Coronavirus Disease-19 (COVID-19) is a new type of disease caused by the coronavirus that first broke out in the city of Wuhan, Hubei, China in December 2019. The situation got worsened by the celebration of Chinese New Year on January 25, 2020. COVID-19 is a zoonotic virus, which means that the virus is transmitted from animals to humans, with the main host was horse shoe bat and mangolin or pangolin species. Zoonotic transmission only occurs in sufferers who are in Wuhan City, while outside Wuhan, the process of transmission occurs from infected person to other person in the vicinity. World Health Organization (WHO) designated COVID-19 as a pandemic event resulted in a global warning around the world in March 2020.
Previously, the world had experienced two infections due to the coronavirus, in 2002 from Severe Acute Respiratory Syndrome Coronavirus Disease-1 (SARS-CoV 1) and in 2013 from Middle East Respiratory Syndrome Coronavirus Disease (MERS-CoV). Through an analytical study of the viral phylogenetic tree approach, it was found that 88% of COVID-19 has similarities with SARS-CoV 1 and 50% with MERS-CoV, so on this basis, COVID-19 is also referred to as Severe Acute Respiratory Syndrome Coronavirus Disease- 2(SARS-CoV 2). In June 2020, COVID-19 had caused 9.76 million cases in the world and the number of cases in Indonesia was 51,427, but in September 2020 the number of COVID-19 cases in Indonesia reached approximately 260 thousand cases.
The coronavirus that causes COVID-19 is a type of RNA virus, single stranded Ribonucleic acid (ssRNA) which means that the content of genetic elements in the virus is RNA content. Viruses generally have two types, DNA and RNA viruses, and they have only one genetic material, either DNA or RNA alone and not both. RNA virus is a type of virus that is easily mutated. The mutations are located in the Open Reading Frames 1a / 1b (ORF 1a / 1b) and the four main structures of the coronavirus: the N protein (Nucleocapsid), M glycoprotein (membrane), S glycoprotein (spike), and E protein (sheath). The entry point of COVID-19 to host (human) cells is Angiotensin Converting Enzyme-2(ACE-2) in the entire human body, however, COVID-19 attacks ACE-2 which is in the human respiratory tract (lungs). The end result of the COVID-19 attack to ACE-2 in the lungs is the occurrence of Acute Lung Injury (ALI), Acute Respiratory Distress Syndrome (ARDS) which leads to death due to sepsis in the patient’s body. The state of transmission and manifestation of COVID-19 is exacerbated by diseases in a person’s body known as comorbidities and increases the risk of death from COVID-19 infection.
This study uses literature review analytical approach where the author collects all data from various sources, such as books, journals, and e-book related to studies on COVID-19 molecular pathogenesis and transmissions. COVID-19 can attach to several objects around humans, known as the concept of Built Environments (BEs) consisting of a biotic environment and an abiotic environment. The attachment of COVID-19 to abiotic materials varies from 48 to 72 hours known as the Tissue Culture Infectious Dose 50 (TCID 50 concept.). Abiotic materials can be: door handles, elevator buttons, and others that are touched by someone.
The concept of BEs is closely related to the transmission pattern of COVID-19 from one person to another. Besides BEs, there are other theories related to COVID-19 transmission process, the concept of contact similar to the concept of BEs. As previously explained, COVID-19 can be transmitted from one person to another through droplets, splatters, and nuclei product droplets that are normally released by even healthy people. These products are aerosol products commonly found in various procedures in dental and medical procedures.
The diagnostic procedure for people with COVID-19 is divided into four types: person under supervision (ODP), patient under supervision (PDP), person without symptoms (OTG), and patient confirmed with COVID-19. In patients with COVID-19, some have issues with their sense of taste and smell as COVID-19 damages the nervous system associated with the senses of taste and smell. This diagnosis can be confirmed by carrying out a chest X-ray, rapid test, and molecular approach using Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR).
Beside from living patients, COVID-19 can also be transmitted from the bodies of patients diagnosed with COVID-19 so that the funeral procession for these patients must be carried out in less than four hours, and if an autopsy had to be carried out, the personnel involved must be as few as possible and must be done in 12 hours after time of death. During the autopsy, all personnel must use level 3 Personal Safety Equipment (PPE), which consists of: three layers of N95 masks, carried out in a room with negative pressure, and it must be carried out on an autopsy travel bag with certain order of organs being autopsied, the abdominal area, pelvis, neck followed by the chest area and the last part is the cranium in the skull.
Author: Dr. H. Ahmad Yudianto, dr., Sp.F(K)., M. Kes., SH
Details of this study can be viewed at: https://e-journal.unair.ac.id/JKL
Fery Setiawan, Heni Puspitasari, Jenny Sunariani, and Ahmad Yudianto (2020) Molecular Review Covid-19 From The Pathogenesis and Transmission Aspect. Environmental Health Journal Volume 12 No.1 Special Issue. DOI: 10.20473 / jkl.v12i1si.2020.94-104
