Abstract
COVID-19 (coronavirus disease – 2019) caused by SARS-CoV-2 (also known as 2019-nCoV) is a new infectious disease by etiology, but in manifestations it has some similarities with SARS (Sever Acute Respiratory Syndrome) that ravaged several countries of the world around 2003. Coronaviruses are RNA containing microbes that ‘hijack’ mammalian cells to replicate themselves intracellularly, just to be released in large quantities. SARS-CoV-2 first replicates in the upper respiratory tract, as opposed to SARS-CoV viruses in the ‘old’ SARS that attack the lower respiratory tree, especially the lungs and cause severe pneumonia. About 80% of COVID-19 patients are mild, some of them are even asymptomatic and only about 10-20% require hospitalization because of pulmonary edema and rapidly developing bronchopneumonia that often leads to multiorgan failure, especially in older patients with chronic comorbidities or immunocompromised system (e.g., obesity, diabetes mellitus, cardiovascular diseases). The overall worldwide mortality is about 1-2%, but some of the genetic variants of the virus caused 4-6% mortality, especially in densely populated areas, like Northern Italy, New York city, Spain. In the most severe cases a ‘cytokine storm’ (a massive release of cytokines) have been described that aggravate the initial damage in the lungs and heart. Epidemiologically, the true incidence and prevalence of COVID-19, most likely, will never be known because of uneven testing in most of the countries for the viral RNA and/or for the developed IgM and IgG antibodies against the virus. From public health perspectives, the hardest hit areas of the world are those that were not prepared, had a poorly organized or underfunded public health service, and/or did not follow the preventive measures such as social distancing, isolation and frequent hand washing. The poor organization of public health services, especially if associated with initial denial of the rapid spread of the disease lead to chaos, panic and, predictably, sever distress in many people