Infección por SARS-CoV-2 y enfermedad por coronavirus-2019 en pediatría / SARS-CoV-2 infection and corona virus disease 2019 in pediatrics

Resumen La infección por SARS-CoV-2 (y la enfermedad causada por este virus: COVID-19), es de menor frecuencia y gravedad en pediatría. La naturaleza de esto sigue siendo motivo de análisis. No obstante, los niños tienen la potencialidad de infectarse, enfermarse y de transmitir la infección a otras personas. Este artículo revisa lo conocido hasta el momento acerca de epidemiología, etiopatogenia, cuadro clínico, diagnóstico y tratamiento de COVID-19 en niños.

SARS-CoV-2 infection (and the disease it causes: COVID-19), is less frequent and milder in the pediatric population. The reasons behind this milder clinical expression are under investigation. Nevertheless, children are still susceptible to be infected, to develop symptoms and disease, and to transmit the virus. In this article, we review the information about COVID-19 in children, including epidemiology, etiopathogenesis, diagnostic approach, clinical outcomes and treatment.

Otro desafío de la naturaleza: el nuevo coronavirus virología y fisiopatología del SARS-COV-2 / Another challenge of nature: the new coronavirus virology and physiopathology of SARS-CoV-2

The recent outbreak of emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) has been brought to global attention in the search of knowledge about the virus and its pathogenesis. The immune response is essential to control and eliminate the infection, however, maladjusted immune responses may result in severe disease fisiopathology. Gaining a deeper understanding of the interaction between SARS-CoV-2 and the immune systems of the hosts may help us anticipate the development of persistent pulmonary inflammation and, why not, be the first step to therapeutic success and trying to save more lives. In this review, we provide an update on CoV virology and our vision of pathogenesis understanding it from the stages of infection, without forgetting the cytokine storm resulting from the interaction of the virus with ACE2 receptors widely distributed in the body.

La reciente emergencia de síndrome de distrés respiratorio agudo producido por coronavirus 2 (SARS-CoV-2), enfermedad denominada COVID-19 ha traído la atención mundial a la búsqueda de conocimiento sobre este virus y su patogenia. La respuesta inmune es esencial para controlar y erradicar la infección, sin embargo, las respuestas inmunes descontroladas pueden resultar en la fisiopatología de la enfermedad grave. Lograr una comprensión más profunda de la interacción entre SARS-COV-2 y el sistema inmune de los huéspedes podría ayudar a anticiparnos al desarrollo de una inflamación pulmonar persistente causada por el SARS-CoV-2, y por qué no, ser la puerta de entrada al éxito terapéutico e intentar salvar mayor número de vidas. En esta revisión, proporcionamos una actualización sobre la virología y nuestra visión de la patogenia, entendiéndola desde las fases o etapas de la infección, sin olvidar el estallido de citoquinas resultantes de la interacción del virus con los receptores ACE2 ampliamente distribuidos en el organismo.

Environmental factors involved in SARS-CoV-2 transmission: effect and role of indoor environmental quality in the strategy for COVID-19 infection control

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a new zoonotic agent that emerged in December 2019, causes coronavirus disease 2019 (COVID-19). This infection can be spread by asymptomatic, presymptomatic, and symptomatic carriers. SARS-CoV-2 spreads primarily via respiratory droplets during close person-to-person contact in a closed space, especially a building. This article summarizes the environmental factors involved in SARS-CoV-2 transmission, including a strategy to prevent SARS-CoV-2 transmission in a building environment. SARS-CoV-2 can persist on surfaces of fomites for at least 3 days depending on the conditions. If SARS-CoV-2 is aerosolized intentionally, it is stable for at least several hours. SARS-CoV-2 is inactivated rapidly on surfaces with sunlight. Close-contact aerosol transmission through smaller aerosolized particles is likely to be combined with respiratory droplets and contact transmission in a confined, crowded, and poorly ventilated indoor environment, as suggested by some cluster cases. Although evidence of the effect of aerosol transmission is limited and uncertainty remains, adequate preventive measures to control indoor environmental quality are required, based on a precautionary approach, because COVID-19 has caused serious global damages to public health, community, and the social economy. The expert panel for COVID-19 in Japan has focused on the "3 Cs," namely, "closed spaces with poor ventilation," "crowded spaces with many people," and "close contact." In addition, the Ministry of Health, Labour and Welfare of Japan has been recommending adequate ventilation in all closed spaces in accordance with the existing standards of the Law for Maintenance of Sanitation in Buildings as one of the initial political actions to prevent the spread of COVID-19. However, specific standards for indoor environmental quality control have not been recommended and many scientific uncertainties remain regarding the infection dynamics and mode of SARS-CoV-2 transmission in closed indoor spaces. Further research and evaluation are required regarding the effect and role of indoor environmental quality control, especially ventilation.

Overview of novel coronavirus infection and replication / 生物工程学报

Coronaviruses are a type of positive-sense single-stranded RNA virus with envelope and widely exist in nature to cause respiratory infectious diseases. The novel coronavirus is a new outbreak virus that is susceptible to all people. Up to now, the disease has been widely spread in the world and poses a great threat to public health. In this review, the genomic features, key proteins, host infection and replication of coronaviruses and novel coronaviruses are reviewed in order to provide theoretical basis for the study of the pathogenic mechanism of virus infection on host cells and to provide basic support for the development of specific antiviral drugs.

Recomendaciones de protección para kinesiólogas y kinesiólogos que realizan técnicas y procedimientos respiratorios en personas con COVID-19 / Protection recommendations for kinesiologists and kinesiologists who perform respiratory techniques and procedures in people with COVID-19

La Organización Mundial de la Salud (OMS) ha definido la infección por coronavirus (SARS-CoV-2) como una pandemia. Su infección puede causar potencialmente una enfermedad respiratoria muy severa1,2. Por otro lado, la tasa de transmisión ha sido muy alta, especialmente entre profesionales de la salud. Los kinesiólogos están en un alto riesgo de contraer la infección, particularmente cuando aplican técnicas respiratorias, el uso de oxígeno o la ventilación no invasiva. El objetivo de estas recomendaciones es proveer información práctica para que los profesionales tomen las precauciones necesarias para evitar contraer la infección. Además describir los riesgos de transmisión, dispersión de partícula según intervención y las recomendaciones basadas en la literatura actual revisada.

Recently the World Health Organization (WHO) has defined coronavirus infection (SARS-CoV-2) as a pandemic. Its infection can potentially cause a very severe respiratory illness1,2. Furthermore, the transmission rate has been very high, especially among health professionals. Physiotherapists are at high risk of contracting the infection, particularly when applying respiratory techniques, the use of oxygen, or non-invasive ventilation1. The objective of these recommendations is to provide practical information for professionals to take the necessary precautions to avoid contracting the infection. Also, to describe the risks of transmission, particle dispersion according to intervention and the recommendations based on the current literature reviewed.

Fisiopatología de COVID-19: función del receptor ACE2 y su vínculo con el ejercicio físico de moderada intensidad / COVID-19 pathophysiology: ACE2 receptor function and its link to moderate-intensity physical exercise

OBJETIVO: Se realizó una revisión que asoció de modo indirecto los efectos del ejercicio físico y los mecanismos fisiopatológicos de Covid-19 con el objetivo de aportar más antecedentes a una posible relación descrita previamente. FUENTES: Se obtuvo la información desde las bases de datos de PubMed y Sciencedirect. MÉTODOS: Fueron incluidos artículos descriptivos y experimentales considerando que la evidencia estuviese respaldada por datos estadísticamente significativos. La información se organizó relacionando los mecanismos compartidos por el ejercicio y la fisiopatología de Covid-19. RESULTADOS: Se logró establecer una asociación bastante concluyente, considerando que la información recopilada guarda una relación indirecta. Conclusiones: El ejercicio físico es un potencial factor protector que podría impedir el avance del virus y sus consecuencias en el organismo posterior a un eventual contagio. Para confirmar definitivamente esta hipótesis es necesario estudiar los efectos del ejercicio físico en condiciones que contemplen una relación más directa con la enfermedad.

OBJECTIVE: The aim of this review is to create a background from the relationship between the pathophysiological mechanisms of Covid-19, the activity of the ACE2 receptor and the effects of physical exercise. SOURCES: Studies were obtained from PubMed and Science direct databases. METHODS: Descriptive and experimental articles were selected, considering that the evidence was supported by statistically significant data. Subsequently, the information was organized by establishing relationships between the pathophysiology of Covid-19 and the physiological mechanisms of exercise. RESULTS: A logical and coherent association was formulated between ACE2 receptor activity, the effects of physical exercise, and the pathophysiological mechanisms of Covid-19. CONCLUSIONS: There is common relationship between Physiological mechanisms and physical exercise with Covid-19. We could establish as incipient evidence an eventual protective role of physical exercise within this disease. Future research could support prevention measures that include the practice of physical exercise.

Bases genéticas y moleculares del COVID-19 (SARS-CoV-2): mecanismos de patogénesis y de respuesta inmune / Genetic and molecular basis of COVID-19 (SARS-CoV-2) mechanisms of pathogenesis and imnune

A fines de diciembre de 2019, un nuevo coronavirus (SARS-CoV-2) fue identificado como el agente causal de una nueva enfermedad respiratoria llamada COVID-19 por la OMS. Sus síntomas incluyen fiebre, tos seca y dificultad respiratoria. Estos síntomas en general son leves, aunque, pueden ser fatales en adultos mayores y pacientes con comorbilidades. Se realizó búsqueda bibliográfica en Pubmed y Clinical Key donde se seleccionaron 22 artículos de acuerdo con los criterios de inclusión. SARS-CoV-2 pertenece al género de los Betacoronavirus y tiene similitudes genómicas con SARS-CoV y MERS-CoV. El virión de SARS-CoV-2 consta de una nucleocápside y de una envoltura externa compuesta por proteínas estructurales principales y accesorias. Su material genético consiste en una cadena de RNA monocatenario de polaridad positiva, en el que, se codifican proteínas importantes para su transcripción y replicación. El mecanismo de infección de SARS-CoV-2 comienza con la unión del virión a un receptor (ACE2) de la célula huésped y su posterior entrada por endocitosis. El genoma RNA viral se libera al citoplasma donde se transcriben y se traducen las proteínas necesarias para la producción de las proteínas estructurales y para la replicación de su material genético. Posteriormente, el RNA replicado se asocia con la nucleocápside y se ensambla junto con las proteínas estructurales para conformar las partículas víricas que serán liberadas de la célula infectada. El sistema inmune hace frente a la infección viral mediante el reconocimiento de patrones moleculares asociados a patógenos (PAMPs) por parte de la inmunidad innata y por la acción de los linfocitos T y B por parte de la inmunidad humoral. El conocimiento de las bases genéticas y moleculares de SARS-CoV-2 permite visualizar la posibilidad de establecer tratamientos farmacológicos o desarrollo de vacunas para controlar y disminuir los efectos patogénicos de la enfermedad.

In late December 2019, a new coronavirus (SARS-CoV-2) was identified as a causative agent of a new respiratory disease called COVID-19 by WHO. Its symptoms include fever, dry cough, and shortness of breath. Generally, these symptoms are mild, although, can be fatal in older adults and patients with comorbidities. A bibliographic search was carried out in Pubmed and Clinical Key. 22 articles were selected according to inclusion criteria. SARS-CoV-2 belongs to the genus of Betacoronaviruses and has genomic similarities to SARS-CoV and MERS-CoV. SARS-CoV-2 virion is made up of a nucleocapsid and external envelope composed of main structural and accesory proteins. Its genetic is a positive sense single stranded RNA in which important proteins are encoded for their transcription and replication. The mechanism of SARS-CoV-2 infection begins with the binding of the virion to (ACE2) receptor of the host cell and subsequent entry by endocytosis. This RNA genome is released into cytoplasm and the necessary proteins for the production of structural proteins and the replication of genetic material are transcribed and translated. Then, the replicated RNA associates with the nucleocapsid and assembles together with the structural proteins to form the viral particles that will be released from the infected cell. The immune system faces viral infection through the recognition of molecular patterns associated with pathogens (PAMPs) by innate immunity and the action of T cells and B cells by humoral immunity. Knowledge of the genetic and molecular basis of SARS-CoV-2 allows us to visualize the possibility of establishing pharmacological or vaccine treatments to control and reduce the pathogenic effects of the disease.