These are challenging times, to say the least. As we have moved through these last several months dealing with the COVID-19 pandemic, it often appears that there are more questions than answers. To add to the uncertainty, there is a lot of misinformation circulating, which leaves many unsure in which direction they should turn. What is this virus? Will it disappear? Will there be a vaccine? It is hard tomake decisions when we don’t have all of the information, but we are all doing our best as together, we sail through these uncharted waters. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2 or 2019-nCoV) is the novel coronavirus that causes the disease which we call COVID-19. Coronaviruses are not new; they are usually associated with nothing more than the common cold in humans, though potentially having a devastating impact on other animal species. The strain that causes COVID-19, however, is unique in many aspects, including how easily it is transmitted. Coronaviruses are so named due to the spikes on their surface that give the virus a crownlike appearance when viewed with an electron microscope (“corona” means crown). These spikes allow the virus to associate with receptors on cells that are targeted for infection. In COVID-19, these receptors are called ACE2 (angiotensin-converting enzyme 2) and there are many different cells that express this receptor beyond lung tissue. In addition to the lungs, ACE2 has been found in the heart, kidney, intestine and blood vessels, to name a few. This wide distribution is potentially part of the reason that the disease has such a diverse and wide-ranging impact on different individuals. Many may recognize the term “ACE” or angiotensin as it is related to some of the medications used for control of hypertension − or high blood pressure. Because of this relationship, there have been theories that there is a higher risk of COVID-19 in people who are taking certain blood pressure medications. It should be noted that there is currently no evidence that people using the various antihypertensive medications are at a greater risk of contracting COVID-19 or having more severe disease. SARS-CoV-2 is in a group of viruses that tend to mutate frequently. Some mutations of the coronavirus have already been seen. This is not to say that new, more pathogenic strains are emerging. This process is normal for emerging viruses and is not occurring in the COVID-19 virus any more rapidly than would be expected. The challenge with viruses with high mutation rates is that it can, at times, be more difficult to design treatments that are highly effective. If a drug or a vaccine is specific for a particular part of the virus, then it is possible that it will be less effective if that part changes slightly. The flip side of a fast-mutating virus is that many mutations could actually make the virus itself less effective. A successful virus finds a balance betweenmutations that allow it to avoid drugs and the immune system and those that may render it less potent. So where do we stand with COVID-19? By Dr. Denise Martin COVID-19 42 | www.snowbirds.org
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