Internet Book of Critical Care (IBCC)

  • COVID-19 is a non-segmented, positive sense RNA virus.
  • COVID-19 is part of the family of coronaviruses.  This contains:
    • (i) Four coronaviruses which are widely distributed and usually cause the common cold (but can cause viral pneumonia in patients with comorbidities).
    • (ii) SARS and MERS – these caused epidemics with high mortality which are somewhat similar to COVID-19.  COVID-19 is most closely related to SARS.
  • COVID-19 binds via the angiotensin-converting enzyme 2 (ACE2) receptor located on type II alveolar cells,  intestinal epithelia, and the vascular endothelium (Hamming 2004).
    • This is the same receptor as used by SARS (hence the technical name for the COVID-19, “SARS-CoV-2”).
    • When considering possible therapies, SARS (a.k.a. “SARS-CoV-1”) is the most closely related virus to COVID-19.
  • COVID-19 is mutating, which may complicate matters even further.  Virulence and transmission will shift over times, in ways which we cannot predict.  Ongoing phylogenetic mapping of new strains can be found here.

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