ABSTRACT
In late December 2019, severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2) was discovered following a cluster of pneumonia cases in Wuhan, China. During the early stages of the COVID-19 pandemic in 2020, it was unclear how this virus would manifest into a multiorgan impacting disease. After over 750 million cases worldwide, it has become increasingly evident that SARS-CoV-2 is a complex multifaceted disease we continue to develop our understanding of the pathophysiology of COVID-19 and how it affects these systems has many theories, ranging from direct viral infection via ACE2 receptor binding, to indirect coagulation dysfunction, cytokine storm, and pathological activation of the complement system. Since the onset of the pandemic, disease presentation, management, and manifestation have changed significantly. This paper intends to expand on the long-term impacts of COVID-19 on the cardiovascular, respiratory, urinary, gastrointestinal, and vascular systems of the body and the changes in clinical management. It is evident that the pharmacological, nonpharmacological and psychological management of COVID-19 patients require clearer guidelines to improve the survival odds and long-term clinical outcomes of those presenting with severe disease.
ABSTRACT
As the world continues to study and understand coronavirus disease (COVID-19), existing investigations and tests have been used to try and detect the virus to slow viral transmission and its global spread. A 'gold-standard' investigation has not yet been identified for detection and monitoring. Initially, computed tomography (CT) was the mainstay investigation as it shows the disease severity and recovery, and its images change at different stages of the disease. However, CT has been found to have limited sensitivity and negative predictive value in the early stages of the disease, and the value of its use has come under debate due to whether its images change the treatment plan, the risk of radiation, as well as its practicality with infection control. Therefore, there has been a shift to the use of other imaging modalities and tests, such as chest X-rays and ultrasound. Furthermore, the use of nucleic acid-based testing such as reverse-transcriptase polymerase chain reaction (RT-PCR) have proven useful with direct confirmation of COVID-19 infection. In this study, we aim to review and analyse current literature to compare RT-PCR, immunological biomarkers, chest radiographs, ultrasound and chest CT scanning as methods of diagnosing COVID-19.
Subject(s)
Betacoronavirus/genetics , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Biomarkers/metabolism , COVID-19 , COVID-19 Testing , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Humans , Infection Control/methods , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Predictive Value of Tests , Radiography, Thoracic/methods , Reverse Transcriptase Polymerase Chain Reaction/methods , SARS-CoV-2 , Severity of Illness Index , Tomography, X-Ray Computed/methods , Ultrasonography/methods , Viral Load/geneticsABSTRACT
The 2019 coronavirus disease is a serious public health emergency, with serious adverse implications for populations, healthcare systems, and economies globally. Recently, concerns have been raised about possible association between ethnicity, incidence and outcomes of COVID-19 arisen from early government data. In this review, we will explore the possible association using both recent COVID-19 studies and studies of previous pandemics. We call for data on ethnicity to be routinely collected by governments, as part of an international collaboration, alongside other patient demographics and further research to robustly determine the magnitude of association. Moreover, governments must learn from previous pandemics and recommended strategies to mitigate risks on minority ethnicities due to socioeconomic disadvantages.