Mucus and the coronavirus - EurekAlert

Posted: 31 Mar 2020 03:01 AM PDT

**IMAGE:** University of Utah biomedical engineering assistant professor Jessica R. Kramer has received a grant to study how mucus, the slimy substance in human tissue, plays a part in the spread... view more

Credit: Dan Hixson/University of Utah College of Engineering

March 31, 2020 -- As the lethal COVID-19 coronavirus propagates around the globe, we know a sneeze, a cough or simply touching a surface with the virus can spread the infection.

What researchers don't know is exactly the role different compositions of mucus, the slimy substance on human tissue, play in the transmission and infection of coronaviruses. Nor do they know why some people known as "super-spreaders" will spread the disease more than others. But University of Utah biomedical engineering assistant professor Jessica R. Kramer is now researching how mucus plays a part in transferring coronaviruses from person to person.

"Not everyone spreads the disease equally. The quality of their mucus may be part of the explanation," Kramer says. "One person may sneeze and transmit it to another person, and another may not, and that is not well understood."

She has received a one-year, $200,000 Rapid Response Research (RAPID) grant from the National Science Foundation for the research.

Understanding how different compositions of the proteins that make up mucus spread coronaviruses could help identify those who are "super-spreaders" as well as those who could be more vulnerable to becoming infected, says Kramer. That could lead to faster, more accurate data on who will spread the virus or more effective quarantine measures for high-risk populations. The nation's epidemiologists have said since the arrival of COVID-19 that accurate testing to know where the infection is growing is a key factor to containing its spread.

Kramer and her team will create different forms of synthetic mucins, the proteins that make up mucus, and test them with non-hazardous versions of coronaviruses. COVID-19, which is the cause of the worldwide pandemic, is a novel coronavirus that by the end of March has so far killed more than 37,000 people since it was first discovered late last year. But it is only one of many forms of coronaviruses.

Kramer will use special aerosols in a closed environment to simulate coughing to help determine how different mucins carry the virus through the air. She will also test the viability of the virus when it lands on a surface based on the mucins that carry it. Her lab will also examine how mucin composition on the next victim's mouth, eyes or lungs affects whether the virus makes it through the mucus into their cells to replicate.

The composition of mucus changes from person to person based on their genetics, environmental factors, or their lifestyle such as whether the person smokes or what their diet is. "It's important that people understand that it's not only the amount of mucus that is a factor but how the molecular composition is different," she says.

Kramer's lab at the University of Utah has been creating synthetic mucins and more recently studying how mucins and bacteria interact with each other. She says researching how mucins interact with viruses is a natural extension of this work.

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Kramer's award is the second NSF RAPID grant to be given to U researchers related to the spread of the COVID-19 coronavirus. Michael Vershinin and Saveez Saffarian of the U's Department of Physics & Astronomy will study how the structure of the coronavirus withstands changes in humidity and temperature and under what conditions the virus falls apart.

This news release and photos may be downloaded from unews.utah.edu.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Coronavirus: What are the symptoms of Covid-19? - Vox.com

Posted: 25 Mar 2020 05:29 AM PDT

So you're not feeling well, and you're afraid you might be infected with the new coronavirus disease, Covid-19. Given that the United States is now beginning to test widely for the disease, and more cases are popping up, that might be a reasonable suspicion.

Health officials are ramping up the response measures, advising people to stay at home as much as possible. Several states and cities have now imposed more severe measures like lockdowns and stay-at-home-orders to contain the virus.

But cases of Covid-19 are following an exponential growth trajectory in the US. That means that the number of infections is rising rapidly in proportion to the number of people infected. You may have been exposed if you have traveled to a region with novel coronavirus transmission or if you've been in close contact with someone who has Covid-19, something that's becoming harder to avoid without social distancing. And some people spreading the virus may not show any symptoms at all.

Here are some signs you may have the illness:

The World Health Organization, based on its research in China, reports the illness can present in different ways, ranging from no symptoms at all to severe pneumonia.

Some symptoms are more frequently seen than others. Based on confirmed cases, the WHO says 88 percent of infected people experienced a fever and 67.7 percent had a dry cough. Less frequent symptoms include thick mucus from coughs (sputum) (33.4 percent), shortness of breath (18.6 percent), sore throat (13.9 percent), and headache (13.6 percent).

"Covid-19 disease usually begins with mild fever, dry cough, sore throat and malaise," writes Megan Murray, a professor of epidemiology at Harvard Medical School, in an FAQ for the Abundance Foundation. "Unlike the coronavirus infections that cause the common cold, it is not usually associated with a runny nose."

These symptoms emerge five or six days after infection on average, but can show up in as little as a day or as much as two weeks after exposure.

The most commons symptoms of Covid-19 are similar to the flu (fever and cough), but onset is generally more abrupt with the flu.

The following symptoms, reported in some research, have not been confirmed as common by the WHO or the Centers for Disease Control and Prevention as of March 25:

A recent, yet-to-be-published German study found that some Covid-19 patients can present with the symptoms of an upper respiratory tract infection, similar to the common cold: runny nose, congestion, and sneezing. (The study involved a very small number of patients, however.)
In a study of 204 Covid-19 patients, researchers in China found that half of patients experienced gastrointestinal symptoms, including diarrhea, vomiting, and abdominal pain.
There are some reports of other symptoms among people with infections. The American Academy of Ophthalmology reported that Covid-19 can present as conjunctivitis, causing red or pink, itchy eyes. The British Rhinological Society also noted in a letter that evidence is mounting that Covid-19 can lead to anosmia, a loss of the sense of smell, even in patients who show no other symptoms.

"We don't have the answer to that yet, although there's quite a bit of interest in this online," Maria Van Kerkhove, the Covid-19 technical lead at the World Health Organization, said on loss of smell, according to the Washington Post.

If you have symptoms, what should you do?

The CDC advises people to seek medical attention immediately if they have trouble breathing or emergency warning signs.

People with symptoms in one of the high-risk groups — those who are over 65 years old; people with diabetes, hypertension, or preexisting breathing problems; or are being treated for cancer — should quickly seek medical advice or treatment. Call your health care provider before heading to a clinic if you suspect you may have Covid-19. That way, the clinic can take appropriate precautions for your visit.

If you're not in a high-risk group and have mild or severe symptoms, you should also call a health professional — a doctor, a nurse, or a public health official. They will work with your local health department and figure out whether you need to get tested or get treatment. And make no mistake: While older people face the highest risks, all age groups can get sick from Covid-19, so everyone needs to take precautions and pay attention to their symptoms.

Doctors and health officials advise not to go to the emergency room if your symptoms do not appear to be life-threatening.

However, some cases develop pneumonia and require care or hospitalization.
If you have symptoms like cough, fever or other respiratory problems, contact your regular doctor first.
Do not go to the emergency room. ERs need to be able to serve those with the most critical needs.
— Public Health - Seattle & King County (@KCPubHealth) March 2, 2020

Also, don't panic. Most people who get infected get better, often on their own with just rest, fluids, and fever medication. If you are advised to stay home, there are several other measures you should take, according to the CDC.

The most important step is to avoid exposing other people to the illness, especially in the early stages of symptoms, when the disease is most contagious. That means staying home from school or work, avoiding public transit or ride shares, and separating yourself from the people and animals in your home. It also means avoiding sharing household items like towels, dishes, and bedding.

Cover your coughs and sneezes with a tissue over your mouth and nose. Wash your hands often with soap and water for at least 20 seconds. Clean the surfaces in your home that you come into contact with regularly, like counters, doorknobs, bedside tables, keyboards, and phones. "It is possible that some of the viral particles ... end up on surfaces (door handles, subway poles, coins) where they might remain viable," Murray writes.

When leaving your home, wear a surgical face mask to avoid spreading the virus — if you're sick. Health officials say that masks do little to protect the wearer if they aren't infected. Officials are also urging the public not to buy N95 masks because they are needed by health workers and are in short supply.

All the while, pay close attention to your symptoms. Call your health care provider if your symptoms get worse. If you have a health emergency and need to call 911, let the dispatcher know that you may have Covid-19 so responders can prepare.

These steps may seem tedious, but remember that they serve to protect not just you but also the people around you. Controlling an outbreak is everyone's job.

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