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COVID-19 & IMMUNITY

COVID-19 & IMMUNITY

What is coronavirus?
How to increase the immunity with vitamins that might help the body to fight against diseases.

Maleeha Fatima

May 14, 2020
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  1. WHAT IS COVID-19
    AND HOW TO
    INCREASE THE
    IMMUNITY ?
    BY
    MALEEHA
    FATIMA

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  2. Contents
    Coronavirus .............................................................................................................. 1
    SARS-COV ............................................................................................................ 2
    MERS-COV ........................................................................................................... 2
    Clinical case ........................................................................................................ 3
    Symptoms .................................................................................................................. 4
    Asymptomatic carrier .............................................................................................. 5
    Immunity ................................................................................................................... 6
    Immune system ......................................................................................................... 6
    Immune response ..................................................................................................... 6
    Antibodies ................................................................................................................. 8
    Vitamins .................................................................................................................... 8
    References ...............................................................................................................10
    Tables
    Table 1 Types of immunity ................................................................................ 7
    Table 2 Foods that provides vitamins ................................................................ 9

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  3. 1
    Coronavirus
    2020 started with the emergence of novel coronavirus known as
    SARS-CoV-2 that caused a pandemic of coronavirus disease (COVID-19)
    which causes respiratory and intestinal infections in humans.
    Coronaviruses are enveloped, positive-sense single-stranded RNA
    viruses. They are members of the subfamily “Coronavirinae” (family;
    Coronaviridae, order; Nidovirales). Coronavirus contains four genera:
    1. alpha-coronavirus (e.g., 229E, NL63) : infect mammals
    2. beta-coronavirus (e.g., SARS-CoV, SARS-CoV-2, HKU1, OC43,
    MERS-CoV) : infect mammals
    3. gamma-coronavirus : infect birds
    4. delta-coronavirus : infect birds [1].
    Human coronaviruses primarily cause respiratory infections. A
    number of strains of coronaviruses are recognized, most of which are
    responsible for the common cold.

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  4. 2
    SARS-CoV
    In 2002 a new strain emerged in China that rapidly spread in the
    region, then to Hong Kong, Vietnam, and Singapore. Focal outbreaks were
    also reported in other countries by travelers from the endemic region who
    became ill when they returned home. The virus was named SARS-CoV.
    Two facts about this virus are critical: person-to-person spread occurred
    readily, including in the health care workers exposed to the patients, and the
    disease was responsible for a high mortality rate, particularly for patients
    with underlying pulmonary disease (i.e., 50% mortality) and in the elderly.
    MERS-CoV
    In 2012 a new coronavirus infection erupted in the Middle East, again
    associated with a high mortality rate. This strain, MERS-CoV, has spread
    from the initial focus in the Kingdom of Saudi Arabia through the Middle
    East and to other countries via travelers. In contrast with the SARS-CoV
    strain, this coronavirus is only intermittently spread person-to-person;
    however, coronaviruses have a high mutation rate so this can change rapidly.
    In addition, the strain continues to circulate in the Middle East.
    It is interesting that both the SARS-CoV and MERS-CoV strains are
    related to bat coronavirus strains. The SARS-CoV strain was isolated in bats,
    and there is epidemiologic evidence to implicate bats in the MERS-CoV.

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  5. 3
    Clinical Case
    Previously Healthy Patient with SARS Infection
    Luo and colleagues described a previously healthy patient who was
    transferred to his hospital after a 9-day history of persistent fevers, myalgias,
    and headache. The patient presented with a fever of 39.4°C, chills, a dry cough,
    shortness of breath, and diarrhea. Chest x-ray showed inflammation in the right
    upper lung fields. White blood cells and chemistries were normal. The patient
    failed to respond to antibiotic treatment. On day 3, he developed a deep cough
    and dyspnea along with diffuse pulmonary inflammation. The diagnosis of
    SARS was made in view of his severe hypoxemia with PaO2
    of 60 mmHg and
    PaO2
    /FiO2
    of 150 mmHg, and a clinical picture consistent with other
    hospitalized patients with SARS. The patient was transferred to the intensive
    care unit and placed on ventilatory support, but continued to deteriorate into
    multiorgan dysfunction syndrome involving the kidney, liver, and heart. The
    medical staff initiated molecular adsorbent recirculating system therapy
    (extracorporeal liver support utilizing albumin dialysis for 8 hours) and after 4
    consecutive days of therapy, clinical improvement was noted. After 13 days,
    ventilatory support was withdrawn and the patient continued to improve. The
    patient was discharged after 44 days of hospitalization. This case illustrates the
    severe infection caused by SARS-CoV [2].

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  6. 4
    Symptoms
    Signs and symptoms of COVID-19 may appear two to 14 days after exposure and
    can include:
     Fever
     Cough
     Shortness of breath
     Persistent pain or pressure in the chest
     New confusion or inability to arouse
     Bluish lips or face [3]
     Tiredness
     Aches
     Runny nose
     Sore throat [4]
     Loss of appetite
     Diarrhea
     Vomiting
     Abdominal pain [5].

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  7. 5
    Asymptomatic carrier
    An asymptomatic carrier is a person who has contracted a virus but isn’t
    manifesting any of the symptoms it causes. In case of COVID-19, the SARS-
    CoV-2 virus infects the cells which are involved in oxygen circulation, also
    known as alveolar cells. It can affect the ability of a person to take in oxygen
    that's why one of the most-common symptoms of the current coronavirus is
    shortness of breath. Asymptomatic and mildly symptomatic transmission is a
    major factor in transmission for COVID-19.
    In asymptomatic carrier the virus has infected the cells, but:
     The immune system is taking too long to react (and symptoms will show up
    later).
     The immune system kicked in early enough in the infection's course to not
    manifest symptoms.
     The infection is very mild and it's not enough to engage a strong immune
    response [6].

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  8. 6
    Immunity
    Immunity is a state of resistance of an organism to invading biotic or
    abiotic pathogens and their harmful effects that prevents the
    development of infection and maintains organism’s integrity by
    counteracing, neutralizing, and clearing pathogens [7].
    Immune system
    Collection of cells, tissues and molecules that mediate resistance to
    infections and eradicate established infections is called immune system.
    Immune response
    The coordinated reaction of cells and molecules to infectious microbes is
    the immune response.

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  9. 7
    Table 1 TYPES OF IMMUNITY
    Innate immunity Adaptive immunity
     It is a host defense
    mechanism that
    provides initial
    protection against
    infections.
     It is a first-line of
    defense against non-
    self pathogens.
     This type of immunity
    is always present in
    healthy individuals,
    prepared to block the
    entry of microbes and
    to rapidly eliminate
    microbes that do
    succeed in entering
    host tissues.
     It is a person’s natural
    immunity which
    generates non-specific
    but a rapid response.
     It is less potent and is
    unable to develop
    memory cells.
     Native or natural
    immunity.
     It develops more
    slowly and mediates
    the later, even more
    effective, defense
    against infections.
     It is a second-line of
    defense.
     It is stimulated by
    microbes that invade
    tissues, that is, it adapts
    to the presence of
    microbial invaders.
     It is an acquired
    immunity which
    generates specific but
    delayed response.
     It is highly potent and
    has capability to
    develop memory cells.
     Specific or acquired
    immunity

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  10. 8
    Antibodies
    Antibodies are proteins produced by the immune system that help to
    defend the host against foreign invasion, when a host is challenged by
    antigen i.e foreign material (bacteria, virus, toxins, etc.). Antibodies are
    medically and experimentally important immune system proteins. By
    binding to foreign molecules with high specificity and affinity, they act as
    flags that guide the immune response.
    Vitamins
     Vitamins support body’s natural defence mechanism by enhancing the
    immune response towards pathogens. They help the body in fighting against
    variety of illness and protect the body from damage to cells.
     Types: A, B, C, D, E, K
     Vitamin A, B, C, D, E provides strength to immune cells during pathogen
    attack/ inhalation of toxic material from air or that may be present in food.
     Drugs, tea, caffeine, smoking, alcohol, dietary fibers etc affect the vitamins.
     Vitamins are essential for antibody production.

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  11. 9
    Table 2 FOODS THAT PROVIDE VITAMINS
    [8, 9]
    Vitamin Sources
    A Sweet potato, spinach, carrot, pistachio, peppers, egg, cheese, apricot,
    legumes
    B6
    Beef liver, chickpeas, tuna, salmon, rice, cereals, onion, legumes,
    green leafy vegetables, fruits, chicken, meat
    B9
    Lettuce, avocado, spinach, kidney beans, egg, rice, peanuts
    B12
    Milk, yogurt, cheese, egg, cereals, meat, soy milk
    C Tomato, cabbage, oranges, green & red pepper, spinach, green peas,
    capsicum, kiwi, lemon, limes, grapefruit, papaya
    D Milk, yogurt, egg, cheese, orange juice, salmon, tuna
    E Peanuts, tomato, spinach, almond

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  12. 10
    References
    1. Khan S et al. The emergence of a novel coronavirus (SARS-CoV-2), their biology and
    therapeutic options. Journal of Clinical Microbiology. 2020: 1-23.
    2. Patrick R. Murray. Basic Medical Microbiology. ELSEVIER.
    3. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
    4. https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-
    20479963
    5. https://www.webmd.com/lung/news/20200319/about-half-of-covid-cases-show-
    digestive-signs
    6. https://www.inverse.com/mind-body/coronavirus-how-asymptomatic-carriers-spread-
    virus-like-covid-19
    7. https://www.sciencedirect.com/topics/immunology-and-microbiology/immunity
    8. Aslam MF et al. Vitamins: Key role players in boosting up immune response- a mini
    review. Vitamins & Minerals. 2017; 6(1): 1-8.
    9. https://www.healthline.com/health/food-nutrition/foods-that-boost-the-immune-system

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