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Bapusaheb et al. World Journal of Pharmacy and Pharmaceutical Sciences
REVIEW: SARS COV-2 COMPILATION IN ACUTE RESPIRATORY
DISTRESS SYNDROME (ARDS)
Thete Sahyadri Bapusaheb* and Chavhan Supriya Anil
Matoshri Miratai Aaher College of Pharmacy, Karjule Harya, Parner,
Ahmednagar, 414304.
ABSTRACT
The aim of present review is the Acute Respiratory Distress Syndrome
Complications in SARS Covid-2. In December 2019 an outbreak of
coronavirus diseases 2019 (Covid-19) was identified in Wuhan, China.
The world Health Organization (WHO) is declare of this outbreaks a
significant threats to the international health. SARS Covid-2 is highly
infectious and can leads to the fetal comorbidities especially Acute
Respiratory Distress Syndrome (ARDS). The pathophysiology of
ARDS is perspective prominent machanism of covid-19 is associated
of ARDS included pulmonary filtration and inflammation leading to
impaired alveolar hemostasis, pulmonary physiology. The ARDS are
many more complications in SARS Covid-2. Covid-19 are mainly affected to the respiratory
system with minor damage to the organs. Injury to the kidney, respiratory, Blood clots,
pnumonia, chronic covid syndrome, is the main complications of ARDS to related SARS
Covid-2. The personalised lung-protective machanical ventilation reduces of mortality and
has become the mainstays of treatment in ARDS. The HFNO can be safe in the some
modarate-severe-patient. Thus the timing of the invasive machanical ventilation is mostly
important. Then the pathophysiology, symptoms, complications, prevention and treatment are
also briefly discussed in the present review.
KYEWORDS: SARS COV-2, Pathophysiology, Symptoms, Complications (ARDS),
Causes, Risk factors, Diagnostic Method, Prevention, Treatment, frequency and Death
WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES
SJIF Impact Factor 7.632
Volume 10, Issue 8, 467-490 Review Article ISSN 2278 – 4357
*Corresponding Author
Thete Sahyadri Bapusaheb
Matoshri Miratai Aaher
College of Pharmacy,
Karjule Harya, Parner
Ahmednagar, 414304.
Article Received on
29 May 2021,
Revised on 19 June 2021,
Accepted on 09 July 2021
DOI: 10.20959/wjpps20218-19456
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INTRODUCTION
An Acute Respiratory Disease caused by a new stranded of Coronavirus (SARS COV-2). It
was 1st identified in the Wuhan, Hubei Provinance, China. It is quickly developed into a
global pandemic. The common sings associated with the Coronavirus diseases 2019
[COVID-19] include the Fever, Cough and shortness of breath. The World Health
Organization (WHO) suggested having a high level of suspicious for patients with severe or
acute respiratory infection/ illness associated with a fever especially those with exposure to
risk factors. These exposure included individuals who have had a contact with conformed or
probable cause of COVID-19 of within 14 days of symptoms onset.[1]
The sereve Acute
Respiratory Distress Syndrome of Coronavirus-2 [SARSCOOVID-2][2]
is the viruses causes
COVID-19 (Coronavirus diseases-2). Also colloquially know Simply as the Coronavirus, it
was previously reffered to by its provisional name, 2019 novel Coronavirus (2019-n
Cob).[3,4,5,6]
The World Health Organization declared the outbreaks a public health emargance
of international concern on 30 January 2020 and a padmic on 11 March 2020.[7,8]
Furthermore the center's for diseases control and prevention of strongly encourages testing
for the others a respiratory illnesses including influenzas. Currently no specific treatment for
the viron existing as well as the current goals of management include supportive care,
including supports of vital organs function. COVID-19 was a clustering onset and mainly
affected to the respiratory system with some patients rapidly progressing to Acute
Respiratory Distress Syndrome (ARDS). Other organ functions were less involved.[9,10]
These patients were likely to be a admitted to the comorbidities at are highest risk of death to
be related to ( ARDS).[11]
Syndrome (SARS COV-2)[12]
is the virus that causes of COVID-19
(Coronavirus Diseases 2019). The Respiratory illnesses responsible for the COVID-19
padmic.[13]
Also Colloquially know Simply as the Coronavirus. It was previously reffered to
by its provisional name 2019 novel Coronavirus (2019 n-cov).[14,15,16,17]
and also been called
human Coronavirus 2019 (H COV-19 or hCOV-19).[18,19,20,21]
The World Health
Organization declared the outbreaks a public Health of International concern on padmic on
11 March 2020.[22,23]
SARS COV-2 is a positive sense signal stranded RNA virus[24]
that is
contagious in human.[25]
As described as the us national Institute of Health. SARS COV-2 is
a virus of the species severe acute respiratory syndrome related Coronavirus (SARS COV-
2).[12]
Research is a ongoing as to the whether of SARS COV-2 comes into directly from the
bats or indirectly through the any intermediate hosts.[26]
The viruses shows a. Little genetic
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diversity indicating that the spillover event introducing SARS COV-2 to human is likely to
have occurred in late 2019.[27]
SARS COVID-2 (Severe acute respiratory syndrome): The Severe Acute Respiratory
Syndrome (SARS COV-2)[12]
is the virus that causes of COVID-19 (Coronavirus
Diseases 2019). The Respiratory illnesses responsible for the COVID-19 padmic.[13]
Also
Colloquially know Simply as the Coronavirus. It was previously reffered to by its
provisional name 2019 novel Coronavirus (2019 n-cov)[14,15,16,17]
and also been called
human Coronavirus 2019 (H COV-19 or hCOV-19).[18,19,20,21]
The World Health
Organization declared the outbreaks a public Health of International concern on padmic
on 11 March 2020.[22,23]
SARS COV-2 is a positive sense signal stranded RNA virus[24]
that is contagious in human.[25]
As described as the us national Institute of Health. SARS
COV-2 is a virus of the species severe acute respiratory syndrome related Coronavirus
(SARS COV-2).[12]
Research is a ongoing as to the whether of SARS COV-2 comes into
directly from the bats or indirectly through the any intermediate hosts.[26]
The viruses
shows a. Little genetic diversity indicating that the spillover event introducing SARS
COV-2 to human is likely to have occurred in late 2019.[27]
Pathophysiology: The route of administration of SARS COV-2 could be coughing and
sneezing. The viruses entres the lungs through the respiratory tract and attacks Alveolar
Epithelial Type-2 (AT2) cells. AT2 produces a surfactant to decrease the surface tension
within a Alveoli to reduces and the collapsing pressure. Interqrins may also induced
ACE2 receptor during its interaction with SARS COV-2.[28]
The SSRNA use the host cell
ribosome to produce polyprotein. It is also used RNA dependant RNA polymerase to
duplicate it's RNA. The Activated Macrophages release cytokinesis (IL-1,IL-6 & TNA
Alpha) the blood stream. The released of this molecules causes vasodilation and increased
to the capillary permiability. As a result there is a decrease in Surfactant levels in AT2
cells. The cascade event ultimately leads to Alveolar collapse and impaired gaseous
exchange. The hypoxic condition, sympathetic can induce tachycardia. All these
abnormal inflammatory response can lead to septic shock and multi organ failure.[29,30]
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Severe acute respiratory syndrome coronavirus 2.
Transmission electron micrograph of SARS-CoV-2 virions with visible coronae
Illustration of a SARS-CoV-2 virion
Illustration of a SARS-CoV-2 virion[1]
Red: spike proteins (S)
Grey: lipid bilayer envelope
Yellow: envelope proteins (E)
Orange: membrane proteins (M)
Virus classification
(Unranked): Virus
Realm: Riboviria
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Kingdom: Orthornavirae
Phylum: Pisuviricota
Class: Pisoniviricetes
Order: Nidovirales
Family: Coronaviridae
Genus: Betacoronavirus
Subgenus: Sarbecovirus
Species: Severe acute respiratory syndrome–related coronavirus
Virus: Severe acute respiratory syndrome coronavirus 2
Variants
B.1.1.7 (Alpha)
B.1.351 (Beta)
P.1 (Gamma)
B.1.617.2 (Delta)
Synonyms
2019-nCoV
Sign and Symptoms: The SARS COV-2 produces flu- like Symptoms and may included
Fever, Muscle Pain, Co shortness ugh, Sore throat and other non- specific symptoms. The
1st symptoms was a high fever of more than 38°c(100.4° F). The SARS COV-2 may
eventually leads to the of breath and Pnumonia or secondary bacterial Pnumonia. While
the some had long term damage to their liver, kidneys and lungs.
Most common symptoms
Fever
Dry cough
Tridness
Less common symptoms:
Aches and pains
Sore throat
Diarrhoea
Conjunctivitis
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Headache
Serious symptoms
Difficulty breathing or shortness of breath
Chest pain or pressure
Loss of speech of movement
On average it takes 5-6 day's form when someone is infected with the virus for symptoms to
show however it can take a 14 days.Seek immediately medical attention if you have a
symptoms. Always call befovisiting your doctor or health facilities.
Complications
Acute respiratory distress syndrome (ARDS): The Acute Respiratory Distress
Syndrome (ARDS) can occur in those who are critically ill or who have significant
injuries. It is often fatal risk increasing with age and servirity of illnesses. The Acute
Respiratory Distress Syndrome is a types of the respiratory failure characterized by a
rapid onset of the widespread of inflammation in the lungs.[31]
Acute respiratory distress syndrome
Other names: Respiratory distress syndrome (RDS), adult respiratory distress syndrome,
shock lung
Chest x-ray.
Specialty: Critical care medicine
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Symptoms: Shortness of breath, rapid breathing, bluish skin coloration Chest pain or
pressure, Loss of speech of movement.[31]
Complications
Lungs- Pulmonary Embolism (PE), Ventilator-Assosiated Pnumonia (VAP), Acute kidney
Injury, pnumothorax, Blood clots, Infection, Pulmonary Fibrosis (Scarring), Nutritional,
Cardiac.
Usual onset
Within a week[31]
Diagnostic method
Adults: PaO2/FiO2 ratio of less than 300 mm Hg[31]
Children: oxygenation index > 4[32]
Differential diagnosis: Heart failure[31]
Treatment: Mechanical ventilation, ECMO[31]
Prognosis: 35 to 90 % risk of death[31]
Frequency: 3 million per year[31]
Pathophysiology: Acute Respiratory Distress Syndrome is a form of fluid accumulations
in the lungs are not explained by the heart failure. It is a typical provoked by the acute
injury to the lungs that results in the flooding of lungs microscopic air sacs and
responsible for the exchange of gases such as oxygen and carbon dioxide with capillaries
in the lungs.[33]
Additional commonly findings in the ARDS including a partial collapse
of the lungs and a low levels of the oxygen in the blood (hypoximia). On this, the
pathology most commonly associated with ARDS is DAD (Diffuse Alveolar Damage). It
is characterized by a Diffuse inflammation of lungs tissue. Nutrophils and the some T-
lymphocytes are quickly migrate into the inflamed lung tissue and contributes in the
amplifications of the phenomenon. Typicals histological presentation is a involved in
Diffuse Alveolar Damage and the hyline membrane form in a Alveolar walls. Although
the trigger machanism are not completely understood recent research has examined the
role of inflammation and machanical stress.
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Fig. Micrograph of diffuse alveolar damage, the histologic correlate of H& E Stain.
Sings and Symptoms
The Signs and Symptoms of ARDS often being within 2hr. Of an inciting event but have
been known to take as long as 1-3 day's of diagnostic criteria required a known as insult to
have happened within 7 days to the syndrome. It may be included shortness of breath, fast
breathing of a low oxygenation level in the blood due to a abnormal ventilation.[34,35]
Other common symptoms include muscle fatigue and general weekness, low blood pressure a
dry, hacking, Cough and Fever.[36]
Complications
1. Lungs
1) Pulmonary embolism: Pulmonary Embolism (PE) is a blockage of an artery in the lungs
by a substance that has moved form elsewhere in the body through the bloodstream
(Embolism).[37]
Sign and Symptoms
Symptoms of a PE may included shortness of breath, chest pain, particularly upon breathing
in coughing up blood.[38]
A blood clot of leg may also be present such as a red warm swallon
and painful leg.[38]
The signs of PE included the low blood oxygen level, rapid breathing,
rapid heart rate and sometimes a mild fever.[46]
Sever case can lead to passing out abnormally
low blood pressure and sudden death.[39]
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Risk factors
Blood clot is increased by Cancer prolonged bed rest, smoking, stroke, certain genetic
condition, Estrogen based medication, pregnancy obesity and after some type of surgery.[40]
Treatment
Treatment is a anticoagulant such as neprine, warfarin or one of the direct acting oral
anticoagulant (DOACS).[42]
Servere case may require thrombosis using medication such as
Tissue plasminogen Activator (TPA) given intravenously or through a eathereter and some
may require surgery.
Pulmonary embolism
A lung illustration depicting a pulmonary embolism as a thrombus (blood clot) that has
travelled from another region of the body, causes occlusion of the pulmonary bronchial
artery, leading to arterial thrombosis of the superior and inferior lobes in the left lung
Specialty: Hematology, cardiology, pulmonology.
Symptoms: Shortness of breath, chest pain, coughing up blood.[38]
Complications: Passing out, abnormally low blood pressure, sudden death.[39]
Usual onset: Advanced age.[40]
Risk factors: Cancer, prolonged bed rest, smoking, stroke, certain genetic conditions,
estrogen-based medication, pregnancy, obesity, after surgery.[40]
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Diagnostic method: Based on symptoms, D-dimer, CT pulmonary angiography, lung
ventilation/perfusion scan[41]
Treatment: Anticoagulants (heparin, warfarin, DOACs)[42]
Frequency: ~450,000 per year (USA), 430,000 (Europe)[43,44,45]
Deaths >10–12,000 per year (USA), >30–40,000 per year (Europe)
Frequency and Death
Pulmonary Embolism effect about 430,000 people each year in Europe.[45]
In United State
between 300,000 and 60,000 case occurred each year[43,44]
and which contributes to at least
40,000 death.
2) Ventilator- Associated pnumonia
Ventilator Associated Pnumonia (VAP) is a type of lungs infection that occurred in people
who are in machanical ventilation breathing machines in Hospital. VAP typically affected
critically in person that are in an Intensive Care Unit (ICU).[47]
A person with VAP have
increased lengths of ICU hospitalization have upto a 20-30% death rate.[48]
Pathophysiology
It is to through by many that VAP primary occurred because the endotracheal or
tracheostomy tube allow free passage of bacteria into the lower segment of the lungs in a
person who often is underlying lunge immune problem. The droplet that care driven into the
airstrom and into the lungs feilds are lofted by a way of Berononlis principal. There is also as
condition called oxidative damage that occure when contact with cells and this damage the
cillia of the cells. Thus inhibiting their actions as part of the body 1st line defence.
Risk factors: Risk factors for VAP included underlying heart or lungs disease,
neurological diseases and trauma as well as modifiable risk factors. Such as head of the
bed is flat or raised. The patient had an aspiration event before intubation of prior
antibiotics exposure.[48]
Diagnosis: The diagnosis of VAP varies by institutions, but tends to be a combination of
sevaral of the following ractiographic, clinical signs and laboratory evidence.[49]
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1) The temperature greater than 38°c or lesss than 36°c.
2) Increased need for oxygen on the ventilatorr[49]
3) Purelent separation, increased secretionn or changes in secretions.[49]
Prevention: The prevention of VAP involves limiting exposure to resistance bacteria,
discontinuing machanical ventilation as soon as possible and a variety of a strategies to
limit infection while incubated.
Treatment: Treatment of VAP should be matched to known causative bacteria. The VAP
with a single antibiotics has been reported to results in similar outcomes as with a
combination of more than one antibiotics.
2. Acute kidney injury
Acute Kidney Injury (AKI) previously called Acute Renal Failure (ARF)[50,51]
is a sudden
decrease in kidney functions that developed within 7 days as shown by as increase in serum
creatinine or a decrease in urine output or both.[52]
Causes
1) Prerenal causes
Sepsis
Dehydration
Excessive blood loss
Cardiogenic shock
2) Intrinsic renal causes
Glomerulonephritis
Acute tubular necrosis.
3) Postrenal cause
Kidney stones
Bladder cancer
Neurogenic bladder
Enlargement of postate
The most commonly causes is a dehydrationn and sepsis combined with nephrotonicc drug.
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Sign and Symptoms
Fatigue
Loss of appetite
Headache
Nausea
Vomating
The various symptoms of AKI functions are associated with a disease.
Acute kidney injury
Other names: Acute renal failure (ARF)
Pathologic kidney specimen showing marked pallor of the cortex, contrasting to the darker
areas of surviving medullary tissue. The patient died with acute kidney injury.
Specialty: Nephrology, Urology
Treatment: In the treatment of the underlying disorders management of AKI routing
includes the avoidance of substance that are toxic to the kidneys called as nephrotoxins. In
the included NSAIDs such as ibuprofen or naproxen, iodinated contracts such as these
antibiotics such as gentamicin.
3) Pnumothorax (Collapse lungs)
A Pnumothorax is on abnormal collection of air in the pleural space between the lungs and
these chest wall.[53]
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Signs & Symptoms
Illustration depicting a collapsed using pneumothorax
• Symptoms is typically include as:-
1) Chest pain
2) Shortness of breathing
3) Tiredness
Causes
1) A primary spontaneous pneumothorax is secure without an apparent & in absence of
lungs diseases.
2) A second spontaneous pneumothorax occurs in the presence of existing lungs diseases.
Risk factors
Smoking increases the risk of the primary spontaneous pneumothorax while the main
underlying causes of secondary pneumothorax are combined asthma & tuberculosis.
Diagnosis
A chest x-ray computed tomography (T-scam) or ultrasound is usually used to confirm its
presence.
Treatment
A small spontaneous pneumothorax will typically resolve without treatment required to only
Monitoring.[53]
Pneumothorax: Collapsed lung[54]
Other names
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A large right-sided spontaneous pneumothorax (left in the image). An arrow indicates the
edge of the collapsed lung.
Specialty: Pulmonology, thoracic surgery
Symptoms: Chest pain, shortness of breath, tiredness[55]
Usual onset: Sudden[53]
Causes: Unknown, trauma[53]
Risk factors: COPD, tuberculosis, smoking[56]
Diagnostic method: Chest X-ray, ultrasound, CT scan[57]
Differential diagnosis: Lung bullae,[53]
hemothorax[55]
Prevention: Smoking cessation[53]
Treatment: conservative, needle aspiration, chest tube, pleurodesis[53]
Frequency: 20 per 100,000 per year[53,57]
• Prevention
Occasionally the surgery may be required if tube drainage is unsuccessful or as prevent
measure.
• Frequency
Absent the 17-23 cases of the pneumothorax occur per 100.000 people per year.[53.57]
3) Blood clots
Laying still in the hospital or on a ventilator can be increases your risk of developing blood
clots. Particularly in the deep veins in your legs. If a clots form in your legs if a portion of can
break & travel to one or both to your lungs (Pulmonary embolism) where it blocks blood
flow.
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4) Infection
The ventilator is attached directly to a tube inserted in your windpipe this make it much easier
for the germs to an infect & further injury your lungs.
5) Pulmonary falmsis (Scarring)
The scarring & thickening of the tissue between the air sacs can occurs within a few weeks of
the insects of ADDS. The stiffens your lungs making a even more difficult for oxygen to flow
form the air sacs to blood stream.
6) Nutritional:- Malnutrition (Catabolic state) electrolyte abnormalities.
7) Cardiac:- Abnormal heart rhythm myocardic function.
• Other complication that are typically associated with are included
1) Atelectasis:- Small air pocket within the lungs collapse.
Complication that arises from the treatment in a hospital Blood clots formed by laying down
for lungs period time the weakness in muscles that are used for the breathing stress ulcers and
even depression or other illness.
2) Failure of multiple organ
Pulmonary hypertension or increase in blood pressure in main artery form the heart to lungs
these complication is occurs due to restrictions of the blood vessels due to the inflammation
of the mechanical ventilation.
• Causes
The ARDS is direct & indirect depending the lungs are initially affected.
Direct cause
Pneumonia (Bacterial or viral)
Aspirations
Inhalation lungs injury
Lungs antigen
Chest trauma
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• Indirect causes
Sepsis
Shock
Pancrititis
Trauma
Cardio pulmonary bypass
Diagnostic method
Diagnostic criteria ARDS change time as understanding of the pathophysiology has evolved.
According to 2012 Berlin define adults ARDS characterized by
Respiratory failure not explained by heart failure or volume overloaded
Decreased Pa O2 / fiO2 ratio (a decreases PaO2 /fiO2 increases reduced arterial oxygenation
form the available inhaled gas
Mild ARDS: 201-300mg Hg (<39.9kpa)
Moderate ARDS: 101-200mg Hg (<26.6kpa)
Severe ADRS <100mm Hg (<13.3pa)
• Mechanical ventilation
Ventilation assisted or intermittent mandatory ventilation (IMV) is the medical term for the
artificial ventilation In this involve a machine called a ventilator or the breathing may be
assisted manually by a suitable qualified professionals as an anesthesia list paramedic.
The two main types of mechanical ventilation is
1) Positive pressure ventilation
When air is pushed into the lungs through the airways.
2) Negative pressure ventilation
The air is usually in essence sucked into the lungs by stimulating movement of the chest.
• Frequency
ARDS affects more than 3 million people a year.
Abbreviation
SARS-COV-2 – Severe Acute Respiratory Syndrome Coronavirus-2.
COVID-19 – Coronavirus-2.
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ARDS – Acute Respiratory Distress Syndrome.
ICU – Intensive Care Unit.
PE – Pulmonary Embolism.
VAP – Ventilator – Associated Pnumonia.
AKI – Acute Kidney Injury.
CONCLUSION
The SARS COV-2 is a viral disease that is causing by a nCoV. Currently, it is a one of the
global issues ever since it had 1st emerged and caused of the outbreaks in China. It is now a
spreading to a different countries of the World. This disease can be transmitted form person
to person through aerosol droplets, direct and indirect contact and handling Clinical cases by
the medical practitioner. Also, it can be transmitted form bats to human, it is confirms its
zoonotic importance. SARS COV-2 can be present various clinical sings that includes fever,
cough, Tridness, fatigue, shortness of breathing. It can be digonised by clinical findings and
laboratory test viral isolation, Ventilization and molecular techniques. The Prevention of
SARS COV-2, in each country of the world should give attention to the diagnosis and
prevention of the disease and have quarantine facilities where the suspected persons can be
kept in a isolation untill the confirmation of the disease or otherwise and all the health care
center should have personal protective equipment during the digonosis and identification of
the disease. The Government's and World Health Organization's are all respectivs of should
give attention to the prevention of the disease by a promoting or amending the laws of
concerning prevention strategies to combat the disease. The scientists, medical workers and
pharmaceutical Organizatios should be work hard to prepare a vaccine for prevention and
control and to discover a specific drugs for the treatment of this disease. Most importantly,
timely disease surveillance and the preventive measures should be implemented all over the
world to fight the disease globally.
REFERENCES
1. World Health Organization, in Global Surveillance for Human Infection with
Coronavirus Disease (COVID-19), World Health Organization, Geneva, Switzerland,
2020.
2. AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. (March). "The
species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV
www.wjpps.com │ Vol 10, Issue 8, 2021. │ ISO 9001:2015 Certified Journal │
484
Bapusaheb et al. World Journal of Pharmacy and Pharmaceutical Sciences
and naming it SARS-CoV-2". Nature Microbiology, 2020; 5(4): 536–544.
doi:10.1038/s41564-020-0695-z. PMC 7095448. PMID 32123347.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7095448
3. Surveillance case definitions for human infection with novel coronavirus (nCoV): interim
guidance v1, January 2020 (Report). World Health Organization. January,
2020. hdl:10665/330376. WHO/2019-nCoV/Surveillance/v2020.1.
https://en.m.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2#cite
_ref-WHO21Jan2020_4-0
4. "Healthcare Professionals: Frequently Asked Questions and Answers". United
States Centers for Disease Control and Prevention (CDC). 11 February
2020. Archived from the original, 2020; 14: 15.
https://en.m.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention
5. About Novel Coronavirus (2019-nCoV)". United States Centers for Disease Control and
Prevention (CDC). 11 February 2020. Archivedfrom the original on, 2020; 11: 25.
https://en.m.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention.
6. Harmon A (4 March 2020). "We Spoke to Six Americans with Coronavirus". The New
York Times. Archived from the original on, 2020; 11: 16.
https://www.nytimes.com/2020/03/04/us/coronavirus-recovery.html
7. China National GeneBank. Archived from the original on, 2020; 17: 2.
https://en.m.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2#cite
_ref-China_natl_GeneBank_11-02020. Retrieved 2 June 2020.
8. ^ a b "Statement on the second meeting of the International Health Regulations (2005)
Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)". World
Health Organization (WHO) (Press release), 2020; 30; 31.
https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-
the-international-health-regulations-(2005)-emergency-committee-regarding-the-
outbreak-of-novel-coronavirus-(2019-ncov)
9. Interim Guidance: Healthcare Professionals 2019-nCoV, Centers for Disease Control and
Prevention, 2020, https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.html.
10. Chan JF-W, Yuan S, Kok K-H, et al. A familial cluster of pneumonia associated with the
2019 novel coronavirus indicating person-to-person transmission: a study of a family
cluster. Lancet, 2020; S0140-6736(20): 30154–9.
11. Nguyen TV, Luong QC, et al. Importation and human-to-human transmission of a novel
coronavirus in Vietnam. N Engl J Med, 2020; 382(9): 872–4.
www.wjpps.com │ Vol 10, Issue 8, 2021. │ ISO 9001:2015 Certified Journal │
485
Bapusaheb et al. World Journal of Pharmacy and Pharmaceutical Sciences
12. AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. (March). "The
species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV
and naming it SARS-CoV-2". Nature Microbiology, 2020; 5(4): 536–544.
doi:10.1038/s41564-020-0695-z. PMC 7095448. PMID 32123347
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7095448
https://www.nytimes.com/2021/02/26/opinion/sunday/coronavirus-alive-dead.html
13. Surveillance case definitions for human infection with novel coronavirus (nCoV): interim
guidance v1, January 2020 (Report). World Health Organization. January,
2020. hdl:10665/330376. WHO/2019-nCoV/Surveillance/v2020.1.9
https://en.m.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2#cite
_ref-WHO21Jan2020_4-0
14. Healthcare Professionals: Frequently Asked Questions and Answers". United
States Centers for Disease Control and Prevention (CDC), 2020; 11: 15.
https://en.m.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention
15. About Novel Coronavirus (2019-nCoV)". United States Centers for Disease Control and
Prevention (CDC), 2020; 11: 25.
https://www.cdc.gov/coronavirus/2019-ncov/about/index.html
16. Harmon A (4 March 2020). "We Spoke to Six Americans with Coronavirus". The New
York Times. Archived from the original on, 2020; 13: 16.
https://www.nytimes.com/2020/03/04/us/coronavirus-recovery.html
17. Wong G, Bi YH, Wang QH, Chen XW, Zhang ZG, Yao YG (May 2020). "Zoonotic
origins of human coronavirus (HCoV-19 / SARS-CoV-2): why is this work
important?". Zoological Research, 2019; 41(3): 213–219. doi:10.24272/j.issn.2095-
8137.2020.031. PMC 7231470. PMID https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7
231470
18. Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF (17 March
2020). "Correspondence: The proximal origin of SARS-CoV-2". Nature Medicine,
2019; 26(4): 450–452. doi: 10.1038/s41591-020-0820-9.
PMC 7095063. PMID 32284615.a b c van Doremalen N, Bushmaker T, Morris
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7095063
19. Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN,
et al. (April). "Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-
CoV-1". The New England Journal of Medicine, 2020; 382(16): 1564–1567.
doi:10.1056/NEJMc2004973. PMC 7121658. PMID 32182409.
www.wjpps.com │ Vol 10, Issue 8, 2021. │ ISO 9001:2015 Certified Journal │
486
Bapusaheb et al. World Journal of Pharmacy and Pharmaceutical Sciences
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7121658
20. hCoV-19 Database". China National GeneBank. Archived from the original on, 2020; 17:
2. https://db.cngb.org/datamart/disease/DATAdis19/
21. Statement on the second meeting of the International Health Regulations (2005)
Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV)". World
Health Organization (WHO) (Press release). 30 January 2020. Archived from the
original, 2020; 31: 30.
https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-
the-international-health-regulations-(2005)-emergency-committee-regarding-the-
outbreak-of-novel-coronavirus-(2019-ncov)
22. "WHO Director-General's opening remarks at the media briefing on COVID-19 – 11
March 2020". World Health Organization (WHO) (Press release). 11 March
2020. Archived from the original on, 2020; 11: 12.
https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-
media-briefing-on-covid-19---11-march-2020
23. Machhi J, Herskovitz J, Senan AM, Dutta D, Nath B, Oleynikov MD, et al. (September
2020). "The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2
Infections". Journal of Neuroimmune Pharmacology, 2020; 15(3): 359–386.
doi:10.1007/s11481-020-09944-5. PMC 7373339. PMID 32696264.
^ a b Chan JF, Yuan S, Kok KH, To KK, Chu H
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373339
24. Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, et al. (February 2020). "A familial
cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-
person transmission: a study of a family cluster". The Lancet, 2020; 395(10223):
514–523. doi:10.1016/S0140-6736(20)30154-9. PMC 7159286. PMID 31986261.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159286
25. Novel Coronavirus (2019-nCoV): situation report, 22 (Report). World Health
Organization, 2020; 11. hdl:10665/330991.
https://en.m.wikipedia.org/wiki/World_Health_Organization
26. Cohen J (January 2020). "Wuhan seafood market may not be source of novel virus
spreading globally". Science. doi:10.1126/science.abb0611.
https://doi.org/10.1126%2Fscience.abb0611
27. Hoffmann M., Kleine-Weber H., Schroeder S., Kruger N., Herrler T., Erichsen S.,
Schiergens T.S., Herrler G., Wu N.H., Nitsche A., Muller M.A., Drosten C., Pohlmann S.
www.wjpps.com │ Vol 10, Issue 8, 2021. │ ISO 9001:2015 Certified Journal │
487
Bapusaheb et al. World Journal of Pharmacy and Pharmaceutical Sciences
SARS- CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically
proven protease inhibitor. Cell, 2020; 181(2): 271–280. doi:
10.1016/j.cell.2020.02.052. [PMC free article] [PubMed] [CrossRef
https://www.ncbi.nlm.nih.gov/pubmed/32142651
28. Cowburn A.S., Macias D., Summers C., Chilvers E.R., Johnson R.S. Cardiovascular
adaptation to hypoxia and the role of peripheral resistance. eLife, 2017; 6. [PMC free
article] [PubMed] [Google Scholar
https://www.ncbi.nlm.nih.gov/pubmed/29049022
29. Balk R.A. Systemic inflammatory response syndrome (SIRS): where did it come from
and is it still relevant today? Virulence, 2014; 5: 20–26. [PMC free
article] [PubMed] [Google Scholar] [Ref list]
https://www.ncbi.nlm.nih.gov/pubmed/24280933
30. Fan, E; Brodie, D; Slutsky, AS (20 February 2018). "Acute Respiratory Distress
Syndrome: Advances in Diagnosis and Treatment". JAMA, 2018; 319(7): 698–710.
doi:10.1001/jama.2017.21907. PMID 29466596. S2CID 3451752.
https://en.m.wikipedia.org/wiki/PMID_(identifier)
31. Cheifetz, Ira M (25 May 2017). "Pediatric ARDS". Respiratory Care, 2017; 62(6):
718–731. doi:10.4187/respcare.05591. PMID 28546374.
https://pubmed.ncbi.nlm.nih.gov/28546374
32. Boyle, AJ; Mac Sweeney, R; McAuley, DF (August 2013). "Pharmacological treatments
in ARDS; a state-of-the-art update". BMC Med, 2013; 11: 166. doi:10.1186/1741-7015-
11-166. PMC 3765621. PMID 23957905.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3765621
33. Bakowitz, Magdalena (August 2012). "Acute lung injury and the acute respiratory
distress syndrome in the injured patient". Scandinavian Journal of Trauma, Resuscitation
and Emergency Medicine, 2012; 20: 54. doi: 10.1186/1757-7241-20-
54. PMC 3518173. PMID 22883052.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC351817335- Marino (2006), pp 435
https://www.google.com/url?sa=t&source=web&rct=j&url=http://scholar.google.co.in/sc
holar%3Fq%3DMarino%2B(2006),%2Bpp%2B435%26hl%3Den%26as_sdt%3D0%26as
_vis%3D1%26oi%3Dscholart&ved=2ahUKEwier5bc3fvwAhUHzTgGHc8-
CdgQgQN6BAgDEAE&usg=AOvVaw3tPNCjUiHT6OuGVyTdlzOw
34. Bakowitz, Magdalena; Bruns, Brandon; McCunn, Maureen (2012-08-10). "Acute lung
injury and the acute respiratory distress syndrome in the injured patient". Scandinavian
www.wjpps.com │ Vol 10, Issue 8, 2021. │ ISO 9001:2015 Certified Journal │
488
Bapusaheb et al. World Journal of Pharmacy and Pharmaceutical Sciences
Journal of Trauma, Resuscitation and Emergency Medicine, 2020; 20:
54. doi:10.1186/1757-7241-20-ISSN 1757-7241. PMC 3518173. PMID 22883052.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3518173
35. What Is Pulmonary Embolism?". NHLBI. July 1, 2011. Archived from the original on,
2016; 12: 15.
https://www.nhlbi.nih.gov/health/health-topics/topics/pe
36. What Are the Signs and Symptoms of Pulmonary Embolism?". NHLBI. July 1,
2011. Archived from the original on, 2016; 12: 11.
https://www.nhlbi.nih.gov/health/health-topics/topics/pe/signs
37. Goldhaber SZ "Pulmonary thromboembolism". In Kasper DL, Braunwald E, Fauci AS,
et al. (eds.). Harrison's Principles of Internal Medicine New York, NY: McGraw-Hill,
2005; 16: 1561–65. ISBN 978-0-07-139140-5.
https://en.m.wikipedia.org/wiki/Special:BookSources/978-0-07-139140-5
38. Who Is at Risk for Pulmonary Embolism?". NHLBI. July 1, 2011. Archived from the
original on, 2016; 12: 11.
https://www.nhlbi.nih.gov/health/health-topics/topics/pe/atrisk
39. How Is Pulmonary Embolism Diagnosed?". NHLBI. July 1, 2011. Archivedfrom the
original on, 2016; 12: 11.
https://www.nhlbi.nih.gov/health/health-topics/topics/pe/diagnosis
40. Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, et al. (February
2016). "Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel
Report". Chest, 2016; 149(2): 315–352.
doi:10.1016/j.chest.2015.11.026. PMID 26867832.
https://en.m.wikipedia.org/wiki/PMID_(identifier)
41. What Is Pulmonary Embolism?". NHLBI. July 1, 2011. Archived from the original on,
2016; 12: 11.
https://www.nhlbi.nih.gov/health/health-topics/topics/pe
42. Rahimtoola A, Bergin JD (February 2005). "Acute pulmonary embolism: an update on
diagnosis and management". Current Problems in Cardiology, 2005; 30(2): 61–114.
doi:10.1016/j.cpcardiol.2004.06.001. PMID 15650680.
https://en.m.wikipedia.org/wiki/PMID_(identifier)
43. Raskob GE, Angchaisuksiri P, Blanco AN, Buller H, Gallus A, Hunt BJ, et al. (November
2014). "Thrombosis: a major contributor to global disease burden". Arteriosclerosis,
www.wjpps.com │ Vol 10, Issue 8, 2021. │ ISO 9001:2015 Certified Journal │
489
Bapusaheb et al. World Journal of Pharmacy and Pharmaceutical Sciences
Thrombosis, and Vascular Biology, 2014; 34(11): 2363–71.
doi:10.1161/atvbaha.114.304488. PMID 25304324.
https://en.m.wikipedia.org/wiki/PMID_(identifier)
44. Tintinalli JE Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine
(Tintinalli)) New York: McGraw-Hill Companies, 2010; 7: 432. ISBN 978-0-07-148480-
0.
https://en.m.wikipedia.org/wiki/Special:BookSources/978-0-07-148480-0
45. Michetti CP, Fakhry SM, Ferguson PL, Cook A, Moore FO, Gross R (May 2012).
"Ventilator-associated pneumonia rates at major trauma centers compared with a
national benchmark: a multi-institutional study of the AAST". The Journal of Trauma and
Acute Care Surgery, 2012; 72(5): 1165–73.
doi:10.1097/TA.0b013e31824d10fa. PMID 22673241.^ a b c Cook D (2000). "Ventilator
associated
https://doi.org/10.1097%2FTA.0b013e31824d10fa
46. Cook D (2000). "Ventilator associated pneumonia: perspectives on the burden of
illness". Intensive Care Medicine, 2000; 26: S31-7.
doi:10.1007/s001340051116. PMID 10786956.
https://pubmed.ncbi.nlm.nih.gov/10786956
47. Pneumonia (Ventilator-associated [VAP] and non-ventilator-associated Pneumonia
[PNEU]) Event" (PDF). Centers for Disease Control and Prevention. January, 2015.
https://www.cdc.gov/nhsn/pdfs/pscmanual/6pscvapcurrent.pdf
48. Webb S, Dobb G (December 2007). "ARF, ATN or AKI? It's now acute kidney
injury". Anaesthesia and Intensive Care, 2007; 35(6): 843–44.
doi:10.1177/0310057X0703500601. PMID 18084974
https://doi.org/10.1177%2F0310057X0703500601
49. Dan Longo; Anthony Fauci; Dennis Kasper; Stephen Hauser; J. Jameson; Joseph
Loscalzo Harrison's Principles of Internal Medicine, 2011; 21: 18. edition. McGraw-Hill
Professional.
https://en.m.wikipedia.org/wiki/McGraw-Hill_Professional
50. Ronco C, Bellomo R, Kellum JA (23 November 2019). "Acute kidney injury". The
Lancet, 2019; 394: 1949–64. doi:10.1016/S0140-6736(19)32563-2. PMID 31777389.
https://en.m.wikipedia.org/wiki/PMID_(identifier)
www.wjpps.com │ Vol 10, Issue 8, 2021. │ ISO 9001:2015 Certified Journal │
490
Bapusaheb et al. World Journal of Pharmacy and Pharmaceutical Sciences
51. Bintcliffe, Oliver; Maskell, Nick (8 May 2014). "Spontaneous pneumothorax". BMJ
(Clinical Research Ed.), 2014; 348: g2928.
doi:10.1136/bmj.g2928. PMID 24812003. S2CID 32575512.
http://www.bmj.com/cgi/content/short/348/may14_1/g3302
52. Orenstein, David M. (2004). Cystic Fibrosis: A Guide for Patient and Family. Lippincott
Williams & Wilkins. p. 62. ISBN 9780781741521. Archived from the original, 2016; 31.
https://books.google.com/books?id=BGefk9zBqlgC&pg=PA62
53. What Are the Signs and Symptoms of Pleurisy and Other Pleural
Disorders". www.nhlbi.nih.gov. 21 September 2011. Archivedfrom the original on, 2016;
31: 8.
http://www.nhlbi.nih.gov/health/health-topics/topics/pleurisy/signs
54. What Causes Pleurisy and Other Pleural Disorders?". NHLBI. 21 September
2011. Archived from the original on, 2016; 8: 31.
http://www.nhlbi.nih.gov/health/health-topics/topics/pleurisy/causes
55. Chen, Lin; Zhang, Zhongheng (August 2015). "Bedside ultrasonography for diagnosis of
pneumothorax". Quantitative Imaging in Medicine and Surgery, 2015; 5(4): 618–23.
doi:10.3978/j.issn.2223-4292.2015.05.04. PMC 4559988. PMID 26435925.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4559988.
