Challenges and Readiness for Covid-19 Therapy at Central Army Hospital Agus Harsoyo
Unit Cardiology Intervention andClinical Electrophysiology Intervention, Department of Cardiology, Faculty of Medicine, Universitas of General Achmad Yani Gatot SoebrotoArmy Central Hospital Jakarta
Abstract
Coronavirus disease 2019 (Covid-19) is caused by the severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2), a newly emergent coronavirus, that was first recognized in Wuhan, Hubei province, China, in December 2019. SARS-CoV-2 is a positive-sense single-stranded RNA virus that is contagious in humans. Epidemiology and virologic studies suggest that transmission mainly occurs from both symptomatic and asymptomatic by close contact through respiratory droplets infected persons, or by aerosols, in enclosed indoors, crowded and inadequately ventilated spaces, where infected persons spend long periods such as workplace offices.The most common symptoms include fever, cough, fatigue, anorexia, dyspnea, sputum production and myalgia. The beginning pathogenesis due to the binding of spike protein SARS-CoV-2 to ACE-2 receptor of host cells. Clinical manifestation of covid-19 is no longer limited to the pulmonary system but also extra-pulmonary systems since ACE-2 receptor abundantly distributed on the other organs. Further, genetic variations of region binding protein of viral spike protein and ACE-2 receptor may predispose clinical manifestation of covid-19.The classification based on symptom such as asymptomatic, mild, moderate, severe, and critical. The diagnostic criteria is divided as suspect, probable, confirmation, and close contact. The basing management and treatment such as supportive therapy, antivirus, antibiotic, corticosteroid, symptomatic therapy, and consider additional therapy for severe/critical covid-19 such as convalescent plasma, IV Immunoglobulin, Anti IL-6 (Tocilizumab), Anti IL-1 (Anakinra), Mesenchymal Stem Cell (MSC).Covid-19 complications almost involve many organ such as respiratory system, cardiovascular, kidney, hematologic, coagulopathy, liver, endocrine, central nervous system, skin, and others system whole body.
Keywords: ACE-2 receptor, Covid-19 classification, Diagnostic and Management, Multi organ complication
