Latest Update Coronavirus in India, Symptoms, Vaccines and Treatment

Latest Update Coronavirus in India, Symptoms, Vaccines and Treatment

Global status of Covid-19 infection


Currently, there are 1,92,66,406  confirmed cases of novel coronavirus infection worldwide, with a total tally of 7,18,530 deaths and it has affected 213 countries and territories across the globe. The top three countries affected by Covid-19 infection are USA (49,49,609 cases), Brazil (29,67,064 cases) and India at number 3 with total 20,88,611 cases. Globally, 1,16,71,253 cases have recovered or been discharged. It is important to note that out of currently infected patients, 99% patients are in mild condition while rest 1% are in serious or critical condition. 

More than 50% of the cases are now outside China where it all started, however China seems to have controlled the infection. 


Current status in India 


As of today, India has 20,88,611 active Covid-19 cases 42,518 deaths, with 14,27,005
cured/discharged cases. Doubling time in India is 21 days. 35 states have reported confirmed cases of Covid-19, with Maharashtra topping the list ( 4,79,779 confirmed cases) followed closely by Tamil Nadu 2,85,024 cases), at the time of writing this.  



Symptoms of Coronavirus infection


Most common symptoms include:
  • Fever
  • Tiredness
  • Dry cough

Less common symptoms are:

  • Sore throat
  • Aches and pains
  • Diarrhea
  • Loss of taste
  • Loss of smell
  • Conjunctivitis
  • Headache
  • A rash on skin, or discolouration of fingers or toes

Serious symptoms include:

  • Difficulty breathing or shortness of breath
  • Chest pain or pressure
  • Loss of speech or movement


It has been found that Covid-19 patients are at 27 times higher risk of experiencing loss of sense of smell in comparison to others. It is also noteworthy that they had merely 2.6-fold higher odds of having fever or chills.

Other symptoms added by the Centres for Disease Control and Prevention (CDC) are runny nose or congestion, and nausea or vomiting.

In severe cases, it can cause pneumonia and respiratory failure sometimes leading to death.

If a patient comes before 9 days, this is acute viral response while if he/she comes after 9 days, this is post-Covid syndrome. These patients have persistent systemic inflammation. Most common symptom is low grade (< 100.4) exertional afternoon rise of temperature or chills without rigors x 6 weeks. This fever does not respond to paracetamol while improves with anti-inflammatory drugs like mefenamic acid, naproxen, nimesulide and indomethacin. Other presentations may include post-Covid bronchitis, sore throat, exertional tachycardia, diarrhea, and cystitis.

Clinical symptoms in children include abdominal pain, diarrhea and vomiting, red rash, cracked lips, red eyes, high fever, swollen glands on neck and swollen hands and feet.

Post-COVID state


1. On the 9th-day, the virus becomes non-infectious
2. Is quite common and presents in India more with low-grade fever and obstruction in the throat. It can also present with shortness of breath, exertional tachycardia, persistent loss of smell and taste and below knee pains
3. Like arthritis in chikungunya
4. Like postherpetic neuralgia
5. Like post-viral syndrome, CFS, etc.

Transmission


WHO has stated that the coronavirus spreads through contact with contaminated surfaces or close contact with infected individuals who tend to spread the virus through saliva, respiratory secretions or droplets that are released when an infected person coughs, sneezes, speaks or sings.
WHO confirms there is emerging evidence of airborne transmission of coronavirus.A new study by scientists at the University of Nebraska revealed that airborne transmission of coronavirus is possible.

Suspecting a Covid-19 case


Fever and respiratory symptoms like cough or shortness of breath AND any individual, including health care workers who may have had any close contact with a laboratory confirmed Covid-19 patient within 14 days of symptom onset. People with a travel history to any of the affected countries are suspected and required to quarantine 

Epidemic cycle of the virus 
First cases [cases and close contacts in household setting] 
First cluster [the general population~ households, heath care professional, school]
First community spread [infection in the general population]
It is important to first contain the virus, then delay the transmission and simultaneously search for avenues to attack it and mitigate it. 


Diagnostic approach


In a patient with suspected Covid-19, chest X-ray may be normal in early or mild disease and even among those with serious disease. Findings are most extensive about 10-12 days after onset of symptoms. 

It should not be used as initial screening tool for Covid-19. In suspected patients with history of fever, dry cough, RT-PCR should be done first instead of chest X-ray.
Oblique CXR is done when lesion is not seen on routine AP view but there may be some data on CT.

CT should not be used as initial screening or diagnostic tool. It can be used to identify early markers for lung impairment in symptomatic patient with RT-PCR positive for Covid-19 or for those with non-resolving symptoms to evaluate disease progression.

Common CT findings include ground glass opacities, consolidation, mixed lesions, crazy paving pattern, reticulations, septal thickening (can be inter- or intra-lobular; commonly seen in advanced disease). 
Specific CT findings are halo sign, reverse halo sign, spider web sign, pulmonary vessel engorgement, vacuolar sign.
Infrequent CT findings are architectural distortion, lymph node enlargement and pleural effusion.
CT severity score: It scores lung opacities in all 6 lung zo