INTRODUCTION
The worldwide pandemic of the novel and highly infectious Coronavirus disease 2019 (COVID-19) originated in Wuhan, China in December 2019.1 The etiology of this disease is due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which as of April 14, 2020, has affected more than 1.9 million people and taken the lives of more than 119,000 worldwide. Currently, it is speculated that the source of this infection is from bat-derived coronavirus, which spread to humans via an unknown intermediate mammal host.
The most frequent routes of transmission are airborne, droplets containing viable viruses, and direct/indirect contact with contaminated surfaces.2 Mucosal membranes that line various facial orifices are the most susceptible to viral transmission. Once the virus enters the body in any of the aforementioned routes, the single-stranded RNA-enveloped (ss-RNA) SARS-CoV-2 virus binds to the angiotensin-converting enzyme 2 (ACE-2) receptor. Once the virus makes contact with the target cell receptor, it enters the cell using the cell endosomes. This mechanism of action is facilitated by the cell's type 2 transmembrane serine protease, TMPRSS2 interacting with the virus S-spike protein. Once inside the cell, the virus takes over the cell’s machinery by first transmitting the ss-RNA into the cell's cytoplasm. Later, the cell is forced to translate the ss-RNA inside the cell's ribosome into viral polyproteins that encode for the replicase-transcriptase complex. Viral structural proteins are created inside the cell cytoplasm with the help of proteinase enzymes. At the same time, the virus makes the infected cell synthesize RNA via its RNA-dependent RNA polymerase. These components are created inside the cell for assembly and release of new viral particles.3
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a beta coronavirus now known to cause illness in humans. Since SARS-CoV-2 proteins bind to gastrointestinal and respiratory cells, they cause mild to severe respiratory and gastrointestinal symptoms.4 The incubation period is believed to be two to fourteen days following exposure. The signs and symptoms of COVID-19 infection range from asymptomatic to mild symptoms to severe respiratory symptoms and mortality. Risk factors for this infection include: adults older than forty or fifty years of age, male gender, pre-existing medical conditions, and lifestyle. Common initial symptoms of infection are fever, non-productive cough, shortness of breath, difficulty breathing, malaise, and fatigue. Less common symptoms are myalgias, headaches, confusion, diarrhea, and rhinorrhea. Twenty percent of individuals with COVID-19 may have a critical presentation of this infection. These symptoms range from pneumonia, renal
The most frequent routes of transmission are airborne, droplets containing viable viruses, and direct/indirect contact with contaminated surfaces.2 Mucosal membranes that line various facial orifices are the most susceptible to viral transmission. Once the virus enters the body in any of the aforementioned routes, the single-stranded RNA-enveloped (ss-RNA) SARS-CoV-2 virus binds to the angiotensin-converting enzyme 2 (ACE-2) receptor. Once the virus makes contact with the target cell receptor, it enters the cell using the cell endosomes. This mechanism of action is facilitated by the cell's type 2 transmembrane serine protease, TMPRSS2 interacting with the virus S-spike protein. Once inside the cell, the virus takes over the cell’s machinery by first transmitting the ss-RNA into the cell's cytoplasm. Later, the cell is forced to translate the ss-RNA inside the cell's ribosome into viral polyproteins that encode for the replicase-transcriptase complex. Viral structural proteins are created inside the cell cytoplasm with the help of proteinase enzymes. At the same time, the virus makes the infected cell synthesize RNA via its RNA-dependent RNA polymerase. These components are created inside the cell for assembly and release of new viral particles.3
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a beta coronavirus now known to cause illness in humans. Since SARS-CoV-2 proteins bind to gastrointestinal and respiratory cells, they cause mild to severe respiratory and gastrointestinal symptoms.4 The incubation period is believed to be two to fourteen days following exposure. The signs and symptoms of COVID-19 infection range from asymptomatic to mild symptoms to severe respiratory symptoms and mortality. Risk factors for this infection include: adults older than forty or fifty years of age, male gender, pre-existing medical conditions, and lifestyle. Common initial symptoms of infection are fever, non-productive cough, shortness of breath, difficulty breathing, malaise, and fatigue. Less common symptoms are myalgias, headaches, confusion, diarrhea, and rhinorrhea. Twenty percent of individuals with COVID-19 may have a critical presentation of this infection. These symptoms range from pneumonia, renal
