AUTHOR: SEOK WOO YANG, MD & PhD (E mail: soplab@outlook.kr)

DATE:2020.03.09

CONTENT:

 

ORGAN ANATOMIC PATHOLOGIC FINDINGS CLINICAL IMPLICATION
Lung

Diffuse alveolar damage.

Desquamation of pneumocytes.

Hyaline membrane disease.

Intra-alveolar fibromyxoid exudate.

Pulmonary edema.

Interstitial mononuclear cell infiltration, predominantly lymphocytes.

Multinucleated syncytial cells with atypical enlarged pneumocytes characterised by large nuclei, amphophilic granular cytoplasm, and prominent nucleoli.[1]

 

Acute respiratory distress syndrome.

Acute lung injury.

Heart Interstitial mononuclear inflammatory infiltrates  
Liver

Moderate microvesicular steatosis.

Mild lobular and portal activity.[1]

 
Kidney in COVID-19

No datum.

 
Kidney in MERS-CoV

Acute kidney injury.

Tubular epithelial cell degnerative/regenerative change.[2]

Kidney failure.
Central nervous system in COVID-19 No datum.  
Central nervous system in SARS-CoV Viral particles rich in brain neurons.[3] A potential neuroinvasion

 

REFERENCE:

[1] Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, Liu S, Zhao P, Liu H, Zhu L, Tai Y, Bai C, Gao T, Song J, Xia P, Dong J, Zhao J, Wang FS. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020 Feb 18:S2213-2600(20)30076-X

[2] Alsaad KO, Hajeer AH, Al Balwi M, Al Moaiqel M, Al Oudah N, Al Ajlan A, AlJohani S, Alsolamy S, Gmati GE, Balkhy H, Al-Jahdali HH, Baharoon SA, Arabi YM. Histopathology of Middle East respiratory syndrome coronovirus (MERS-CoV)
infection - clinicopathological and ultrastructural study. Histopathology. 2018 Feb;72(3):516-524.

[3] Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may be at least partially responsible for the respiratory failure of COVID-19 patients. J Med Virol. 2020 Feb 27.

Author: SEOK WOO YANG, MD & PhD (E.mail: soplab@outlook.kr)

Date: 2020.03.04.

Content:

 

 To prevent further spread and contagion of coronavirus 19, two environmental factors like temperature and humidity should be considered.

 

TEMPERATURE

 

 As one of the key factors facilitating the transmission of Coronaviruses, the environmental temperature has been reported in many articles.

 

 Chan et al(2011) reported that SARS coronavirus could maintain active for at least 5 days on a smooth surface in an environment where the temperature was 22-25℃ and relative humidity 40-50%. This environmental temperature range from 22 to 25℃ is similar to the room temperature, which is 20-22℃. For this reason, these explain why an outbreak of SARS occurred in Hong Kong(subtropical area, the air-conditioned environment in the spring), whereas SARS transmission was not prominent in the tropical areas(such as Malaysia, Indonesia or Thailand) with high temperature and high relative humidity environment.[1]

 

 As a supportive opinion, Ian Lipkin(director of the Columbia University's Center for Infection and Immunity) says sunlight, which is less abundant in winter, can also help break down viruses that have been transmitted to surfaces. The reason for this phenomenon is that UV light with sunlight breaks down nucleic acid. It almost sterilizes surfaces contaminated with coronaviruses. The UV light is so effective at killing bacteria and viruses it’s often used in hospitals to sterilize equipment.[2]

 

 Besides the environmental temperature condition, human nasal and oropharyngeal temperature plays a major role in coronavirus infection. 

 

 The optimal temperature for the replication of human coronavirus is 33℃.[3]

 

 During quiet breathing of room air, the average physiologic temperature ranged from 32.0 +/- 0.05 ℃ in the upper trachea to 35.5 +/- 0.3℃ in the subsegmental bronchi.[4]

 

 For this reason, it may explain why human coronavirus infection mainly occurs in the upper respiratory tract(nose, oropharynx, and larynx are included). 

 

 

HUMIDITY

 

 In a normal healthy state, nose and pharynx secrete and are covered by viscous wet mucus, which is appropriate for trapping virus droplets.

 

 Cold and dry air makes normally viscous wet mucus drier and less efficient for trapping virus particles.

 

 This explains why Coronavirus outbreaks like SARS and COVID 19 happen in the winter season with low environmental temperature and humidity.



SUMMARY

 

 In terms of both environmental and human physiologic upper respiratory tract temperature and humidity, high environmental temperature and humidity can be a key factor to prevent transmission of coronavirus. 

 

 As a method to satisfy the above conditions in our body, facial mask, adequate hydration(water intake) and sun exposure can be an alternative. 

 

 The facial mask makes human airways keep more humid and warmer, namely high humidity and high temperature, the condition of which inhibits transmission of coronavirus droplets. 

 

REFERENCE

[1] K.H. Chan, J.S.M. Peiris, S.Y. Lam, L.L.M. Poon, K. Yuen, W.H. Seto, The Effects of

Temperature and Relative Humidity on the Viability of the SARS Coronavirus, Advances in

Virology, 2011 (2011) 734690-734690.)

[2] Sarah Gibbens. Will warming spring temperatures slow the coronavirus outbreak?. NATIONAL GEOGRAPHIC. Feb 25. 2020.

[3] M.M. Darville and E.O. Caul. Coronavirus. Chapter 57 In Medical Microbiology Edited by David Greenwood, Richard C.B.Slack, John F.Peutherer. 16th ed. 2002. p548.

[4] McFadden ER Jr, Pichurko BM, Bowman HF, Ingenito E, Burns S, Dowling N,

Solway J. Thermal mapping of the airways in humans. J Appl Physiol (1985). 1985

Feb;58(2):564-70. doi: 10.1152/jappl.1985.58.2.564. PMID: 3980358.

 

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