progress of the epidemic or the pandemic.
The excess of "unnecessary prevention" can overload health services, induce unnecessary health costs (for example protective masks, unreported diagnostic examinations, and unnecessary visits), taking away important resources. Instead, all those individual and social behaviours that are at minimum or no cost should be encouraged because they are useful for preventing and mitigating other pathologies and for strengthening social and psychological cohesion and support, which are also fundamental in a time of crisis.
The infection is transmitted from each infected person to 2-3 other people. For this reason, it seems that the numbers are constantly increasing, but these are the consequences of the first infections. Hence, it is important to implement measures that can restrict the spread of infection.
Coronaviruses are RNA viruses that lead to infections of the upper respiratory tract. However, some have tropism to the lower respiratory tract and lead to more serious diseases such as SARS. The main mechanism of morbidity and severity of SARS is the so-called acute respiratory distress syndrome (ARDS). Therefore, after infection of the lower respiratory epithelium mediated by the interaction of the virus surface protein with the ACE2 receptor, a violent acute inflammation of the lungs is triggered which leads to the formation of a fibrin layer on the alveoli, thus preventing gaseous exchanges (a mechanism known as interstitial pneumonia). ARDS is a condition that requires complex interventions such as the extracorporeal membrane oxygenation (ECMO).
What are the different symptoms of the infection?
The most common symptoms of an upper respiratory tract infection by coronaviruses involve fever, cough, headache, pharyngodynia, and breathing difficulty. In severe cases, the infection may cause pneumonia or bronchitis, severe acute respiratory syndrome, and renal failure. The involvement of the lower respiratory tract and complications are more frequent in people with pre-existing chronic diseases of the cardiovascular and/or respiratory system and in people with impaired immune systems, newborns, the elderly and patients with diabetes.
Medications used to treat Covid-19 disease
There are a number of medications that are used by the doctors who work in the clinics and hospitals in Turkey, Izmir, Istanbul, Ankara, and Bursa.
Antiviral therapy in Turkey and Istanbul
Several protease inhibitors such as darunavir and atazanavir are currently employed in HIV therapy and could inhibit the viral replication of coronavirus by inactivating proteases, which are critical for replication.
In fact, among the main drugs used in the framework of the national emergency management plan COVID-19 in Turkey and Istanbul, we find the Lopinavir / Ritonavir (Kaletra), which are mainly employed in COVID-19 patients in the initial stages of the disease. Previous experience with SARS-Cov-1 and MERS infection suggests that this drug may improve some clinical parameters of patients.
Remdesivir, belonging to the class of nucleotide analogues, previously used in the Ebola virus epidemic in Africa, is also employed in patients with moderate and severe disease.
Added to that, chloroquine and Hydroxychloroquine are antiviral drugs and both have an immunomodulatory activity that could enhance the antiviral effect.
Inflammation inhibitors: Clinical management
Numerous experimental and clinical evidences have shown that an important part of the damage caused by the virus is linked to an altered inflammatory response and in some patients to an abnormal release of pro-inflammatory cytokines such as interleukin-6, interferon-gamma, and tumor necrosis factor alpha.
Antibodies taken from the blood of cured patients are a therapeutic option currently under study by Turquie Santé. It is estimated that the dose of antibodies needed to treat a patient with SARS-Cov-2 requires the collection of antibodies from at least three patients cured of this infection.
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