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Genome analysis of COVID-19 shows that it shares 88% of its sequence with bat-derived severe acute respiratory syndromes (SARS)-like coronaviruses. Based on data we currently have, it seems that COVID-19 may have been initially transmitted from bats to humans via wild animals sold at the Huanan seafood market in Wuhan, China. Later, it spread from human to human.

Other sources state that the virus may have originated elsewhere and was brought into the market after human infection. This is still a controversial issue and we do not know for sure how it arised.

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2) How does COVID-19 progress through the body?

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2) How does COVID-19 progress through the body?

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SARS-CoV2 gets inhaled and binds to the ciliated secretory cells in the nasal epithelium via ACE-2. Viral replication and propagation takes place with a limited immune response. Involvement of the conducting airways, upper respiratory tract and migration into the lower respiratory tract takes place. Invasion and infection of the type II pulmonary alveolar epithelial cells via ACE-2:

1.

Release of IL-1, IL-6 (major culprit), IL-8, IL-10, IL-12, TNF-alpha, IFN-lambda, and IFN-beta, CXCL-10, G-CSF, GM-CSF, MCP-1 and MIP-1alpha (cytokine storm)

Chemo-attraction for Neutrophils, CD4 and CD8 cells along with B cell differentiation

Sequestration of inflammatory cells in the lung tissue, with CD8 mediated cytotoxicity accompanied with lung injury

The host tries to defend and clear virus

Diffuse Alveolar damage with resulting acute respiratory distress syndrome (ARDS)

2.

Viral replication and release of particles with resulting apoptosis of the host cell

Viral replication and infection of the adjacent healthy alveolar epithelial cells continue

Both Type I and type II pneumocytes are lost

Diffuse Alveolar damage with resulting ARDS

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3) How does COVID-19 affect the pulmonary system?

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3) How does COVID-19 affect the pulmonary system?

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The spike protein on the COVID-19 virus binds to the ACE-2 receptors on the human cells, injects their genome into the cells and forces them to make more copies of the virus. As the virus travels down your respiratory tract, the lining of the tract becomes irritated and inflamed. This inflammation may lead to more severe, life-threatening conditions. One of these conditions is pneumonia.
In pneumonia, the air sacs in the lungs are filled with fluid, limiting their ability to take in oxygen. This leads to breathing difficulties that may become severe enough to require hospital treatment where they have to receive oxygen or be put on a ventilator.

As COVID-19 pneumonia progresses, more alveoli are filled with fluid causing shortness of breath that leads to Acute Respiratory Distress Syndrome (ARDS) which is a form of lung failure that may be fatal. Even if the patient survives ARDS and COVID-19, they may be left with lasting pulmonary scarring.

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9) Why does the COVID-19 mutate so frequently?

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9) Why does the COVID-19 mutate so frequently?

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COVID-19 contains the viral SARS-CoV-2 gene that is a RNA virus where most RNA viruses that copy their genome do not have the error correction mechanism that prevents mutations. Mutations are a very natural part of all living things including viruses. Mutations occur when an error occurs in the replication of the virus’s genetic code. This mutation may be either helpful or detrimental to the virus. Natural selection then selects for the virus that is most capable of survival and eliminates the weaker viruses. Now we are left with viruses that have mutations that are dangerous to us.

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4) How does COVID-19 affect organ systems other than the lungs?

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4) How does COVID-19 affect organ systems other than the lungs?

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A severe complication of COVID is sepsis. This is when infection spreads through the bloodstream causing tissue damage as it goes through. Normally, the body systems work together to maintain the health of the body. For example, the cardiovascular system works with the pulmonary system to oxygenate the body, and other systems like the renal system assist in this process too. So when sepsis occurs, this cooperation falls apart and whole organ systems begin to shut down. Superinfections can also happen. When the body is busy fighting COVID-19, the body becomes vulnerable to an infection by a different pathogen, which will cause damage of its own in the body.

COVID-19 may also cause problems in the heart, kidneys and brain. It has been reported that some people suffer from long term heart complications, kidney impairment, stroke and Guillain-Barre Syndrome after a COVID infection.

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5) What are the symptoms of the coronavirus?

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5) What are the symptoms of the coronavirus?

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Symptoms of COVID-19 may appear 2-14 days after exposure, the time after exposure and before symptoms are called the incubation period. Presymptomatic transmission means you can still spread COVID-19 before showing symptoms.

Common symptoms include: Fever, cough, tiredness.

Early symptoms may include: Loss of smell and taste.

Other symptoms can include: shortness of breath/difficulty breathing, muscle aches, chills, sore throat, runny nose, headache, chest pain, pink eye, nausea, vomiting, diarrhea and rash.

This list is not complete and children have similar symptoms than adults. Symptoms appear different in every person and can range from very mild to severe. Some people are asymptomatic and show no symptoms.

Older people and people with existing medical conditions have a higher risk of serious illness. Certain medical conditions with higher risk includes: serious heart disease, cancer, COPD, Type 1 and type 2 diabetes, obesity, high blood pressure, smoking, chronic kidney disease, sickle cell disease, weakened immune due to solid organ transplant or bone marrow transplant, pregnancy, asthma, chronic lung disease, liver disease, dementia, down syndrome, brain and nervous system conditions and substance use disorders. This list is not complete.

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The diagnosis of COVID-19 is the detection of the viral Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 gene which is a positive sense single stranded genomic RNA virus which can be detected by the Real Time PCR method. Diagnostic criteria include history of exposure or close contact with someone who has tested positive, developed clinical symptoms/features and positive COVID-19 results from a real time PCR method. Knowing the history  of exposure or close contact with a patient who has tested positive is critical evidence in determining the diagnosis of COVID-19.

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One of the treatments for COVID-19 is Anti-SARS-CoV-2 Monoclonal Antibody Treatment/Therapy. An antibody is a protein produced by the immune system in response to an antigen. Monoclonal antibodies are proteins produced in a lab that fight COVID-19 by imitating the body’s immune system. Therefore, monoclonal antibody therapy is a way to treat COVID-19 for people who have tested positive, have mild symptoms and are at high risk of developing serious symptoms. The three Anti-SARS-CoV-2 products include Bamlanivimab, Casirivimab, and Sotrovimab which are all administered as an IV infusion. The purpose of this treatment is to lower viral loads, reduce hospitalizations, and reduce symptom severity. Under an Emergency Use Authorization (EUA), the Food and Drug Administration (FDA) has approved the use of monoclonal antibody therapy for the treatment of COVID-19 in patients aged 12 and up.

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A COVID PCR test is a polymerase chain reaction test which is a laboratory method used to analyze genetic material like the RNA of SARS-CoV-2 with an upper respiratory specimen. The method amplifies RNA samples into DNA and replicates until SARS-CoV-2 is detected.
First there is a sample collection from a nasal swab to collect genetic respiratory material and sent to the laboratory to extract genetic material from other material then the PCR machine uses thermal cycles that amplifies the targeted genetic material and detects the signal as a positive result. The COVID PCR test is the most accurate and reliable method as it directly detects and measures the viral gene that causes COVID-19.

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8) What is the mechanism of the coronavirus vaccine? 

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8) What is the mechanism of the coronavirus vaccine? 

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The mRNA that is able to translate and code for spike proteins of the virus is isolated and included in a lipid nanoparticle. The vaccine (nanoparticle) is injected intramuscularly into the body. The nanoparticle attaches to the host cell and inserts its mRNA into the cytoplasm in order to reach the ribosomes and synthesize the viral spike proteins (translation). Proteins target the cellular membrane and activate the antibodies against the viral spike proteins and also the cells of the immune system like the T-helper (Th) cells which produce cytokines such as IL-2, IL-4 and Il-5. The interleukins also stimulate the T-cells to proliferate the memory T-cells and kill the current infected cells.

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“Covid-19 (Coronavirus): Long-Term Effects.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 22 Oct. 2021, https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351.

5) “Coronavirus Disease 2019 (Covid-19).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 1 Feb. 2022, www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963.

6) Abbasi-Oshaghi, E., Mirzaei, F., Farahani, F., Khodadadi, I., & Tayebinia, H. (2020). Diagnosis and treatment of coronavirus disease 2019 (COVID-19): Laboratory, PCR, and chest CT imaging findings. International journal of surgery (London, England), 79, 143–153. https://doi.org/10.1016/j.ijsu.2020.05.018

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9) Wei-Haas, Maya. “The Coronavirus Is Mutating-but What Determines How Quickly?” Science, National Geographic, 4 May 2021, https://www.nationalgeographic.com/science/article/the-coronavirus-is-mutating-but-what-determines-how-quickly.

10.)Yüce, M., Filiztekin, E., & Özkaya, K. G. (2021). COVID-19 diagnosis -A review of current methods. Biosensors & bioelectronics, 172, 112752. https://doi.org/10.1016/j.bios.2020.112752