COVID-19
Dr. Moe Yee Soe
Assistant Lecturer
Department of Microbiology
UM1
COVID-19
means
Corona Virus Disease 2019 caused by
SARS CoV-2 virus.It is Pandemic disease
including Myanmar
e end of 2019, Wuhan an emerging business hub of China experienced
reak of a novel coronavirus that killed more than eighteen hundred and
ted over seventy thousand individuals within the first fifty days of the
emic
rted to be a member of the Beta group of coronaviruses
el virus was named as Wuhan coronavirus or 2019 novel coronavirus (2
) by the Chinese researchers
nternational Committee on Taxonomy of Viruses (ICTV) named the viru
-CoV-2 and the disease as COVID-19
Comparative analysis of emergence and spreading
of coronaviruses
03, the Chinese population was infected with a virus causing Severe Ac
iratory Syndrome (SARS) in Guangdong province
virus was confirmed as a member of the Beta coronavirus subgroup and
ed SARS-CoV
nfected patients exhibited pneumonia symptoms with a diffused alveo
y which lead to acute respiratory distress syndrome (ARDS)
initially emerged in Guangdong, China and then spread rapidly around
e with 8096 infected persons and 774 deaths
mparative analysis of emergence and spreading
of coronaviruses
cade later in 2012, a couple of Saudi Arabian nationals were diagnosed
ted with another coronavirus
detected virus was confirmed as a member of coronaviruses and name
Middle East Respiratory Syndrome Coronavirus (MERS-CoV).
O reported that MERS coronavirus infected 2494 individuals and 858 de
S-CoV -beta-coronavirus subgroup and phylogenetically diverse from ot
an-CoV
d upper respiratory injury while progression leads to severe respiratory
ase
RS-coronavirus suffer pneumonia, followed by ARDS and renal failure
Comparative analysis of emergence and
spreading of coronaviruses
e end of 2019, WHO was informed by the Chinese government about
ral cases of pneumonia with unfamiliar etiology.
outbreak was initiated from the Hunan seafood market in Wuhan city o
a and rapidly infected more than 50 peoples. The live animals are frequ
at the Hunan seafood market such as bats, frogs, snakes, birds, marmo
ts
2 January 2020, the National Health Commission of China released furt
ls about the epidemic, suggested viral pneumonia
m the sequence-based analysis of isolates from the patients, the virus w
ified as a novel coronavirus
Comparative analysis of emergence and
spreading of coronaviruses
ally, it was suggested that the patients infected with Wuhan coronaviru
uced pneumonia in China may have visited the seafood market where l
mals were sold or may have used infected animals or birds as a source o
d
ther investigations -some individuals contracted the infection even with
ord of visiting the seafood market
man to the human spreading capability due to close contact with an infe
son, exposed to coughing, sneezing, respiratory droplets or aerosols.
se aerosols can penetrate the human body (lungs) via inhalation throug
e or mouth
American Society for Microbiology
Novel Coronavirus (COVID-19) Resources
April 1, 2020
day, March 24: The FDA allows treatment of life-threatening COVID-19
convalescent plasma
day, March 17: ASM issued a statement commending the FDA for their
ance to increase COVID-19 testing capacity
nesday, March 11: The World Health Organization declares the coronav
reak a pandemic, acknowledging that the virus will likely spread to all
tries on the globe
American Society for Microbiology
Novel Coronavirus (COVID-19) Resources
April 1, 2020
Saturday, Feb. 29: The FDA took steps to expand novel coronavirus
testing to hospital clinical microbiology laboratories.
Wednesday, Feb. 26: NIH scientists began a randomized controlled
trial of the antiviral drug remdesivir that had been developed for
Ebola, on a patient infected with SARS-CoV-2. This is the first clinical
trial in the U.S. for an experimental treatment for COVID-19
American Society for Microbiology
Novel Coronavirus (COVID-19) Resources
April 1, 2020
Thursday, Jan. 30, WHO Declared Coronavirus A Global Health
Emergency. The U.S. Centers for Disease Control and Prevention (CDC
is now screening passengers arriving from Wuhan on entry at multiple
international airports
date as of 2nd April,2020 by WHO (Situation Report
Globally • South-East Asia Region
896 450 confirmed (72 839) • 5324 confirmed (149)
45 526 deaths (4193) • 216 deaths (21)
• Eastern Mediterranean Region
Western Pacific Region • 58 168confirmed (3887)
107626 confirmed (1204) • 3280 deaths (165)
3723 deaths (30) • Region of the Americas
• 216 912 confirmed (28161)
European Region • 4565deaths (1165)
503 006 confirmed (38 809) • African Region
33604 deaths (3515) • 4702 confirmed (629)
• 127deaths (36)
• WHO RISKASSESSMENT
• Global level Very High
ld Wide Data as of2nd April, 2020(ECDC)
As of2nd April, 2020,
20 cases are infected and one death case
Structure of Corona Virus
ly : Coronaviridae family
n :Spherical, 120 - 160 nm in diameter, helical nucleocapsid
ome: Single-stranded RNA, linear, non-segmented, positive-sense, infec
eins : Two glycoproteins (E,M)and one phosphoprotein,Spike protein(S
lope : Contains large, club or petal-shaped spikes, suggestive of a
na (Latin = crown)
cation : in the cytoplasm of host cells
tural protein S -bind to the receptor of the host cell, keyprotein for v
vade susceptible cells
nd E proteins :involved in the formation of the virus envelope
otein :assembly of the virus
Structure of Corona virus
rding to the genome structure and phylogenetic analysis of coronavirus
Coronaviridae family can be divided into four genera: α, β, γ, and δ
d β genera -infect mammals and humans
d δ genera - infect birds
-CoV-2 -a novel coronavirus of the β genus
ein sequence analysis -the amino acid similarity -SARS-CoV-2 and SARS-
94.6%, suggesting that they might belong to the same species
homology between the SARS-CoV-2 genome and the bat SARS-like
navirus (Bat-CoV (RaTG13)) genome is 96%.5
Reaction to Physical and Chemical agents
tive to heat and ultraviolet rays
be stored for several years at −80 °C and inactivated at 56 °C for 30 min
commonly used method to inactivate SARS-CoV-2 in the laboratory)
ethanol, peracetic acid, and chlorine containing disinfectants can effec
ivate SARS-CoV-2
Pathogenesis
navirus can cause human respiratory tract infection or animal intestina
tion. The process of virus infection requires the participation of recepto
urface of the host cell membrane
tein bind to theACE2 receptor -invade the host cell through clathrin-
ated endocytosis
overactivation of T cells-an increase in Th17 and the high cytotoxicity of
s -severe immune injury
ce of infection - COVID-19 patients, asymptomatic patient
bation period - 1–14 days, average of 3–7 days
rvoir -Bats
e of transmission
iratory droplet
ct and indirect contact with articles contaminated with virus droplets
eic acid can be detected in the feces and urine of patients with COVID-1
be transmitted through the digestive tract through the fecal–oral route
Transmission of COVID-19
Clinical Manifestations
symptoms of COVID-19 caused by SARS-CoV-2
er, dry cough, shortness of breath
w patients may have fatigue, runny nose, sore throat, and diarrhea,
ous form of COVID-19 -rapidly progress to acute respiratory distress
drome, coagulation dysfunction, septic shock
d patients -low fever and slight fatigue but no pneumonia
st patients -a good prognosis
ew patients-severe condition
erly and those with chronic basic diseases -poor prognosis
Cardinal Symptoms
Fever, Cough, Shortness of Breath
CXR CT Lungs
Risk groups
unocompromised individuals
nic disease: Bronchial asthma
etes
erlying cardiovascular diseases
Laboratory Diagnosis
men
er respiratory tract swab, aspirate or wash
pharyngeal swab, Nasophryngeal swab)
er respiratory tract
hoAlveolar lavage,Sputum
l
tigen and Nucleic Acid detection
Coronavirus antigens in cells in respiratory secretions
on microscopy - detect coronavirus-like particles in stool specimens
R - nucleic acid in respiratory secretions =gold standard
asophrangeal Swab and Viral transport media
lation and identification of virus
pharyngeal specimens inoculated into Vero monkey kidney cells
icult and requires stringent biosafety level 3 conditions
ology
A, indirect immunofluorescent antibody assays and hemagglutination t
ntly, immunoglobulin M (IgM) and IgG antibody detection reagents and
-CoV-2 antigen detection reagents established by colloidal gold and en
d immunosorbent technologies have also been successfully developed
ed for auxiliary diagnosis
Treatment
ial therapeutic strategies against COVID-19
ferons alpha nebulization,-broad-spectrum antibiotics(Initial treatment
viral drugs -Remdesivir-reduce the viral load
desivir +chloroquine or interferon beta -blocked the SARSCoV-2 replica
RS-CoV-2 vaccines
Prevention and Control
y detection of suspected cases
tainment of infection
antine and isolation measures
ection of people and environment
thcare personnel
er patients
ly and community members
onal hygiene and environmental hygiene
dwashing and respiratory etiquette during sneezing and coughing
ier nursing
ted persons in the designated SARS hospitals
sonal Protective Equipment (PPE)
goggles, mask (N 95, N 100), long
d gowns, apron, gloves, boots or disposable cover-all for shoes
nd washing ,20 seconds, with soap and water
Comparison of SARS, MERS and COVID- 19
SARS MERS COVID-19
2002 2012 2019
untries Guangdong, China Middle Eastern countries(Saudi Wuhan, China
Arabia)
nimal Chinese horseshoe bats Camels Bats
r) Civet cats Bats
1.Droplet infections 1.Droplet infections 1.Droplet infections
sion 2.Direct and indirect contacts
3.Faecal-oral route or 2.Direct and indirect co
aerosolization of sewage
4.Ingestion of exotic game animals
such as civet cats
5.Nosocomial transmission
Global alert No person to person transmission Pandemic
on 6 days 14 days
SARS CoV MERS COVID-19
(SARS COV-1) (SARS COV-2)
atures Fever, Sore throat, Shortness of 1.Pneumonia Fever, Cough, Shortness of b
breath, Respiratory Distress 2.Renal Failure Respiratory Distress Syndrom
Syndrome 80 percent-mild
20 percent -diarrhoea
1.Upper respiratory tract swab, 1.Upper respiratory tract swa
aspirate or wash aspirate or wash(Oropharyng
2.Lower respiratory tract- swab, Nasophrangeal swab)
BAL,Sputum 2.Lower respiratory tract-BA
3.Stool 3.stool
y 1.Antigen and Nucleic acid detection 1.Antigen and Nucleic acid d
ELISA,RT-PCR ELISA,RT-PCR
2.Isolation of virus 2.Isolation of virus
3.Serology-ELISA for antibody 3.Serology-ELISA for antibod
detection detection
RT-PCR is gold Standard RT-PCR is gold Standard
SARS MERS COVID-19
nt interferons nebulization,
-broad-spectrum antibiotics,
-anti-viral drugs -to reduce the viral lo
(Remdesivir)
Remdesivir +chloroquine or interferon
blocked the SARSCoV-2 replication
infected 8096 individuals with 774 deaths 2494 individuals As of 2nd April,2020 ,998,949 cases, de
mortality rate of 9.6%, across 29countries infected and 858 51,285 cases,recovered-210,191
in the world, deaths(fatality 204 countries and territories around t
No SARS in Myanmar rate 34.4%) world
In Myanmar-20 cases infected, one ex
case
on 1.Early Detection of suspected cases 1.Early Detection of suspected cases
trol 2.Quarantine 2.Quarantine
3.Protection of people and environment 3.Protection of people and environme
-health care personnel,other patients -health care personnel,other patients
-family and community members -family and community members
4.Personal hygiene 4.Personal hygiene
-hand washing,respiratory etiquette -hand washing, respiratory etiquette
5.Barrier Nursing 5.Barrier Nursing
6.Personal protection-PPE 6.Personal protection-PPE
MCQ points
COVID -19 (Caused by SARS COV -2 virus)
Novel corona virus, RNA virus, enveloped virus
Originated from Wuhan,China,2019
Animal origin-bats
WHO announced Pandemic on March11,2020,Wednesday
204 countries worldwide affected
The most affected countries are USA, Italy, Spain
In Myanmar as of 2nd April, 20 cases infected and one death case
cardinal symptoms- fever,cough,shortness of breath
to ARDS
pharyngeal and Oro pharyngeal swab, sputum can be tested
CR is gold standard
body test kits are under trials
ntion and control
e stay,Avoid crowd,Healthy lifestyle
d washing
antine
tion
viral may be effective
THE END
