patients are contagious between 8 and 37 days

A new study, published in The Lancet, describes the risk factors associated with Covid-19. In accordance with previous work on the subject, the team of Chinese scientists identified hypertension, diabetes and cardiovascular disease as factors aggravating the disease. They also studied the excretion of the virus over time. In the most severe cases, the patient produces infectious virions for a median of 20 days.

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When the virus finished his replication within his cell host, it leaves it to infect others. Of virions infectious agents can then be excreted from the body via preferred routes, such as the respiratory tract. The patients are contagious and can spread the virus to others. In the case of Covid-19, the temporality of virus excretion, still unclear, was studied, among other data, in a study published in The Lancet.

The cohort of patients is made up of 191 patients treated in two hospitals, the Jiniyntan Hospital and the Wuhan Pulmonary Hospital. They all had a severe form of Covid-19 disease requiring constant monitoring. At the time of the study, 137 survived and 54 died.

Survivors excreted virions of Sars-CoV-2 during a duration median of 20 days after the onset of the disease. Data range from 8 days for the lowest excretion time to 37 days for the highest. The deceased patients were contagious until their death.

A treatment that does not prevent the excretion of the Covid-19 virus

Scientists light another parameter. Treatments given to patients do not decrease the median duration of virus shedding. In the absence of specific treatment for coronavirus, 29 patients from the cohort were treated with Lopinavir / Ritonavir, an antiretroviral used for HIV. It targets a protease which, when inhibited, prevents replication of the virus. For these patients, the median duration of viral shedding is 22 days after the onset of symptoms.

In A press release, Professor Bin Cao, co-author of the study, points out that " notWe must clarify that the duration of viral excretion should not be confused with isolation measures for people exposed to Covid-19 but without symptoms, since this measurement is based on the incubation time of the virus. " He also recommends letting the negative Review patients leave the hospital. screening after their healing.

If these results give a first glimpse on the duration of the excretion of the virus by a patient, the authors of the study still point out that their data were limited by problems of detection of the material genetic coronavirus in respiratory samples, which are also rare.

Covid-19 symptoms: diabetes and hypertension as aggravating factors

Article published on February 13, 2020 by Julie Kern

New study refines our knowledge of symptoms caused byepidemic Covid-19 which affects 60,349 people in 28 countries around the world. It also highlights the presence of aggravating factors in the most severe cases.

At the end of January, an initial publication described the symptoms of 41 patients at the start of the Covid-19 epidemic. Although small, this sample described key symptoms of the coronavirus such as fever, cough, and abnormal fatigue.

At the beginning of February, a new study was published, this time including 1,099 patients who came to the hospital for a pneumonia originally unknown. The presence of the virus has been confirmed by an analysis RT-PCR. This study is not currently published in a classic scientific journal, but available on Medrvix. It was therefore not reread by a committee of scientists.

What does this new study tell us about the symptoms caused by Covid-19?

Characteristic symptoms caused by Covid-19

In broad outline, this study confirms the previous symptoms. The median age of the patients studied is 47 years. The proportion of women is 41.8%, a higher figure than in the first study which included 27% women. A bias probably due to the small sample size. The median incubation period is three days, althoughit can extend up to 24 days.

The three major symptoms of Covid-19 are a body temperature higher than 38 ° C (87.9% of patients), coughing fits (67.7%) and severe fatigue (38.1%). In 79.1% of cases, the coronavirus degenerates to a pneumonia. Patients whose condition deteriorates are then transferred to intensive care. The coronavirus evolves quickly, pneumonia can appear only three days after the first diagnostic. Severe cases represent 18.7% of the patients included in this study.

Blood and chest tests show that 82.1% of patients have leukopenia and a visible lung condition in to scan thoracic in 76.4% of cases.

Diabetes, high blood pressure and smoking can worsen coronavirus disease

When looking at critically ill patients, two very common diseases seem to worsen Covid-19 infection. The first is thehypertension since 23.7% of patients in critical condition suffer from it. In second position comes the diabetes, without a type distinction being made, which affects 16.2% of the most serious cases.

Bad lifestyle habits, such as smoking, can also play a role. While 85.6% of infected patients are non-smokers, 16.9% of severe cases declared that they used tobacco (compared to 11.8% of less severe cases).

There is no specific treatment for Covid-19 yet. Doctors are therefore trying to fight the coronavirus with existing treatments. Patients admitted to hospital are administered antibiotics intravenously (57.5% of cases), prescribeoseltamivir, a antiviral to be taken orally (35.8% of cases), and corticosteroids (18.6% of cases). This protocol is accompanied by oxygen therapy and ventilation non-invasive for the most severely affected patients.

Is it effective? Difficult to say because practically all the patients remained in the hospital during the time of the study. Only 55 patients out of the 1,099 considered were able to return health home.

China coronavirus symptoms and diagnosis: what you need to know

Article published on January 27, 2020 by Julie Kern

Friday, January 24, 2020, the first two scientific studies describing the symptoms of about forty patients infected with the Chinese coronavirus were published. They report the most common symptoms but also complications related to the Chinese virus.

As of January 27, 2020, the epidemic caused by Wuhan coronavirus continues to expand. It infected 2,794 people in 15 countries, including France. Eighty of those cared for in hospitals died. For the first time since the start of the epidemic, Chinese scientists accurately described clinical symptoms for 41 patients in a publication in the medical journal The Lancet. But what are the warning symptoms of the infection?

Fever and cough, the most common symptoms caused by Wuhan coronavirus

The 41 patients examined in this study were admitted to the hospital with rather frequent symptoms of respiratory illnesses, i.e. a fever higher than 38.1 ° C (98% of patients), coughing fits (76% of patients) and finally severe fatigue or myalgia (44% of patients). If the symptoms are very similar to those of SARS, 2019-nCoV causes diarrhea only in rare cases: 3% of patients against 20-25% for the etiological agent of SARS. The dyspnea (55% of patients) appears after eight days and is the first severe complication of the disease.

The vast majority of patients (73%) are adult men. No children or adolescents were examined in this study. The median age of the patients is 49 years and 66% of them attended the Wuhan Sea market, closed since 1er January.

When taken in charge in the hospital, the patients underwent a thoracic scanner (precisely a CAT-scan). In all cases, the images show lungs abnormal. For the most serious, doctors observed bilateral nodules as well as areas where the lung tissue is compressed by the presence of liquid.

To Review the presence of 2019-nCoV in the patient's body, doctors performed several examinations.

Wuhan coronavirus diagnosis

To find out if all this was linked to the presence of the coronavirus, the scientists looked for the presence of its genome, namely a ARN single-strand of positive polarity, in the plasma of patients by RT-PCR. The viral genome was identified in 15% of the patients examined. However, they did not look for infectious viral particles in the blood, so this Review is not a viremia.

A second study analyzes the effects of the virus on the epithelial cells of the mucosa respiratory in vitro. The virus was isolated from bronchoalveolar lavage samples and then infected cultured epithelial cells.

Cytopathic effects appear 96 hours after infection with Wuhan coronavirus. Infected epithelial cells demonstrate frequency lower beats of their eyelashes. These epithelial cells protect the respiratory mucosa, in particular by evacuating the mucus infected when coughing. In many respiratory diseases, and during an infection with the Chinese coronavirus, the purification of mucus by the airways is disturbed by the decrease in the ciliary activity of the cells.

The studies presented here are only a first overview of the pathophysiology of pneumonia due to 2019-nCoV. The 41 cases studied are not enough to understand all the parameters of this new disease. Among them, six died after their hospitalization, making Wuhan coronavirus a serious threat.

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