The Week (US)

What exactly is the coronaviru­s?

Once the coronaviru­s infects a human body, what happens?

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A virus is a parasitic microbe, so tiny that hundreds of millions could fit on the head of a pin. It’s a coiled strand of genetic material embedded in a protective coat of protein that invades healthy human cells and essentiall­y hijacks them, using the cell’s genetic machinery to duplicate itself. The one currently wreaking global havoc, technicall­y called SARS-CoV-2, is a type of coronaviru­s, a family of viruses covered with knobby spikes that are used to latch onto cell membranes (their appearance suggests a crown, or “corona,” thus the name). Many coronaviru­ses are fairly harmless, like the ones that cause common colds, while others are deadly: The one that causes Middle East Respirator­y Syndrome, or MERS, kills about a third of the people it infects. SARS-CoV-2 is a novel virus in that it has never before infected humans; it is thought to have jumped from bats to humans via an intermedia­te animal, perhaps a pangolin, in Wuhan, China. That’s why no one had immunity when it began spreading across the globe.

How does the virus infect people?

to appear (though they can take two days or up to two weeks), are typically fever, a dry cough, and fatigue. About 80 percent of cases are relatively mild, and the infection stays largely in the upper respirator­y tract; as the immune system makes antibodies and activates T-cells that neutralize and clear the virus, the victim recovers in a couple of weeks. In other cases, the invader pushes on to the lower respirator­y tract, where serious problems can set in. “The lungs are the major target,” said Martin Hirsch, part of the infectious disease unit at Massachuse­tts General Hospital.

What happens in the lungs?

At this point, the virus begins to attack cells lining the lungs, inflaming the tiny sacs that send oxygen to the blood and remove carbon dioxide. Breaths become shorter and more difficult. As cells die, the lungs become clogged with fluid and debris and can develop secondary infections; this is pneumonia. In the most severe cases, the patient needs the help of a mechanical ventilator to continue to breathe. Some nonetheles­s die. How the immune system reacts apparently is the key factor determinin­g how bad a patient’s condition gets. In the most critical cases, for reasons doctors don’t entirely understand, the immune response goes haywire, setting off what’s called a cytokine storm.

What is a cytokine storm?

Cytokines are chemicals released as an alarm signal when the body detects dead cell fragments indicating that an attack is underway. These chemicals rally the immune system and set off a battle to expel the invader. In a cytokine storm, the immune response spins out of control and starts attacking healthy cells as well as damaged ones. “Instead of shooting at a target with a gun, you’re using a missile launcher,” said Angela Rasmussen, a virologist at Columbia University. Inflammati­on spikes, and fluid and dying cells fill the lung sacs, essentiall­y drowning the patient; meanwhile, the condition can extend into the circulator­y system and spiral into multiple-organ failure. This is what happens in many fatal cases, estimated to be 1 to 3 percent of infections. Understand­ing better why this happens to certain patients and how it can be treated or prevented is a key focus for scientists battling the pandemic. “I think it’s going to take a really, really long time to understand the mechanisti­c, biological basis of why some people get sicker than others,” says Rasmussen.

 ??  ?? A CT scan of the lungs of a Covid-19 patient with pneumonia
A CT scan of the lungs of a Covid-19 patient with pneumonia

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