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The novel coronavirus has now become an integral part of our daily lives. Accurate and reliable information is essential, both for protecting our own health and that of our loved ones.

Andreas Fretzayas, Professor of Pediatrics and Scientific Advisor to the Athens Pediatric Center, answers the most important questions and informs us about everything we need to know about COVID-19.

GENERAL QUESTIONS ABOUT CORONAVIRUS

• When did the clinical presence of coronavirus become known?

On 31/12/2019, the World Health Organization was notified by the health authorities of China.

• Why did it immediately cause concern?

It was identified as a new virus, and every new infectious agent raises concerns about the possibility of causing a pandemic because there is no immunity in the community.

• Have there been previous coronaviruses that caused disease?

In 2003, a virus belonging to the coronavirus family caused Severe Acute Respiratory Syndrome (SARS-CoV, transmitted from cats), and in 2012 another virus from the same family was transmitted from camels and caused Middle East Respiratory Syndrome (MERS-CoV).

SYMPTOMS AND TRANSMISSION OF CORONAVIRUS

• Is there person-to-person transmission of the virus and how does it occur?

Yes, through droplets of saliva during coughing and sneezing. It can also be transmitted through contact with contaminated objects followed by touching the eyes, nose or mouth.

• What are the symptoms of the novel virus?

They do not differ significantly from those of influenza and include high fever, headache, sore throat, cough, muscle aches, joint pain and respiratory distress. More recently, loss of smell, loss of taste and diarrhea have also been added. In children, acute inflammatory syndrome may be observed more frequently.

• What are the most serious complications?

Pneumonia, often affecting both lungs, and respiratory failure. Myocarditis and arterial / venous / thrombotic events have also been reported, particularly in adults.

• What self-protection measures should we take?

1. Personal hygiene measures such as frequent handwashing with soap and water for at least 20 seconds or with an alcohol-based antiseptic solution.
2. Avoid contact with sick individuals.
3. Avoid touching your mouth, nose and eyes with your hands.
4. Use a tissue when coughing or sneezing and dispose of it in a waste bin.
5. Avoid enclosed and crowded spaces.
6. Avoid contact with people who have returned from areas of China where the virus is endemic or from other regions and countries where cases have recently been reported.

• Is there a reliable method of laboratory diagnosis?

Yes, with molecular techniques (PCR). Rapid detection tests (rapid tests) have lower sensitivity and are suitable for epidemiological purposes.

DIAGNOSIS AND TREATMENT OF CORONAVIRUS

• Is there a vaccine?

No, not at present.

• Is there a specific treatment?

No, only supportive treatment in hospital. More recently, dexamethasone and remdesivir have been added for intubated patients, and the administration of serum containing antibodies derived from the blood of people who were infected with SARS-CoV-2 and recovered has also been tested.

• Will there be further waves of infection?

This is the usual pattern in pandemics caused by infectious diseases, as was previously seen with influenza and, even earlier, with the plague. As long as the basic protective measures (mask, distancing, handwashing / hand antisepsis) are not followed and immunity in the community remains low, the likelihood will increase.

• At what stage of illness with COVID-19 and influenza is a person infectious and the risk of transmission present?

For COVID-19, infectiousness gradually increases up to 7-10 days from the onset of symptoms. Infectiousness in COVID-19 peaks 2 days before onset and 1 day after onset, with presymptomatic transmission estimated at 37-48%. For influenza, infectiousness occurs shortly before the onset of symptoms (1-2 days) and at the beginning of the symptomatic phase of the disease.

More specifically, a recent study (Nature Medicine 20;672,2020) showed that transmission of COVID-19 before the 7^th day occurs at a rate of <0.1%, before the 5^th day at 1%, and before the 3^rd day from symptom onset at 9%.