A novel coronavirus (COVID-19) causes critical acute respiratory symptoms. The formal name given to the disease is Coronavirus disease 2019 (COVID-19). It was first recognized in the Hubei Province, China. A recent study shows that individuals with particular comorbidities face a longer duration to receive positive COVID-19 PCR test results.
History of COVID-19
Wuhan, China, is the first city where the first case appeared after the whole world was affected. The submission of the initial report of the novel virus by the World Health Organization (WHO) took place on 31st December 2019. The announcement of the COVID-19 outbreak as a global health crisis took place on 30th January 2020 by WHO. However, by looking at the risking number of cases, which declared COVID-19 as a global pandemic on 11th March 2020. After the H1N1 influenza pandemic, this is the first such classification after 2009.
SARS-CoV-2 is responsible for causing illness. WHO termed SARS-CoV-2 as COVID-19. Thus, it is a short form of coronavirus disease 2019. Moreover, WHO selected the name to try not to undermine the original locations of the infection as far as human, geographic, or animal association. Simultaneously, the International Committee on Taxonomy of Viruses (ICTV) allocated the official place of the novel virus. The committee suggested the virus as severe acute respiratory syndrome coronavirus 2, also known as SARS-CoV-2.
COVID-19 introductions ranged from adverse asymptomatic/mild side effects to serious illness and death. Typical manifestations include fever, asthma, and coughing. Different symptoms, such as pain and breathing, are also present.
CDC investigated to find out when SARS-CoV-2 entered the U.S. The investigation shows that the virus started to spread in late January or in early February 2020. But, the identification of the virus was late as it had already spread in the community. Since then, the U.S is experiencing a widespread infection. The estimate shows that more than 33.4 million cases were reported and more than 600,000 deaths.
Actions to prevent the spread of COVID-19
In all these scenarios, CDC set guidelines for the public on 3rd April 2020. The recommendation put forward by CDC was to wear the mask all the time and to maintain social distance. These recommendations were for everyone, whether the person is ill due to a virus or not. But, social distancing measures are somehow difficult to maintain.
According to the CDC, if people do not follow the rules and recommendations, more people will suffer. Due to COVID-19, a few of the country’s situation is critical, as seen in INDIA with many patients requiring medical care. Hence, this is going to overburden the public healthcare system resulting in a high rate of fatalities. The best strategy to overcome the spread and control of the virus is nonpharmaceutical interventions (NIPs). Shockingly, these concerns are proven to be right.
Every government is trying to halt or slow down viral transmission by implementing suppression and mitigation strategies. CDC strongly advises implementing population-wide social distancing along with closures of business, schools, and home self-isolation. But, such policies must be implemented for a longer period to prevent the reappearance of the virus in the population. As in many countries, there are high chances of the second and third ways of the virus infection.
CDC procedures like a regular face mask, avoiding nonessential indoor activities, avoiding traveling, physical distancing, enhancing ventilation, and implementing hand hygiene are crucial.
Individuals at high risk
Those individuals are at high risk of infection in areas with ongoing transmission, including doctors, nurses, and workers taking care of patients with COVID-19. Even travelers are also at high risk after returning from areas where the virus is at its peak.
CDC publishes evidence of comorbidities. The CDC report gets well backing from systematic review/meta-analysis indicating a high association with risk of severe COVID-19 illness. The condition is as follows:
- Heart conditions
- Diabetes mellitus, type 1 and type 2
- Chronic obstructive pulmonary disease
- Organ transplant
- Cerebrovascular disease
- Smoking, current or former
- Chronic kidney disease
Most of the observational studies that support Comorbidities:
- Down syndrome
- Children with certain underlying conditions
- Another lung disease
- Blood stem cell transplantation
- Neurologic conditions
- Substance use
- immunosuppressive medications.
- Sickle cell disease
Case reports that support:
- Cystic fibrosis
Mix evidence that supports Comorbidities:
- Immune deficiencies
- Liver disease
Precaution taken by such individuals are:
- Avoid close contact.
- Develop a plan.
- Stay home.
- Stock up on supplies.
- Wash hands often.
Comorbid Affected by SARS-CoV-2
Diagnosis of people with the comorbid condition is difficult for COVID-19. This can affect how long they stay in getting positive results in the SARS-CoV-2 polymerase chain response (PCR) test. People above 60 years old have at least three chronic diseases. The most common type of disease is obesity, diabetes, organ transplant, or rheumatologic disease. Therefore, such people will always have PCR results positive for SARS-CoV-2 compared to younger people with no comorbidities. At the same time, there is no significant data to show the difference in the duration of PCR test results for immunocompromised people or receiving chemotherapy.
New research is published on Comorbid in open forum infectious disease. The current research was accompanied by a group of scientists from Boston Medical center. The group experiment consists of one of the largest data sets, SARS-CoV-2 PCR of non-immunocompromised and immunocompromised. Therefore, making this comparison between the two groups is easy.
Rachel Epstein is an infectious disease physician, explains that there is not enough data available on how long Immunocompromised individuals. The data can indicate how long such individuals continue to test positive with COVID-19. The study of Boston Medical center shows if the current proposals are to consider it by retesting several immunocompromised individuals.
CDC stance on immunocompromised individuals
CDC claims that many immunocompromised individuals are most likely to indicate a positive result for COVID-19. Experts analyzed data from 3,758 people retested using the SARS-CoV-2 PCR test following a positive causal effect. Subdivision of people into groups according to age as a precautionary measure:
- Four percent of the study group consist of intense dynamic chemotherapy, HIV with a CD4 check under 200, organ transplant somewhat recently, or ongoing high-portion steroids.
- Moderate – organ transplant beneficiary more significant than one year earlier, HIV with a CD4 check more prominent than 200, and others taking persistent drugs (4.2 percent of the investigation group)
- Not immunocompromised (88.4 percent of the investigation group)
The median time for non-severely impaired patients is 22 days to receive adverse effects of the SARS-CoV-2 PCR test. On the other hand, for tolerant and uninfected individuals, the time was 20 and 16 days, alone. However, for people with organ transplants, rheumatology, diabetes, or over 60 years, such as those with three or more comorbid cases, it takes longer to get the SARS-CoV-2 PCR test result.
Epstein, an assistant professor at Boston University School, explains the process in one of the interviews. Rethinking people to eliminate discriminatory safety measures can delay care. However, that is not necessary for people with immunodeficiency. Moreover, it is unlikely for the person to transmit the infection to another person if they are ill due to the virus for more than 20 days.
Epstein also indicates that retesting recommendations consist of a combination of many conditions. Even it may consist of a certain group of individuals who are immunocompromised. The rare cases in the report show positive results of the COVID-19 trial. However, the reason behind that is the onset of disease in patients who have passed through an organ or bone marrow transplant or received antigen receptor (CAR) T-cell treatment.
It is very clear from the many studies that individuals above 60 years get COVID-19 PCR test results positive. The reason behind that is quite obvious as such individuals have weak immunity. Also, they are dealing with many different diseases at the same time. Moreover, those individuals with an organ transplant or fighting Cancer are also the potential target for the virus. Previously, the data was insufficient to support this theory, but many researchers are working on this theory.
Thus, finding out ways can help in the prevention of transmission among elderly individuals. Also, this helps physicians to think straight while handling such patients. Once the physician knows the individual is fighting other conditions too alongside COVID-19. They need to make arrangements by considering everything in mind.
Moreover, such studies help CDC to improve its guidelines. However, research is still an ongoing process to find out the mode of action of the COVID-19 virus. There is also a need to understand how the COVID-19 virus behaves when an immunocompromised individual is infected. Hence, all researchers need to work in collaboration to find a way to fight against the COVID-19.
Therefore, everyone needs to play their role to prevent the spread of COVID-19. It is only possible when everyone understands that elderly and individuals with serious conditions are at high risk of catching the illness. Once the person with a serious condition is diagnosed with COVID-19 special care is required. At the same time, people working in healthcare settings dealing with COVID-19 should also take extreme precautions. To protect themselves as well as their families and friends. As we know, the virus will not leave us soon, so we need to keep ourselves protected.