Yıl: 2020 Cilt: 16 Sayı: 1 Sayfa Aralığı: 1 - 8 Metin Dili: İngilizce DOI: 10.5222/BMJ.2020.22931 İndeks Tarihi: 17-04-2020

The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease

Öz:
At the end of December 2019, a new respiratory virus infection was identified in Wuhan city, China, in the province of Hubei, after patients with acute severerespiratory infections showed clustering. The cases were thought that they could be related to exposure in the Huanan Seafood Market where wholesale fish andlive animals are sold in this city. In January 2019, the causative agent was named 2019-nCoV (2019 novel coronavirus), severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2) and 2019 coronavirus disease (COVID-19) by the World Health Organization (WHO).Coronaviruses are enveloped and single-stranded RNA viruses of the Coronaviridae family and are known as “crown viruses” due to their crown-like protrusionson their outer surfaces. They can infect various species. In addition to mild upper respiratory diseases, it is the causative agent of serious acute respiratorysyndrome (SARS) and Middle East respiratory syndrome (MERS). 2019-nCoV shows 79% similarity to SARS-CoV and means that bats such as SARS-CoV may havebeen the original host of this virus. The route of transmission is by respiratory droplets and direct contact. In order to prevent the spread of infection, earlydiagnosis, proper isolation and personal protective measures are especially important in the hospital environment. The agent uses angiotensin converting enzyme2 (ACE2) receptor to enter the cell. The incubation period is usually 3-7 days and can extend up to 14 days. While it is more severe in upper-middle aged people,those with advanced age and additional comorbidities pose risk factors for severe disease. Adult patients have high fever, weakness and dry cough, and somehave headaches and muscle pain. As the disease period progresses, shortness of breath acute respiratory distress syndrome, septic shock, metabolic acidosis,clotting disorders, and multiple organ failure may occur. In particular, children can pose an unnoticed threat in spreading the outbreak. Children are less likelythan adults to have the infection as an obvious clinical status. The clinical features of the disease are milder and death has not been reported under 10 years ofage. Blood count and C-reactive protein values can usually be found normal or slightly increased. In the radiological evaluation of the lung, ground glassappearance and bronchial shadows may be evident. A nucleic acid test is performed from the nose or throat swab to determine the exact cause of the disease.Adequate calorie and fluid intake and the need for oxygen should be ensured in the treatment. An effective anti-virus treatment is not yet available. However, insevere cases, interferon-α nebulization and efficacy have not been proven, lopinavir / ritonavir and chloroquine are recommended. In certain cases, corticosteroidscan be used. The virus can be inactivated with disinfectants containing ethanol and chlorine. People with close contacts and suspicious exposure should be advisedof 14 days of observation and isolation, starting from the last contact day with the patient infected with 2019-nCoV. Vaccine development studies for 2019-nCoVare ongoing.
Anahtar Kelime:

Konular: Cerrahi

İnsanlığın “Yeni” Sorunu: Yeni Koronavirüs (2019-nCoV / COVID-19) Hastalığı

Öz:
İlk olarak 2019 Aralık ayı sonunda Çin’in Hubei eyaletinde bulunan Wuhan kentinde akut ağır solunum yolu enfeksiyonu tanılı hastaların kümelenme göstermesi üzerine dikkat çeken yeni bir solunum virüs enfeksiyonu tanımlandı ve vakaların bu şehirde bulunan toptan balık ve canlı hayvan satışının yapıldığı Huanan Deniz Ürünleri Pazarı’nda maruziyetle ilişkili olabileceğini bildirdi. Ocak 2019 içinde de etken Dünya Sağlık Örgütü (DSÖ) tarafından 2019-nCoV (2019 novel coronavirus), şiddetli akut solunum sendromu koronavirüs 2 (SARS-CoV-2) ve 2019 koronavirüs hastalığı (COVID-19) virüsü olarak adlandırıldı. Koronavirüsler Coronaviridae ailesinin zarflı ve tek sarmallı RNA virüsleridir ve dış yüzeylerindeki taç benzeri çıkıntılarından dolayı “taç virüs” olarak bilinir. Çeşitli canlı türünü enfekte edebilirler. Hafif üst solunum yolu hastalıkları yanında ciddi akut solunum sendromu (SARS) ve Orta Doğu solunum sendromu (MERS) etkenidir. 2019- nCoV SARS-CoV’a %79 benzerlik göstermektedir ve SARS-CoV gibi yarasaların bu virüsün orijinal konağı olabileceği anlamına gelmektedir. Bulaşma yolu solunum damlacıklarıyla ve doğrudan temasla olmaktadır. Enfeksiyonun yayılmasını engellemek için erken tanısı, uygun izolasyon ve özellikle hastane ortamında kişisel koruyucu önlemler çok önemlidir. Etken hücre içine girmek için anjiotensin dönüştürücü enzim 2 (ACE2) reseptörünü kullanmaktadır. Kuluçka süresi genellikle 3-7 gündür ve 14 güne kadar uzayabilir. Daha çok orta yaş üzeri kişilerde daha ağır klinik tablo oluştururken yoğun bakıma yatırılanlar ileri yaşta ve ek hastalığı bulunanlar olmaktadır. Erişkinlerde yüksek ateş, halsizlik ve kuru öksürük, bazılarında baş ağrısı ve kas ağrısı görülür. İlerledikçe nefes darlığı akut solunum sıkıntısı sendromu, septik şok, metabolik asidoz, pıhtılaşma bozuklukları ve çoklu organ yetmezliği oluşabilir. Özellikle çocuklar, salgını yaymada farkedilmeyen tehdidi oluşturabilir. Çocuklarda enfeksiyonun aşikar hastalık olarak ortaya çıkma ihtimali erişkinlerden daha azdır; hastalığın klinik özellikleri daha hafiftir ve ölüm 10 yaş altına bildirilmemiştir. Kan sayımı ve C-reaktif protein değerleri genellikle normal ya da hafif artmış bulunabilir. Akciğer radyolojik değerlendirmesinde buzlu cam görünümü ve bronşiyal izlerde belirginleşme olabilir. Hastalığın etkeninin kesin ortaya konması için burun veya boğaz sürüntüsünden nükleik asit testi yapılır. Tedavide yeterli kalori ve sıvı alımının sağlanmalı, oksijen ihtiyacı giderilmelidir. Etkili bir virüs karşıtı tedavisi henüz mevcut değildir; ancak ağır vakalarda interferon-α nebulizasyonu ve etkinliği kanıtlanmış olmasa da lopinavir/ritonavir ve klorokin önerilmektedir. Belirli durumlarda kortikostroidlerden yararlanılabilir. Virüs etanol ve klor içeren dezenfektanlarla inaktive edilebilir. Yakın temasları ve şüpheli maruziyeti olan kişilere, 2019-nCoV ile enfekte hastayla son temas gününden başlayarak 14 günlük gözlem ve izolasyon tavsiye edilmelidir. 2019-nCoV için aşı geliştirme çalışmaları devam etmektedir.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
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APA HATİPOĞLU N (2020). The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease. , 1 - 8. 10.5222/BMJ.2020.22931
Chicago HATİPOĞLU Nevin The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease. (2020): 1 - 8. 10.5222/BMJ.2020.22931
MLA HATİPOĞLU Nevin The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease. , 2020, ss.1 - 8. 10.5222/BMJ.2020.22931
AMA HATİPOĞLU N The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease. . 2020; 1 - 8. 10.5222/BMJ.2020.22931
Vancouver HATİPOĞLU N The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease. . 2020; 1 - 8. 10.5222/BMJ.2020.22931
IEEE HATİPOĞLU N "The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease." , ss.1 - 8, 2020. 10.5222/BMJ.2020.22931
ISNAD HATİPOĞLU, Nevin. "The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease". (2020), 1-8. https://doi.org/10.5222/BMJ.2020.22931
APA HATİPOĞLU N (2020). The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease. Bakırköy Tıp Dergisi, 16(1), 1 - 8. 10.5222/BMJ.2020.22931
Chicago HATİPOĞLU Nevin The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease. Bakırköy Tıp Dergisi 16, no.1 (2020): 1 - 8. 10.5222/BMJ.2020.22931
MLA HATİPOĞLU Nevin The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease. Bakırköy Tıp Dergisi, vol.16, no.1, 2020, ss.1 - 8. 10.5222/BMJ.2020.22931
AMA HATİPOĞLU N The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease. Bakırköy Tıp Dergisi. 2020; 16(1): 1 - 8. 10.5222/BMJ.2020.22931
Vancouver HATİPOĞLU N The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease. Bakırköy Tıp Dergisi. 2020; 16(1): 1 - 8. 10.5222/BMJ.2020.22931
IEEE HATİPOĞLU N "The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease." Bakırköy Tıp Dergisi, 16, ss.1 - 8, 2020. 10.5222/BMJ.2020.22931
ISNAD HATİPOĞLU, Nevin. "The “New” Problem of Humanity: New Coronavirus (2019-nCoV / COVID-19) Disease". Bakırköy Tıp Dergisi 16/1 (2020), 1-8. https://doi.org/10.5222/BMJ.2020.22931