Open AccessUnclear Issues Regarding COVID-19
Author(s) -
Aycan Yüksel,
Dilek Karadoğan,
Canan Gündüz Gürkan,
Fatma Tokgöz Akyıl,
Zehra Nur Töreyin,
Feride Marım,
Hüseyin Arıkan,
Tuğba Şişmanlar Eyüboğlu,
Nagehan Emiralioğlu,
İrem Şerifoğlu,
Elif Develi,
Selman Çelik,
Ümran Özden Sertçelik,
Tuğba Ramaslı Gürsoy,
Mehmet Fatih Elversli,
Aslı Öncel,
Berrin Er,
Ali Fırıncıoğluları,
Fatma Esra Günaydın,
Hilal Özakıncı,
Neslihan Özçelik,
Dorina Esendağlı,
Asena Aydın,
Neslihan Köse,
Merve Erçelik,
Pınar Yıldız Gülhan,
Ethem Yıldız,
İlim Irmak,
Bilge Kara,
Selçuk Gürz,
Fatma Gülsüm Karakaş,
Metin Akgün
Publication year - 2020
Publication title -
the eurasian journal of medicine
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.337
H-Index - 13
eISSN - 1308-8742
pISSN - 1308-8734
DOI - 10.5152/eurasianjmed.2020.20092
Subject(s) - medicine , disease , immunology , asymptomatic , coronavirus , covid-19 , pathogenesis , bioinformatics , biology , infectious disease (medical specialty)
Scientists from all over the world have been intensively working to discover different aspects of Coronavirus disease 2019 (COVID-19) since the first cluster of cases was reported in China. Herein, we aimed to investigate unclear issues related to transmission and pathogenesis of disease as well as accuracy of diagnostic tests and treatment modalities. A literature search on PubMed, Ovid, and EMBASE databases was conducted, and articles pertinent to identified search terms were extracted. A snow-ball search strategy was followed in order to retrieve additional relevant articles. It was reported that viral spread may occur during the asymptomatic phase of infection, and viral load was suggested to be a useful marker to assess disease severity. In contrast to immune response against viral infections, cytotoxic T lymphocytes decline in SARS-CoV-2 infection, which can be partially explained by direct invasion of T lymphocytes or apoptosis activated by SARS-CoV-2. Dysregulation of the urokinase pathway, cleavage of the SARS-CoV-2 Spike protein by FXa and FIIa, and consumption coagulopathy were the proposed mechanisms of the coagulation dysfunction in COVID-19. False-negative rates of reverse transcriptase polymerase chain reaction varied between 3% and 41% across studies. The probability of the positive test was proposed to decrease with the number of days past from symptom onset. Safety issues related to infection spread limit the use of high flow nasal oxygen (HFNO) and continuous positive airway pressure (CPAP) in hypoxic patients. Further studies are required to elucidate the challenging issues, thus enhancing the management of COVID-19 patients.