More about coronavirus. Interview with Academician A.V. Karaulova.

More about coronavirus. Interview with Academician A.V. Karaulova. 06.01.2021 00:00

More about coronavirus. Interview with Academician of the Russian Academy of Sciences A.V. Karaulova.

What is discovered about the coronavirus? One of the key factors cause severe respiratory illnesses in people is the coronavirus.

The most vulnerable groups to coronavirus infection are elderly individuals, persons with weak immune systems, and patients with chronic conditions. In order to avoid the spread of the illness, it is crucial to boost the immune system and adopt preventative measures, including using immunocorrective medications.

 

Interview with Academician of the Russian Academy of Sciences A. V. Karaulov

1.The planet has been infected by a brand-new coronavirus. What virus is this? What is the relationship between this epidemic and earlier coronavirus outbreaks?

 

A new strain of coronavirus, the disease-causing agent in animals, has spread from animals to people for the third time in the past 30 years. In late 2002, the SARS-CoV coronavirus emerged, the causative agent of SARS, which caused severe acute respiratory syndrome (SARS) in humans. The natural reservoir of SARS-CoV is bats, the intermediate hosts are camels and Himalayan civets. Over 8,000 cases in total—774 of which were fatal—were reported throughout the pandemic era in 37 different countries. In 2012, the world faced the new coronavirus MERS (MERS-CoV), the causative agent of the Middle East respiratory syndrome. The primary natural reservoir for MERS-CoV coronaviruses is camels. The MERS-CoV virus has been implicated in 2494 coronavirus infections since 2012, 858 of which have resulted in death. 2019-nCoV, a brand-new coronavirus type, was just identified in the Chinese city of Wuhan. The virus was isolated from people who worked in a market that sells seafood and animals for food. At first, it was thought that this sickness could only be slightly or not at all spread from person to person. It is now known, nevertheless, that the virus may spread from person to person. It is most likely that the infection is transmitted by direct contact with an infected person (i.e., by contact) and by “large droplets” rather than by aerosol. Chinese researchers decoded the genome of 2019-nCoV and discovered that it shares 75–80% of its genetic material with the SARS-CoV virus, which was the source of the severe acute respiratory syndrome outbreak (SARS).

 

2. How is the coronavirus infection spreading in China and throughout the world?

 

At first, Wuhan in China was where the sickness was most widespread. New coronavirus cases are now being reported in Asia, North America, and Europe (Thailand, Japan, Republic of Korea, Vietnam, Malaysia, Nepal, Taiwan, Singapore, Australia, USA, Canada, France, Germany). As of January 31, 2020, reports of the virus's discovery have been received from 23 various countries.

 

3. Is this infection really that dangerous?

 

More than 1300 of the 7824 patients with confirmed coronavirus infection as of January 30 are in severe instances, according to the European CDC. This represents about 20%. (i.e. one in five). At this time, the mortality rate is anticipated to be between 2.5% and 3%. (As of January 30, according to official data, 170 people died). When compared to illnesses like Ebola, SARS-CoV, and MERS-CoV, this is a bit lower. It is important to note that deaths account for a relatively high proportion of severe illness cases. The newest coronavirus is also quite aggressive. The number of cases is still rising, indicating that the pandemic has not yet been contained. About 800 instances of illness had been reported as of January 24, 7.7 thousand had been by January 30, and 9.7 thousand had been on January 31.

 

4. Who is more prone to the disease's severe course?

 

Like with most respiratory infections, individuals with comorbid conditions (that is, with chronic diseases), older patients, and patients with weaker immune systems are at an increased risk of developing a severe course of the illness. Bacterial superinfection may occur in those who already have chronic illnesses and a coronavirus infection, which can severely worsen the condition. There is currently no proof that children are more likely than adults to carry the illness. However, there are now known risk factors for childhood serious disease. Additionally, they apply to all coronavirus variations. Children with lung disorders, Kawasaki disease, immunodeficiency diseases, and mixed infections, such as a concurrent respiratory syncytial virus infection, are considered to be up to 4 years old.

 

5. How might a coronavirus infection be suspected?

 

The odd thing about coronavirus infection is that some people might carry the virus even if they don't show any symptoms. The incubation time ranges from two to fourteen days. Clinical signs of an acute respiratory virus infection, such as fever, a cough (dry or with some sputum), shortness of breath, muscular soreness, and a sensation of chest congestion, are present in the majority of patients. These symptoms are accompanied by increased exhaustion in roughly half of the cases. Sepsis, septic shock, fast progressing pneumonia, and multiple organ failure are seen in severe instances. More than 30% of patients experience hypoxemia, which is a decrease of oxygen level in blood. As a result, since coronavirus symptoms are similar to those of other respiratory viruses, it is not always easy to tell from a person's symptoms whether or not they have a coronavirus infection. Conducting a PCR test, which enables you to identify the virus, is required as part of a particular investigation to correctly identify the disease's source. PCR can also identify the virus in people who are asymptomatic.

 

6.Is it correct to claim that the coronavirus has a significant impact on human immunity?

 

There hasn't been enough research done on the pathogenesis of the newest coronavirus infection. Regarding the immune reaction particularly to the novel coronavirus from China, nothing is known. However, information has been gathered about additional coronaviruses that people have come into contact with. In an effort to "knock out" the virus from its "territories" in the lungs or other tissues, the immune system becomes overactive during a coronovirus infection and ends up doing more harm than the pathogen itself. This is one of the main characteristics of the immunological response to coronaviruses. This is relevant for coronaviruses that humans have previously encountered (and is confirmed by the fact that glucocorticoids, suppressors of the immune response, are successfully used to treat coronavirus infection). However, other studies claim that the immune response to the Wuhan virus is not very strong and that using glucocorticoids is not having the same beneficial effects as it had in prior years. Additionally, coronaviruses possess unique defense mechanisms that enable them to combat the immune system on their own. For instance, the SARS-coronavirus, whose infection clinic shares some characteristics with Wuhan, has proteins that inhibit the production of interferons and antiviral cytokines, which let you avoid them. It is not yet known if this holds true for the Wuhan type. The defensin proteins that serve as protection are also ineffective against the SARS virus. It is also known that coronavirus causes the death of T-lymphocytes. T-lymphocytes can die from coronavirus, as is also known. Depletion of the immune system's T-cell component, immunological-mediated lung damage, and a delay in the virus's removal from the body are all signs of late stages of infection. Limited information indicates that lymphopenia affects two thirds of 2019-nCoV patients (that is, a decrease in the number of lymphocytes - the main cells of the immune system - in the blood). (Li G. et al. Coronavirus Infections and Immune Responses // Journal of Medical Virology). It is possible that a past illness caused by one type of coronavirus may lead to protection against another type of coronavirus, such observations exist. But on the other hand, cases of re-infection are also possible.

 

7. What determines the severity of the coronavirus infection?

 

First of all, it is a cytokine storm. Pro-inflammatory cytokines, or those that enhance inflammation in the body, are more concentrated as a result of the infection. It was demonstrated that the concentration of the pro-inflammatory cytokines GCSF, IP10, MCP1, MIP1A, and TNF was much greater in patients who required admission in the critical care unit than in patients who had a milder illness. The gastrointestinal system, lungs, and lower respiratory tract are the primary sources of infection. Pneumonia and, in certain circumstances, diarrhea are the early symptoms of inflammation in these organs. Although the complete impact of disintoxication and antioxidant treatment has not been investigated, they corroborate the existence of immunological hyperreactivity in critically sick patients.

 

8. How to protect yourself from this infection?

 

Follow the CDC's (Center for Disease Control and Prevention, USA) advice to restrict contact with sick people who show symptoms of a respiratory infection and wash your hands regularly with soap or disinfectants in order to protect yourself from respiratory infections, which include coronavirus. Try to avoid touching your face with unclean hands and avoid going out in public as much as possible. The Ministry of Health released guidelines that included a request for the use of medical masks. Special advice is provided for medical personnel about the use of overalls and other sanitation practices, such as air and waste disinfection. A significant amount of consideration is given to preventative interventions for those in high-risk categories. These individuals need to utilize topical medications with a preventive effect that have barrier properties, as well as elimination treatment, which includes irrigation of the nasal mucosa with isotonic sodium chloride solution. The incident of the virus spreading within a family, which was just recounted in an article, is quite revealing. While the rest of the family was exposed to the virus, a 7-year-old girl who, according to her mother, spent the most of the time wearing a surgical mask throughout the pandemic in Wuhan remained uninfected. But keep in mind that you can't wear the same mask all day; they need to be changed frequently!

 

9. What medications should be used more effectively to avoid coronavirus infection?

 

Methods of specific coronavirus infection control measures are currently being developed. Now, all that is being discussed is non-specific medication prevention of coronavirus infection, which is suggested to be done during the first 48 hours of coming into contact with a patient or an infection source and up to 14 days, which is the expected incubation period. It should be mentioned that in the northern hemisphere, this is also flu and respiratory illness season. Damage to the cells of the lower respiratory tract's mucous membrane and a lack of mucosal immunity components are symptoms of any respiratory illness that affects the broncho-pulmonary system. As you are aware, the mucous membrane takes roughly a month to heal. Additionally, viral infections influence the overall immune response. In this regard, at this time, we should pay special attention to the prevention of any respiratory infections, especially those who have neglected the recommendations to get a flu shot. In addition to non-specific prophylaxis measures aimed at preventing the spread of infection, one can also think about drugs approved for the prevention of respiratory infections. These include Polyoxidonium, which has demonstrated efficacy in preventing severe respiratory infections in both adults and children. This is a result of the drug's capacity to activate neutrophils and macrophages' antimicrobial capabilities, improve their capacity to absorb infections, and raise the protective qualities of saliva and mucus production in the upper respiratory tract. The excellent safety profile of polyoxidonium is crucial, especially given the impending possibility of a coronavirus infection epidemic.

 

10. What can you say about the treatment of coronavirus infection?

 

From the perspective of evidence-based medicine, there aren't any suggestions for etiotropic therapy at the moment to treat 2019-nCoV infection. In other words, there isn't a specialized antiviral medication that targets the coronavirus alone. It is thought that using ribavirin together with lopinavir and ritonavir as an etiotropic treatment may be possible. However, due to the drug's propensity to have negative side effects, its usage should be approached cautiously. I want to emphasize that these medications can only be used for treating symptoms—not preventing them. Regarding pathogenetic therapy, it goes without saying that detoxification and antioxidant therapy must be administered during the early (feverish) phase of the illness. The Ministry of Health's recommendations make clear reference to this. The experience of China also suggests that extracorporeal oxygenation, or quick and effective blood oxygenation, may be prescribed as a treatment.

 

11. Can immunomodulatory treatment be used when there is a high risk of infection following contact with the ill or during the early stages of infection?

 

Very important question. The Ministry of Health's official recommendations, "Interim guidelines: PREVENTION, DIAGNOSTICS AND TREATMENT OF THE NEW CORONAVIRUS INFECTION (2019-nCoV)," just made reference to this. I will quote exactly: In the early stages of the condition, immuno-replacing and perhaps immunomodulatory medications can be helpful. According to these recommendations, it is possible to use interferons of the first type - IFN-β, which can have a positive effect and shift the cytokine balance towards anti-inflammatory cytokines. In children, the use of interferon α2b (including drops, spray, ointment, suppositories, gel) is recommended. According to these recommendations, it is possible to use interferons of the first type - IFN-β, which can have a positive effect and shift the cytokine balance towards anti-inflammatory cytokines. It is advised to utilize interferon 2b in the form of gel, drops, sprays, ointments, and drops in youngsters.

 

12. When will medications for coronavirus infection prevention and therapy become available?

 

I want to highlight the scientific community's accomplishments in the quick identification of a new virus' gene sequence. SARS-CoV and MERS-CoV were therefore discovered after several months of testing. The 2019 coronavirus was fully characterized in less than a month, though (Gralinski L. E., Menachery V. D. Return of the Coronavirus: 2019-nCoV / Viruses. - 2020. - T. 12. - No. 2. - P. 135). As a result, work on developing medications for both coronavirus prevention and treatment has already started, and we are extremely hopeful that the results will be seen soon.

 

13. And the last question: Is it worth it now to stop traveling abroad in the near future?

 

Elderly travelers and those who already have health issues should be alert to the possibility of a more severe course of the illness and talk to their doctor before leaving. The CDC also advises people who have recently visited China and are feeling unwell or have symptoms resembling a coronavirus infection, such as fever, coughing, or difficulty breathing, to seek medical attention right away. They should also call their local hospital to inform them of their recent trip to China and take all necessary precautions to prevent the infection of others (cover your mouth and nose with a tissue or sleeve when coughing or sneezing). Of course, while you are unwell, you should not consider traveling. Last but not least, WHO Director-General Tedros Ghebreyesus declared the coronavirus outbreak a public health emergency of global concern, emphasizing once more the outbreak's global scope and the necessity of looking for fresh molecules with antiviral properties against various coronavirus subtypes.

Please get medical advice before using the medication.

 

 

The following dose regimen is advised for Polyoxidonium® (tablets, 12 mg) usage in adults and children older than three years old who want to avoid acute respiratory infections:

 

One pill for adults once per day for ten days.

For kids aged 3 to 10, take half a pill every day for seven days.

Over-10-year-old children: 1 pill daily for 7 days.

A preventative course only comes in one package!

Six months following a term of administration, a convenient and brief course of the medication helps to limit the incidence of re-infections.

There are warning signs. Read the directions before using *Polyoxidonium® tablets. 

Instructions for using Polyoxidonium® in a medical setting.