3. COVID-19 |

3. COVID-19

3.2 High infectivity (Why is COVID-19 so infectious?)

3.3 Case fatality rate (CFR) & risk factors

3.1 Main symptoms of COVID-19

References
Guan W, Ni Z, Hu Y, et al. (2020): Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine. In press

3.2 High infectivity (Why is COVID-19 so infectious?)

1. Molecular Level: SARS-CoV-2 utilizes the same cellular receptors as SARS-CoV, the human Angiotensin Converting Enzyme 2 (hACE2). Therefore, it is expected that this new virus would behave similar to SARS-CoV in terms of transmission properties, such as causing lower instead of upper respiratory tract symptoms. However, unlike SARS-CoV or MERS-CoV, epithelial cells in human airway are more suitable than standard tissue culture medium for the growth of SARS-CoV-2.

2. Long Incubation Period & Asymptomatic Transmission: The incubation period of SARS-CoV-2 is up to 24 days and the virus is capable of human-to-human transmission among asymptomatic individuals or those displaying only mild symptoms. Unlike SARS in which most patients developed fever, a very large study involving 1,099 COVID-19 patients showed only 43.8% of them had fever at the time of admission. This renders comprehensive early identification of cases via temperature screening extremely difficult.

3. Low CFR: People would be more complacent and less compliant to preventive measures.

References
Guan W, Ni Z, Hu Y, et al. (2020): Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine. In press
Habibzadeh P & Stoneman EK (2020): The Novel Coronavirus: A Bird’s Eye View. The International Journal of Occupational and Environmental Medcine 11: 65-71.
Rothe C, Schunk M, Sothmann P, et al. (2020): Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. New England Journal of Medicine 382: 970-971.

3.3 Case fatality rate (CFR) & risk factors

CFR of male is 39.0% higher
than that of female

CFR increases with age
Elderly (aged >70) should have higher level of awareness

CFR increases with pre-existing medical conditions
People with cardiovascular disease should have higher level of awareness

For details, please visit here (https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/)

3.4 Anti-COVID drugs

Disclaimer: The APJO COVID-19 FAQs resource has aggregated the below third-party content and resources. For the avoidance of doubt, the views and opinions expressed are those of third-party authors and do not reflect the official policy or position of any APJO/APAO/AAPPO affiliated agency, organisation or individual.

Reducing and managing fear is a major challenge for governments who are facing the COVID-19 outbreaks. Pharmaceutic companies and researchers around the world are racing to develop new effective treatments against the disease. Hundreds of thousands of compounds have been screened for their inhibitory effects against the SARS-CoV-2, among which ≥ 5 of them have entered phase IV clinical trial stage in China!

As of today, there are no proven effective treatment against COVID-19. The role of Traditional Chinese Medicine is to be explored. Recent randomized controlled trial found no benefit in the time to clinical improvement in lopinavir–ritonavir compared to the standard of care in hospitalized adult patients with severe COVID-19.

References
Sandro GVR, Wilson CS. Clinical trials on drug repositioning for COVID-19 treatment. Rev Panam Salud Publica. doi: https://doi.org/10.26633/RPSP.2020.40