COVID-19, Causes, Diagnosis, Treatment, Prevention, Complications

COVID-19, Causes, Diagnosis, Treatment, Prevention, Complications

COVID-19 is a disease caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 can cause respiratory system disorders, ranging from mild symptoms such as flu, to lung infections, such as pneumonia.

COVID-19 (coronavirus disease 2019) is a new disease caused by a virus from the Coronavirus group, namely SARS-CoV-2 which is also often called the Corona virus.

The first case of this disease occurred in the city of Wuhan, China, at the end of December 2019. After that, COVID-19 spread between humans very quickly and spread to a number of countries.

To prevent the spread of COVID-19 from spreading further, several countries have imposed lockdown policies. In Indonesia, the government has implemented a policy of implementing Community Activity Restrictions to suppress the spread of this virus.

Death Rate Due to COVID-19

According to data released by the Task Force for the Acceleration of Handling COVID-19, the number of confirmed positive cases as of June 21, 2022 was 6,069,255 people, with a death toll of 156,695.

From these two figures, it can be concluded that the case fatality rate or death rate caused by COVID-19 in Indonesia is around 2.6%. The case fatality rate (CFR) is the percentage of deaths from all confirmed and reported positive cases of COVID-19.

Meanwhile, the number of survivors or people who have been infected with COVID-19 and then recovered continues to grow, namely 5,903,461 people.

Causes of COVID-19

COVID-19 is caused by SARS-CoV-2, which is a new type of coronavirus (a group of viruses that infects the respiratory system). Corona virus infection can cause mild to moderate respiratory infections, such as the flu, or infections of the respiratory system and lungs, such as pneumonia.

COVID-19 was originally thought to be transmitted from animals to humans. After that, it was discovered that this infection can also be transmitted from human to human. Transmission can be through the following ways:

• Accidentally inhale the spit (droplets) that come out when a person with COVID-19 sneezes or coughs
• Holding your mouth, nose, or eyes without washing your hands first, after touching objects that have COVID-19 droplets, such as money or doorknobs
• Close contact (less than 2 meters) with people with COVID-19 without wearing a mask

The CDC and WHO state that COVID-19 can also be transmitted through aerosols (particles of substances in the air). However, this mode of transmission usually occurs in certain medical procedures, such as bronchoscopy, endotracheal intubation, suctioning of mucus, and administration of inhaled drugs via a nebulizer.

Transmission through the air can also more easily occur in a crowd of people, especially in closed spaces.

From the data released by WHO, to date, several variants of SARS-CoV-2 that cause COVID-19 have been found.

Here are the details of the new variant types:

• Variant Alfa (B.1.1.7), which was first discovered in the UK in September 2020.
• Beta variant (B.1.351/B.1.351.2/B.1.351.3), which was first discovered in South Africa in May 2020.
• Gamma variant (P.1/P.1.1/P.1.2), which was first discovered in Brazil in November 2020.
• The Delta variant (B.1.617.2/AY.1/AY.2/AY.3), which was first discovered in India in October 2020.
• The Omicron variant (B.1.1.529) was first discovered in South Africa in November 2021.

The Omicron variant is the main variant of the virus that causes COVID-19 which is currently spreading widely. The Omicron variant consists of several subvariants, namely BA.1, BA. 1.1, BA.2, and BA.3.

The Omicron BA.4 and BA.5 variants are the latest subvariants that were only detected in Indonesia in June 2022. These subvariants are likely to spread more quickly than the BA.1 and BA.2 subvariants.

COVID-19 Risk Factors

COVID-19 can infect anyone, but its effects will be more dangerous or even fatal if it attacks the elderly, pregnant women, smokers, people with certain diseases, and people with weak immune systems, such as cancer patients.

Because it is easily contagious, this disease is also at high risk of infecting medical personnel who treat COVID-19 patients. Therefore, medical personnel and people who come into contact with COVID-19 patients need to use personal protective equipment (PPE).

Symptoms of COVID-19

Early symptoms of COVID-19 infection can resemble flu symptoms, namely fever, runny nose, dry cough, sore throat, and headache. After that, the symptoms may disappear and heal or even worsen.

Patients with severe symptoms may experience high fever, cough with phlegm or blood, shortness of breath, and chest pain. The symptoms mentioned above appear when the body reacts against the COVID-19 virus.

In general, there are three general symptoms that can indicate a person is infected with COVID-19, namely:

• Fever (body temperature above 38°C)
• dry cough
• Hard to breathe

In addition to the symptoms above, there are several other symptoms that are rare, but can also appear in COVID-19 infection, namely:

• Tired easily
• Muscle ache
• Chest pain
• Sore throat
• Headache
• Nausea or vomiting
• Diarrhea
• Runny nose or stuffy nose
• Shivering
• Sneeze
• Loss of ability to taste
• Loss of ability to smell (anosmia)

Symptoms of COVID-19 can appear within 2 days to 2 weeks after a person is infected with the virus that causes it. Some sufferers also experience happy hypoxia, which is a decrease in oxygen without any other symptoms. In addition, several case reports also mention that some COVID-19 patients may develop skin rashes.

To determine whether these symptoms are symptoms of the Corona virus, a rapid test or PCR is needed. To find a place to do a rapid test or PCR around your home, click here.

In some patients, COVID-19 can cause no symptoms at all. People who have been confirmed positive for COVID-19 through RT-PCR examination but do not experience symptoms are referred to as asymptomatic confirmed cases. These patients can still transmit COVID-19 to others.

In July 2020, the Ministry of Health of the Republic of Indonesia changed the old operational terms for COVID-19, such as ODP, PDP, OTG to new terms, namely suspect, probable, and confirmed.

When to go to the doctor

Immediately self-isolate if you experience symptoms of COVID-19 infection as mentioned above, especially if in the last 2 weeks you have been in an area that has COVID-19 cases or has been in contact with COVID-19 sufferers. After that, call the COVID-19 hotline at 119 Ext. 9 for further guidance.

If you suspect that you have COVID-19 but have no symptoms or have mild symptoms, you don't need to go to the hospital. You just need to self-isolate at home for 10 days from the onset of symptoms, plus 3 days free of symptoms of fever and respiratory problems.

If new symptoms appear, ask the doctor by telephone or online health applications, about what actions need to be taken and what medicines need to be taken.

If your symptoms are getting worse or you need an immediate examination by a doctor.

COVID-19 diagnosis

To determine whether a patient is infected with COVID-19, the doctor will ask the patient's symptoms, the patient's travel history, and whether the patient has previously had close contact with people suspected of being infected with COVID-19.

After that, the doctor will perform the following examinations:

• Rapid antigen test, to detect antigens, namely proteins that are on the outside of the virus
• PCR (polymerase chain reaction) test or swab test, to detect the Corona virus in the lining of the nose
• CT scan or chest X-ray, to detect infiltrates or fluid in the lungs
• Complete blood test, to check the levels of white blood cells and C-reactive protein
• Blood gas analysis, to check the oxygen and carbon dioxide levels in the blood

Please note, the rapid test on COVID-19 is only used as a screening test or initial examination, not to confirm the diagnosis of COVID-19. A positive rapid test result does not necessarily mean you have COVID-19. You can get positive results if you have been infected with other viruses or other types of Coronavirus.

On the other hand, a negative COVID-19 rapid test result does not necessarily indicate that you are free from COVID-19. Therefore, whatever the results of your rapid test, consult your doctor so that further guidance can be given, including whether or not to confirm the test results with a PCR test. Usually the PCR test will attach a positive or negative result to the CT value.

COVID-19 Treatment

Until now, there is no drug that can definitively treat COVID-19. If you are diagnosed with COVID-19 but have no symptoms or only have mild symptoms, you can simply do treatment or self-isolate at home.

It is important to remember, the isolation room must have good ventilation and light and adequate air exchange. In addition, the isolation room must also be cleaned every day with soapy water or disinfectant.

During self-isolation, keep the following in mind:

• Do self-isolation for 2 weeks by not leaving the house and keeping a distance from people in the same house.
• Always use a mask when leaving the house or when interacting with family members.
• Practice cough etiquette.
• Take body temperature twice a day, morning and night.
• Wash hands with soap, running water, or hand sanitizer.
• Drink lots of water to maintain body fluid levels.
• Get enough rest to speed up the healing process.
• Take cough, fever, and pain relievers, after consulting a doctor.
• Pay attention to the symptoms you are experiencing and contact your doctor immediately if the symptoms worsen.

Research shows that COVID-19 patients with mild symptoms can recover within 2 weeks. However, before you end your self-isolation and return to your activities, continue to consult with your doctor to find out if you have met the criteria for recovering from COVID-19.

If you are diagnosed with COVID-19 and have severe symptoms, your doctor will refer you for treatment and quarantine at a referral hospital. Methods that doctors can use include:

• Give medication to reduce complaints and symptoms
• Install a ventilator or breathing apparatus to meet oxygen needs
• Give fluid infusions to stay hydrated
• Give blood thinners and prevent blood clots
• Administer anti-inflammatory drugs or antiinterleukin-6 (IL-6)

In addition to the methods above, research on several types of drugs and effective methods for dealing with COVID-19 is still being carried out. These drugs include several types of antivirals, namely favipiravir, molnupiravir, and remdesivir to fight the corona virus.

However, to date, research has shown that antiviral drugs have not been shown to be effective in treating COVID-19.

COVID-19 Complications

In severe cases, COVID-19 infection can cause serious complications, including:

• Acute respiratory failure
• Pneumonia
• Acute heart failure
• Acute liver failure
• Secondary infection of other organs, such as black fungus disease
• Kidney failure
• Blood clotting disorders
• Rhabdomyolysis
• ARDS (acute respiratory distress syndrome)
• Septic shock
• Dead

In addition, currently the term long haul COVID-19 appears. This term refers to someone who has been declared cured through a negative PCR test result, but still feels complaints, such as:

• Weak
• Cough
• Joint pain
• Chest pain
• Difficult to concentrate
• Heart beat
• Fever that goes away

Covid-19 prevention

Currently, Indonesia is implementing a COVID-19 vaccination program in stages. As of June 2022, data shows 96.6% of the population has received the first dose of vaccine and about 80.91% have received the second dose of vaccine. In addition, 23.59% of the population has received booster vaccines.

The COVID-19 vaccination aims to build immunity against the Corona virus, as well as form group immunity or herd immunity. The more people who are vaccinated, the faster the transmission of COVID-19 will be cut off. In addition, economic conditions affected by the pandemic will also recover.

In order to achieve the above objectives, the COVID-19 vaccine is now being administered to children aged 6–18 years, pregnant women, and breastfeeding mothers. Meanwhile, for people with a history of certain diseases or health conditions, giving the vaccine must be accompanied by permission from a doctor.

Please note, even if you have received a second dose of the COVID-19 vaccine, you should still avoid factors that can increase your risk of getting infected with this virus. The trick is to do the things below:

• Apply physical distancing, which is to maintain a minimum distance of 2 meters from other people, and don't go out of the house unless there is an urgent need.
• Use a mask when doing activities in public places or crowds, including when going shopping for groceries.
• Wash your hands regularly with soap and water or a hand sanitizer that contains at least 60% alcohol, especially after activities outside the home or in public places.
• Do not touch your eyes, mouth and nose before washing your hands.
• Increase endurance by living a healthy lifestyle, such as regular exercise and consuming nutritious foods and supplements.
• Avoid contact with people with COVID-19, people who are suspected of being positively infected with COVID-19, or people who are sick with fever, cough, or runny nose.
• Cover your mouth and nose with a tissue when you cough or sneeze, then throw the tissue in the trash.
• Keep objects that are frequently touched and the environment clean, including the cleanliness of the house.
• Keep the air circulation and cleanliness in the room. If necessary, you can use an air purifier.

For people suspected of being affected by COVID-19 (including the suspect and probable categories) previously referred to as ODP (people under monitoring) and PDP (patients under surveillance), there are several steps that can be taken so as not to transmit the Corona virus to others, namely:

• Do self-isolation by staying in a separate room from other people for a while. If this is not possible, use a bedroom and bathroom that is different from that used by other people.
• Take medicines that are recommended by the doctor.
• Take temperature measurements twice a day, morning and night.
• Do not leave the house, except to get treatment.
• Call the hospital to pick you up if your symptoms get worse.
• Forbid and prevent others from visiting or visiting you until you are completely healed.
• As much as possible do not have meetings with people who are sick.
• Avoid sharing the use of eating and drinking utensils, toiletries, and sleeping equipment with others.
• Wear a mask and gloves if you have to be in a public place, such as a hospital or with other people.
• Use a tissue to cover your mouth and nose when you cough or sneeze, then throw the tissue in the trash immediately.

Conditions that require direct treatment by a doctor in a hospital, such as childbirth, surgery, dialysis, or child vaccination, will be handled differently with some adjustments during the COVID-19 pandemic. The goal is to prevent the transmission of COVID-19 while you are in the hospital.

Therefore, consult with your doctor about the best course of action that needs to be taken if you experience the conditions above.

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