The Virus (SARS-CoV-2)
The virus that causes a respiratory disease called coronavirus disease 19 (COVID-19). SARS-CoV-2 is a member of a large family of viruses called coronaviruses. These viruses can infect people and some animals. SARS-CoV-2 was first known to infect people in 2019. The virus is thought to spread from person to person through droplets released when an infected person coughs, sneezes, or talks. It may also be spread by touching a surface with the virus on it and then touching one's mouth, nose, or eyes, but this is less common. Research is being done to treat COVID-19 and to prevent infection with SARS-CoV-2. Also called severe acute respiratory syndrome coronavirus 2.
In December 2019, several locals in Wuhan, China presented to the hospital with respiratory symptoms due to a novel pathogen. The pathogen was identified and named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 is classified as a type of RNA virus, a member of the coronavirus family, and belongs to the "beta" genus. Other members of the same genus include SARS-CoV-1 and Middle East respiratory syndrome coronavirus (MERS-CoV). The possible origin of SARS-CoV-2 from bats could be elucidated by its similarity (88% identical) to two other SARS-like CoVs derived from bats (bat-SL-CoVZC45 and bat-SL-CoVZXC21).
Since its origin, the virus has spread all over the world, affecting nearly every continent and triggering an international public health emergency in its wake. On March 11, the World Health Organization (WHO) declared coronavirus disease of 2019 (COVID-19) a pandemic. According to the most recent WHO COVID-19 situation reports (dated May 19, 2020), a total of 4,731,458 individuals have been infected, with 316,169 confirmed deaths. In the Eastern Mediterranean region, Pakistan has the third-highest number of cases after Iran (122,492 cases) and Saudi Arabia (59,854 cases). Pakistan has 45,734 cases (17,947 in Sindh, 16,685 in Punjab, 6,554 in Khyber Pakhtunkhwa, 2,885 in Baluchistan, 689 in Gilgit-Baltistan and Azad Kashmir) with 985 deaths as of May 20, 2020.
The rampant nature of SARS-CoV-2 is due to its high infectivity. The virus can be transmitted from human to human through physical contact, respiratory droplets produced by coughing, or sneezing. Recently, vertical transmission through the mother to the newborn has also been postulated.
SARS-CoV, MERS-CoV, and the recently identified SARS-CoV-2 all cause respiratory symptoms. The main clinical manifestations of SAR-CoV-2 range from mild asymptomatic disease to life-threatening complications. Initially, the patient presents with cough, fever, dyspnea, and fatigue. Other less common complaints may include diarrhea, headache, and the production of sputum. The disease can progress to cause pneumonia, leukopenia, and lymphopenia. Severe complications may occur, such as acute respiratory distress syndrome (ARDS), RNAaemia, acute cardiac injury (ACI), secondary infection, heart failure (HF), and multiple organ failure requiring intensive care unit (ICU) admissions.
Since its spread in Pakistan, the government has taken drastic measures for control and prevention of the further spread of COVID-19, including quarantine of suspected individuals carrying the disease and improvement in diagnostic and treatment procedures. Nonetheless, the already scarce resources of the healthcare system of Pakistan have been stretched thin. The primary aim of this retrospective observational study was to report the epidemiological features and statistics of individuals infected with COVID-19 from February 26 to April 24 from East Karachi, Pakistan, and contribute towards an accurate collection of figures from the country. We also aimed to study the age groups, modes of transmission, and durations and details of symptoms, among other variables, to understand this wide-spreading disease better and work effectively towards prevention and suitable management plans.