COVID-19: What We Know So Far

Abstract

Objective: Since the emergence of the COVID-19 pandemic at the end of 2019, the number of affected cases has not stopped rising. Similarly, the number of scientific publications and pre-prints has been increasing exponentially, with an effort to understand this disease more and find a proper solution. The purpose of this article is to review the current understanding of the novel coronavirus. Background: The latest COVID-19 pandemic caused by the SARS-CoV-2 has spread globally ever since it emerged in Wuhan's city in China. This rapidly spreading disease has changed our lives in unimaginable ways, spreading fear and uncertainty due to the lack of knowledge and the flooding with new information, which lacks the scientific method and cannot be critically appraised. The purpose of this article is to gather some of the best knowledge that has been published so far in a unified narrative review, making it easy for the scientific community to review the most accurate and recent understandings about COVID-19. Methods: We screened relevant articles using a specified number of keywords and specific databases, including PubMed and Embase. We selected peer-reviewed English published material related to the topic, except for a few pre-prints that we deemed necessary to include. We also screened the reference lists of these articles to find relevant publications with the same criteria. Discussion: This narrative overview comprises several subsections that discuss the epidemiology, virology, pathogenesis, clinical manifestations, diagnostic methods, and management of the disease. We also presented a section on the implications of the disease in pregnancy. We wrapped up the review with a special division regarding the response to COVID-19, which has been diverse in different countries. Conclusion: COVID-19 has been a serious global health threat with a high transmission and case fatality rate, particularly in vulnerable populations. Epidemiologic models have so far guided the response, but they need to be interpreted carefully, with an understanding of their limitations. The disease's response has varied among different countries; with no current vaccine or standard treatment, the world stands in fear, maximizing preventive strategies to reduce the damages caused by this virus. This manuscript presents a summary of everything that is so far known about COVID-19 to make it easier for the medical community to overview the disease that has changed the world.

Multisystem Inflammatory Syndrome due to COVID-19 in a Newborn Patient: A Case Report from Lebanon

“…Only a small subset of pediatric patients required hospitalization. This was documented in the United States, where approximately 2% of COVID-19 cases were less than 18 years of age [2,3].…”

COVID-19 Myocarditis Clinical Presentation, Diagnosis and Management: A Narrative Review

“…Patients with acute myocarditis can be asymptomatic and often present with nonspecific symptoms such as chest pain, dyspnea, and palpitations. Those who develop acute heart failure develop dyspnea, fatigue, and exercise intolerance, often with paroxysmal nocturnal dyspnea and orthopnea [1,[8][9][10]. To note, a viral prodrome with fever, myalgias, and respiratory or gastrointestinal symptoms may be related to myocarditis, though this remains variable [10].…”

“…A novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan City infected clusters in December 2019 and caused an outbreak of SARS-like respiratory illness worldwide with associated human-to-human transmission [1]. The new coronavirus disease 2019 (COVID- 19) outbreak was declared a Public Health Emergency of International Concern by the World Health Organization on January 30, 2020 [2] and upgraded to a pandemic on March 11, 2020 [3].…”

“…A study showed that up to 19% of COVID-19 hospitalized patients demonstrated cardiac injury [4]. The mechanism of cardiac disease is thought to be multifactorial, involving (1) the entry of the SARS-CoV-2 virus into cardiomyocytes, which induces direct cardiotoxicity, and (2) the viral driven inflammatory process with cytokine release, which leads to myocarditis, hypercoagulability, vascular inflammation, and plaque instability [5].…”

“…While different cardiac manifestations have been reported in COVID-19, such as ACS, arrhythmias, myocardial injury, and thromboembolism, early studies in China reported that 7-20% of patients diagnosed with COVID-19 had viral myocarditis [6]. Viral myocarditis caused by the SARS-CoV-2 has also been documented as a cause of dilated cardiomyopathy, albeit in rare case reports [1,7]. Although many of these early studies did not include echocardiography or Magnetic Resonance Imaging (MRI) data to assert whether the typical myocarditis features were present in these patients, the number of reports of COVID-19 myocarditis published warrants a necessity to review this topic.…”