Meaning of covid-19: treatment, duration, incubation …

end 2019, cluster cases of pneumonia have occurred in China some of which were fatal. January 9 virus the person responsible is identified, it is called a new coronavirus SARS-CoV-2 responsible for a disease called Covid-19. Symptoms, incubation period, contagion, people at risk … Current knowledge of this new infectious disease that we have not yet been able to stop in the world.

Covid-19 is the name given by the WHO on February 11, 2020 to a new respiratory infectious disease appeared in December 2019, in China, and caused by the SARS-CoV-2 coronavirus.

• “Co “for” crown “,
• “vi” for “virus”
• “D” for “disease” (“disease” in English).
• 19 for the year of its appearance: 2019.

“We had to find a name that didn’t refer to a geographical location, an animal, an individual or a group of people” WHO Director General, Dr. Tedros Adhanom Ghebreyesus explained in detail to avoid any stigmatization of the disease. This disease would have been transmitted to humans following the consumption of contaminated meat – bat or pangolin are the two most advanced hypotheses – sold to Wuhan local market in China.

More information about the virus:

The manifestations of Covid-19 disease are now well recognized: they concern in particular the lung, the kidneys, the nervous system (including psychiatric manifestations), the heart, the skin, the digestive system and the ENT sphere. Unlike the flu, which arises suddenly, a Coronavirus infection “it is done gradually over several days” indicates the Institut Pasteur. Patients report symptoms that appear over a week and a fairly long healing time.

In France there are almost of them 15% of severe forms of Covid-19. According to the work of a Franco-American team published by Inserm, these patients All reportedly lack the activity of type I interferons, immune system molecules that normally have potent antiviral activity. The main danger of Covid-19 infection lies in its pulmonary complications. Inflammatory syndromes have also been reported in some children who needed hospitalization.

Who are the people most at risk?

Covid-19 disease is second most seriousage (over 65s are overrepresented among deaths), sex (humans are more at risk of serious disease and the death rate is higher in humans) e presence of comorbidities. The the three comorbidities most at risk in France, severe forms of Covid-19 are” Hypertension, heart disease and diabetes. Insecurity is another documented risk factor.

The average incubation time is 5 days with a maximum duration from 12 to 14 days.

A person with Covid-19 is contagious 2-3 days before symptoms appear is up to 8 days later, shows a summary published by Santé Publique France on July 8. Additionally, approximately 50% of transmissions would occur during the pre-symptomatic phase of the source patient. Once contaminated, the patient can remain so Many weeks. On Collective Inter-reanimation on Facebook, caregivers indicate that patients “are still positive after more than 3 weeks of resuscitation “.

According to Dr. Gerald Kierzek, “healing occurs after a fifteen days when you have mild symptoms. It is spontaneous except when there is a severe form and we are in intensive care where we need oxygen, where we have pneumonia and there we need drugs “. It can also cause SARS-COV2 infection persistent symptoms, more than 3 weeks after the first clinical manifestations (post-covid syndrome). Fatigue can persist for a long time.

In France, several tests are available for screening for Covid-19 disease. The reference is the RT-PCR test which is performed in the nose. People with symptoms are given priority.

No treatment with direct viral activity has scientifically proven its effectiveness in the fight against SARS-CoV-2.

• In mild forms of the disease that do not require hospitalization: in case of fever it is recommended to take paracetamol and not anti-inflammatory drugs that can inflame the infection. Symptom progression should be monitored and if worsening with breathing difficulties, call 15.
• For severe forms during hospitalization, outside of an intensive care unit: oxygen support, ventilatory support and:

→ the use of corticosteroids (dexamethasone), anti-inflammatory treatment that reduces mortality in patients requiring oxygen support according to the Recovery randomized controlled clinical trial

→ the use of tocilizumab (anti-interleukin-6 receptor treatment) which appears to be effective in patients requiring more than 3 liters / minute of oxygen.

“The number of reported cases of reinfection remains anecdotal.”

→ anticoagulant from heparin which allows decrease the risk of thrombosis and embolism

→ Remdesivir: the 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 forms and resumption of the three therapies mentioned above (corticosteroids, tocilizumab and heparin).

Excluded treatments:

• Antibiotics : in an opinion of 6 June 2020, the HCSP advises against taking antibiotics in a patient presenting with symptoms related to a confirmed Covid-19 (outside of another infectious outbreak) “due to the exceptional nature of bacterial coinfection”. The antibiotic Azithromycin has been given to several patients with Covid-19 since the outbreak began. Pending confirmation of the virological diagnosis of Covid-19 and in case of doubt with a bacterial infection, the HCSP indicates that there may be a prescription for amoxicillin.
• Hydroxychloroquine : “After initial observations from non-randomized cohorts suggesting the efficacy of hydroxychloroquine, alone or in combination, the vast majority of randomized trials conducted in France, Europe, the United States, Brazil or the WHO study, did not find this effect “ explains the Covid-19 Scientific Council.
• Lopinavir / ritonavir: In hospitalized patients with severe or critical form of the disease, 4 randomized controlled trials did not find efficacy of lopinavir / ritonavir administration.
• Sarilumab : the drug was tested in the United States. The companies stopped the trial due to the lack of efficacy of the drug found and more frequent serious side effects.

• Vaccines against covid19

At the end of October 2020, according to the WHO list, nearly 200 candidate vaccines against SARS-CoV-2 are under development, using eight different technology platforms: live attenuated and inactivated vaccines, protein sub-unit based vaccines, vaccines from viral genetic material (RNA and DNA, never commercialized in humans), vaccines with replicative or non-replicative viral vector and vaccines with viral pseudo-particles “virus-like particles”.

> Learn more about 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.” points out October 15 to the World Health Organization, which opposes the principle of collective immunity as a means to fight the Covid-19 epidemic. “Until we have a better understanding of immunity to the COVID-19 virus, it will not be possible to know what percentage of a population is immune and how long that immunity lasts, let alone make predictions for these questions should rule out any idea of ​​strengthening the immunity within a population by letting the virus spread “.

In a report published on 1 December, the Alta Autorité de Santé indicates this “The number of reported reinfection cases remains anecdotal. These clearly documented reinfections, about ten, because they involve different viruses during the two infectious episodes – they were seen in quite young subjects who were not immunosuppressed.”