Emerging in late 2019, the Covid-19 disease is responsible for a global epidemic for which no vaccine or treatment has been successfully stopped. Origin of name, symptoms, duration of infection, incubation, people at risk … What do we know about this new infectious disease?
End 2019, pneumonia cases clustered in China some of them were fatal. January 9th virus responsible identified, it is a new coronavirus called SARS-CoV-2 responsible for a a disease called Covid-19. Symptoms, incubation period, transmission, people at risk… Currently the knowledge of new infectious diseases that we have is still not successful in stopping the world.
Covid-19 is the name given by WHO on February 11, 2020 to a new respiratory tract infections appeared in December 2019, in China, and is caused by the SARS-CoV-2 coronavirus.
- “Co “for” corona “,
- “vi” for “virus”
- “D” for “disease” (“disease” in English).
- 19 for the year it appeared: 2019.
“We had to find a name that did not refer to a geographic location, animal, individual or group of people” WHO Director General Dr Tedros Adhanom Ghebreyesus explained in detail to avoid stigmatization of this disease. The disease will be transmitted to humans after consumption of contaminated meat – bats or pangolins are the two most advanced hypotheses – sold at Wuhan local market in China.
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The manifestations of Covid-19 are now well known; especially concerning the lungs, kidneys, nervous system (including psychiatric manifestations), heart, skin, digestive system and ENT sphere. Unlike the flu that appears suddenly, a coronavirus infection “done gradually over several days” shows the Pasteur Institute. Patients reported symptoms lasting a week and a longer recovery time.
In France, almost there 15% of the severe form from Covid-19. According to the work of the French-American team published by Inserm, these patients all reported lack of activity for interferon type I, an immune system molecule that typically has strong antiviral activity. The main danger of Covid-19 infection lies in the complications of the lungs. Inflammatory syndrome has also been reported in some children requiring hospitalization.
Who are the people most at risk?
The Covid-19 disease is more serious accordingage (those over 65 are too many of the deaths), sex (humans are more at risk of developing severe disease and mortality is higher in humans) and there are comorbidities. That the three comorbidities most at risk in France, the severe form of Covid-19 is moderate” Hypertension, heart disease and diabetes. Insecurity is another documented risk factor.
The average incubation time is 5 days with maximum duration of 12 to 14 days.
A person with Covid-19 is contagious 2-3 days before symptoms appear and up to 8 days later, shows a summary published by Santé Publique France on 8 July. In addition, approximately 50% of transmission will occur during the pre-symptomatic phase of the source patient. Once contaminated, the patient can remain so Several weeks. In Collective Inter-reanimation on Facebook, caregivers point out that patients “still positive after more than 3 weeks of resuscitation “.
According to Dr. Gerald Kierzek, “healing occurs after a two weeks when you have mild symptoms. This happens spontaneously unless there is a serious form and we find ourselves in intensive care where we need oxygen, where we have pneumonia and there we need treatment. “. SARS-COV2 infection can also cause persistent symptoms, more than 3 weeks after the first clinical manifestation (post-covid syndrome). Asthenia can last a long time.
Several tests are available in France to screen for Covid-19. One reference is the RT-PCR test which is performed in the nose. People with symptoms are given priority.
There is no treatment with direct viral activity that has scientifically proven its effectiveness in fighting SARS-CoV-2.
- In the form of a minor illness that does not require hospitalization: In case of fever, it is advisable to use paracetamol instead of anti-inflammatory drugs which can inflame the infection. Symptom progress should be monitored and if it worsens with difficulty breathing, call 15.
- For severe forms during hospitalization, outside the intensive care unit: oxygen support, ventilation support and:
→ use corticosteroids (dexamethasone), an anti-inflammatory treatment that reduces mortality in patients requiring oxygen support according to a randomized controlled clinical trial.
→ use tocilizumab (anti-interleukin-6 receptor treatment) which appears to be effective in patients requiring more than 3 liters / minute of oxygen.
→ anticoagulation by heparin which allow lowers the risk of thrombosis and embolism
→ Remdesivir: this drug has been validated by the European Medicines Agency, not yet at the French level.
- For severe forms in intensive care : use of invasive mechanical ventilation (intubation), or even extracorporeal oxygenation in the most severe form and resumption of the three therapies listed above (corticosteroids, tocilizumab, and heparin).
Care is discarded:
- Antibiotics : in Opinion 6 June 2020, HCSP advised against taking antibiotics in patients showing symptoms associated with confirmed Covid-19 (outside the focus of other infections) “due to extraordinary bacterial co-infection properties”. Antibiotics Azithromycin given to several Covid-19 patients since the start of the epidemic. Confirmation of the virological diagnosis of Covid-19 is delayed and if there is any doubt with bacterial infection, HCSP suggests that there may be a prescription for amoxicillin.
- Hydroxychloroquine : “After preliminary observations from a non-randomized group showing the efficacy of hydroxychloroquine, alone or in combination, most randomized trials conducted in France, Europe, the United States, Brazil or in WHO trials, did not find this effect” explained the Covid-19 Scientific Council.
- Lopinavir / ritonavir: In hospitalized patients with severe or critical forms of illness, 4 randomized controlled trials have not found the efficacy of administering lopinavir / ritonavir.
- Sarilumab : the drug has been tested in the United States. The company stopped their trials because of the lack of found efficacy of the drugs and more frequent severe side effects.
> More information on Covid-19 treatments and vaccines
Without certainty. “Most infected people develop an immune response within the first few weeks, but we don’t know if it’s strong, how long it lasts, or how it manifests in different people. There have also been reports of reinfection. “ indicated the World Health Organization on October 15, which opposes the principle of collective immunity as a means of fighting the Covid-19 epidemic. “Until we better understand immunity to the COVID-19 virus, it will be impossible to know what proportion of the population is immune and how long that immunity lasts, let alone make predictions for it. These questions should rule out any idea of strengthening immunity in a population by means of let the virus spread. “