Introduction to covid 19

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus.
Most people who fall sick with COVID-19 will experience mild to moderate symptoms and recover without special treatment.
HOW IT SPREADS
The virus that causes COVID-19 is mainly transmitted through droplets generated when an infected person coughs, sneezes, or exhales. These droplets are too heavy to hang in the air, and quickly fall on floors or surfaces.
You can be infected by breathing in the virus if you are within close proximity of someone who has COVID-19, or by touching a contaminated surface and then your eyes, nose or mouth.

1. Introduction to Covid-19 G roup members: Manahil Khanam Minahil khalid Aneeqa Sadiq Iqra Malik Afra Ejaz Ariba Nameen. Presented to : Dr. Humaira Yasmeen . Presented by : Group 4

2. Content: Introduction of Covid-19 History &Origin Transmission Pathogenesis Signs & Symptoms Prevention Death & Cases Advance Researches Conclusion

3. W hat is Covid-19 Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus . 'CO' stands for corona , 'VI' for virus, and 'D' for disease . Formerly, this disease was referred to as '2019 novel coronavirus ' or '2019-nCoV.' The COVID-19 virus is a new virus linked to the same family of viruses as Severe Acute Respiratory Syndrome (SARS) and some types of common cold

4. Spike Glycoprotein Envelope Small Membrane Protein RNA Hemagglutinin Esterase Membrane Protein Structure of CORONA VIRUS (COVID-19)

5. 1 . SARS: Severe Acute Respiratory Syndrome . 2. MERS : Middle East Respiratory Syndrome MERS – COV SARS – COV Types of CORONA VIRUS (COVID-19)

6. History and origin of COVID-19

7. Where did the first case of the coronavirus disease originate? Retrospective investigations by Chinese authorities have identified human cases with onset of symptoms in early December 2019 . While some of the earliest known cases had a link to a wholesale food market in Wuhan, some did not . On 31 December 2019 , the World Health Organization (WHO) was formally notified about a cluster of cases of pneumonia in Wuhan City , home to 11 million people and the cultural and economic hub of central China

8. Where did the first case of the coronavirus disease originate? The novel human coronavirus disease COVID-19 has become the fifth documented pandemic since the 1918 flu pandemic The cause of the severe acute respiratory syndrome that became known as COVID‐19 was a novel coronavirus, SARS‐CoV‐2 . The rest is history, albeit history that is constantly being rewritten: as of 12 May, 82,591 new cases of COVID‐19 worldwide were being confirmed daily and the death rate was over 4200 per day

9. CORONA A family of viruses affecting Respiratory Tract Causing Disease from common cold to Pneumonia. Usually lives in bats & other wiled animals. Transmitted to humans directly, or via other animals. Can also transmit between humans via respiratory droplets, Corona Viruses in Man.

10. Covid-19 infection. Like SARS‐CoV , the SARS‐CoV‐2 virus responsible for COVID‐19 can survive in aerosols for hours and on surfaces including stainless steel, plastic and cardboard for days,  although washing with soap or detergent will destroy the virus. It can be transmitted during the asymptomatic incubation phase (this is estimated to occur in 50–60% of cases) and for up to two weeks after the onset of symptoms  Each person infected passes the virus on to an average of three others .  The incubation period is about 5–6 days (range 1–14 days ).

11. Clinical presentation varies from asymptomatic, subclinical infection and mild illness to severe or fatal illness; deterioration can occur rapidly, often during the second week of illness. Viral load is up to 60 times greater in people with severe symptoms compared with mild cases Death is due to pneumonia and possibly hyperinflammation associated with cytokine storm syndrome

12. Hospitalization rates and crude mortality rates in Europe up to 22 April showing the influence of increasing age, are shown in Figures 1 and 2 F igure 1 Age‐specific hospitalization rates among all reported cases of COVID‐19 , data from 14 countries in the European Surveillance System up to 22 April 2020 8 F igure 2 Age‐specific crude case fatality ( deaths/all reported cases of COVID‐19), data from 13 countries in the European Surveillance up to 22 April 2020 8

13. The search starts in Wuhan An international team of epidemiologists, virologists and researchers with expertise in public health, animal health and food safety will lead the WHO’s COVID-19 investigation. The agency has not released their names. The team held its first virtual meeting, including researchers in China, on 30 October , and is reviewing the preliminary evidence and developing study protocols, says the WHO . The initial phase of investigations in Wuhan will probably be conducted by researchers already in China, and international researchers will travel to the country after reviewing those results, the agency says.

14. The search starts in Wuhan In Wuhan, researchers will take a closer look at the Huanan meat and animal market , which many of the earliest people diagnosed with COVID-19 h ad visited. What part the market played in the virus’s spread remains a mystery. Early investigations sampled frozen animal carcasses at the market, but none found evidence of SARS-CoV-2 , according to a  5 November report of the WHO mission’s terms of reference. However, environmental samples, taken mostly from drains and sewage, did test positive for the virus. “Preliminary studies have not generated credible leads to narrow the area of research,” the report states The WHO mission will investigate the wild and farmed animals sold at the market, including foxes, raccoons ( Procyon lotor ) and sika deer ( Cervus nippon ). They will also investigate other markets in Wuhan, and trace the animals’ journeys through China and across borders. The investigators will prioritize animals that are known to be susceptible to the virus, such as cats and mink

15. The search starts in Wuhan The team will also look at Wuhan’s hospital records, to find out whether the virus was spreading before December 2019 . The researchers will interview the first people identified to have had COVID-19, to find out where they might have been exposed, and will test blood samples from medical staff, laboratory technicians and farm workers collected in the weeks and months before Decembe r, looking for antibodies against SARS-CoV-2 . The report acknowledges that some of this work might already be under way in China Plans to look beyond China are sensible, given that extensive surveillance in bats in China since the 2002 SARS outbreak has identified only a distant relative of SARS-CoV-2 , says Wang. A growing number of experts think that the immediate or close ancestors of SARS-CoV-2 are more likely to exist in bats outside China, says Wang. He says the WHO team should survey bats and other wildlife across southeast Asia for SARS-CoV-2 antibodies

16. The search starts in Wuhan The investigation should also prioritize carnivorous mammals farmed for fur, such as raccoon dogs and civets, which had a role in the SARS outbreak , says Martin Beer, a virologist at the Federal Research Institute for Animal Health in Riems , Germany. Beer says, " It is surprising that there is no mention of these animals in the report, and we have no information from China about whether these animals have been tested ,” A spokesperson for the WHO says the mission will be guided by science, and “will be open-minded , iterative, not excluding any hypothesis that could contribute to generating evidence and narrowing the focus of research”.

17. Reference: Nature  587, 341-342 (2020) doi :  https://doi.org/10.1038/d41586-020-03165-9 https://www.bbc.com/news/world-asia-china-55555466 https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline?gclid=CjwKCAiAi_D_BRApEiwASslbJ9x4_nFPrLYWInq-Jiip1WEZoTEImBrq4fAfkF8OJAt4iOTuc50_dxoCuGYQAvD_BwE#event-115 https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen https://www.physio-pedia.com/Coronavirus_Disease_(COVID-19) https://www.sciencedirect.com/science/article/pii/S2319417020300445 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332915/ https://www.cdc.gov/coronavirus/2019-ncov/cdcresponse/about-COVID-19.html https://www.labmanager.com/lab-health-and-safety/covid-19-a-history-of-coronavirus-22021 Novel Corona virus (COVID-19) Situation Dashboard , Centers for Disease Control and Prevention.    https://experience.arcgis.com/experience/685d0ace521648f8a5beeeee1b9125cd 2-  SARS (severe acute respiratory syndrome.  NHS Choices . United Kingdom:  National Health Service . 3 October 2014 .

18. Transmission of Covid-19

19. Direct Contact and Droplet Transmission COVID-19 is caused by the SARS-CoV-2 virus , which spreads between people, mainly when an infected person is in close contact with another person. 20% 65% The virus can spread from an infected person’s mouth or nose in small liquid particles when they : Cough S neeze S peak B reath heavily.

20. Direct contact and droplet transmission These liquid particles are different sizes, ranging from larger ‘respiratory droplets’ to smaller ‘ aerosols’ COVID-19 virus is transmitted through respiratory droplets and contact routes . Respiratory droplets are >5-10 μm in diameter Droplet nuclei are <5μm in diameter In an analysis of 75,465 COVID-19 cases in China, airborne transmission was not reported

21. Airborne transmission. For example . 2020.03 Airborne transmission may be possible in specific circumstances and settings in which procedures or support treatments that generate aerosols are performed Turning the patient to the prone position Disconnecting the patient from the ventilator Open suctioning Tracheostomy Cardiopulmonary resuscitation. Endotracheal intubation Administration of nebulized treatment

22. Aerosol Transmission Aerosol transmission can occur in specific settings, particularly in indoor, crowded and inadequately ventilated spaces, where infected person(s) spend long periods of time with others, such as restaurants, choir practices, fitness classes, nightclubs, offices and/or places of worship. More studies are underway to better understand the conditions in which aerosol transmission is occurring outside of medical facilities where specific medical procedures, called aerosol generating procedures , are conducted

23. Indirect Transmission Indirect transmission through fomites that have been contaminated by respiratory secretions is considered possible The virus can also spread after infected people sneeze, cough on, or touch surfaces, or objects, such as tables, doorknobs and handrails. Other people may become infected by touching these contaminated surfaces, then touching their eyes, noses or mouths without having cleaned their hands first

24. Other mode of transmission. There is some evidence that COVID-19 infection may lead to intestinal infection and be present in faeces . However, to date only one study has cultured the COVID-19 virus from a single stool specimen. There have been no reports of faecal−oral transmission of the COVID-19 virus to date

25. Asymptomatic Transmission Asymptomatic transmission i.e. when the infector has no symptoms throughout the course of the disease, is difficult to quantify . Available data, mainly derived from observational studies, vary in quality and seem to be prone to publication bias. Mathematical modelling studies (not peer-reviewed ) have suggested that asymptomatic individuals might be major drivers for the growth of the COVID-19 pandemic   Similar viral loads in asymptomatic versus symptomatic cases have been reported, indicating the potential of virus transmission from asymptomatic patients

26. Pre- Symptomatic Transmission Pre-symptomatic transmission i.e. when the infector develops symptoms after transmitting the virus to another person has been reported. Exposure of secondary cases occurred 1–3 days before the source patient developed symptoms. It has been inferred through modelling that, in the presence of control measures, pre-symptomatic transmission contributed to 48% and 62% of transmissions in Singapore and China, respectively. Pre-symptomatic transmission was deemed likely based on a shorter serial interval of COVID-19 (4.0 to 4.6 days) than the mean incubation period ( five days)

27. Reference: https://www.ecdc.europa.eu/en/covid-19/latest-evidence/transmission Modes of transmission of virus causing COVID-19 ... www.who.int › Newsroom › Commentaries › Detail How does COVID-19 spread? - World Health Organization Ad·www.who.int/coronavirus/spread

28. Pathogenesis of Covid-19

29. Path-physiology 1. 2. 3. 4 . It is believed that bat coronavirus had acquired the ability to infect human , extending the host range (may be Pangolin), by having a few mutations in the spike protein . The detail Pathogenesis of covid-19 is explained by the following steps: 5. Virus Entry and Spread Pathological Findings Acute Respiratory Distress Syndrome (ARDS) Cytokine Storm Immune Dysfunction

30. A. Virus Entry and Spread 1 . 2. 3. 4 . 5. SARS-CoV-2 is transmitted via respiratory droplet, contact, and potential in fecal-oral . Primary viral replication is in mucosal epithelium of upper respiratory tract (nasal cavity and pharynx ) . F urther multiplication in lower respiratory tract and gastrointestinal mucosa, giving rise to a mild viremia. Few infections at this point and remain asymptomatic. Some patients have also exhibited non- respiratory symptoms such as acute liver and heart injury , kidney failure , diarrhea, implying multiple organ involvement.

31. A. Virus Entry and Spread 6. 7. 8. 9. SARS-CoV-2 attaches to the host cell by binding its S protein to the receptor protein, angiotensin- converting enzyme 2 (ACE2 ). ACE2 is expressed by epithelial cells of the intestine, kidney, blood vessels, and, most abundantly, in type II alveolar cells of the lungs . The human enzyme transmembrane protease, serine 2 (TMPRSS2), is also used by the virus for S protein priming and to aid in membrane fusion. The virus then enters the host cell via endocytosis.

32. B . Pathological Findings 1. The first report of pathological findings from a severe COVID-19 showed pulmonary bilateral diffuse alveolar damage . 2. The right lung showed evident desquamation of pneumocytes and hyaline membrane formation, indicatig acute respiratory distress syndrome. 3. The left lung tissue displayed pulmonary edema with hyaline membrane formation, suggestive of early- phase acute respiratory distress syndrome (ARDS ). 4. Interstitial mononuclear inflammatory infiltrates, dominated by lymphocytes, could be observed in both lungs.

33. C. Acute Respiratory Distress Syndrome(ARDS) 1. A life-threatening lung condition that prevents enough oxygen from getting to the lungs and into the circulation, accounting for mortality of most respiratory disorders and acute lung injury. 2. More than 40 candidate genes including ACE2 , interleukin 10 (IL-10), tumor necrosis factor (TNF), and vascular endothelial growth factor (VEGF) among others have been considered to be associated with the development or outcome of ARDS. 3. Increased levels of plasma IL-6 and IL-8 were also demonstrated to be related to adverse outcomes of ARDS

34. D . Cytokine Storm 1. Rapid viral replication and cellular damage, virus induced ACE2 downregulation and shedding, and antibody dependent enhancement (ADE) are are responsible for aggressive inflammation caused by SARS-CoV-2 . 2. The initial onset of rapid viral replication may cause massive epithelial and endothelial cell death and vascular leakage, triggering the production of pro-inflammatory cytokines and chemokines . 3. Loss of pulmonary ACE2 function has been proposed to be related to acute lung injury and further enhance inflammation and cause vascular permeability .

35. E . Immune Dysfun ct ion 1. Peripheral CD4 and CD8 T cells showed reduction and hyperactivation in a severe patient. 2. High concentrations of proinflammatory CD4 T cells and cytotoxic granules CD8 T cells were also determined,suggesting antiviral immune responses and overactivation of T cells. 3. several studies have reported that lymphopenia is a common feature of COVID-19 , suggestive of a critical factor accounting for severity and mortality.

36. Stages of infection Stage 1 : Asymptomatic stage (initial 1-2 days of infection) 1. The inhaled virus SARS-CoV-2 likely binds to epithelial cells in the nasal cavity and starts replicating. 2. In vitro data with SARS-CoV indicate that the ciliated cells are primary cells infected in the conducting airways 3. There is local propagation of the virus but a limited innate immune response. At this stage the virus can be detected by nasal swabs. 4. Although the viral burden may be low, these individuals are infectious. 5. The RT-PCR value for the viral RNA might be useful to predict the viral load and the subsequent infectivity and clinical course

37. Stages of infection Stage 2 : Upper airway & conducting airway response 1. The virus propagates and migrates down the respiratory tract along the conducting airways, and a more robust innate immune response is triggered. 2. Nasal swabs or sputum should yield the virus (SARS CoV-2) as well as early markers of the innate immune response. At this time, the disease COVID-19 is clinically manifest. 3. The level of CXCL10 (or some other innate response cytokine) may be predictive of the subsequent clinical course. 4. For about 80% of the infected patients, the disease will be mild and mostly restricted to the upper and conducting airways

38. Stages of infection Stage 3 : Hypoxia, ground glass infiltrates and progression to ARDS 1. Unfortunately, about 20% of the infected patients will progress to stage 3 disease and will develop pulmonary infiltrates and some of these will develop very severe disease . 2 . The virus now reaches the gas exchange units of the lung and infects alveolar type II cells. 3 . SARS-CoV propagates within type II cells, large number of viral particles are released, and the cells undergo apoptosis and die. 4 . Suspect areas of the lung will likely lose most of their type II cells , and secondary pathway for epithelial regeneration will be triggered.

39. Stages of infection 5. The pathological result of SARS and COVID-19 is diffuse alveolar damage with fibrin rich hyaline membranes and a few multinucleated giant cells. 6. The aberrant wound healing may lead to more severe scarring and fibrosis than other forms of ARDS . Recovery will require a vigorous innate and acquired immune response and epithelial regeneration. 7. Elderly individuals are particularly at risk because of their diminished immune response and reduced ability to repair the damaged epithelium. 8. The elderly also have reduced mucociliary clearance, and this may allow the virus to spread to the gas exchange units of the lung more readily

40. Reference: https :// www.researchgate.net/publication/342834705_The_Pathogenesis_of_Coronavirus_Disease_2019_COVID-19_Evaluation_and_Prevention outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; in press. Wan Y, Shang J, Graham R, et al. Receptor recognition by novel coronavirus from Wuhan: An analysis based on decade-long structural studies of SARS. J Virol 2020; 94: e00127-20. Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020; in press. Sims AC, Baric RS, Yount B, et al. Severe acute respiratory syndrome coronavirus infection of human ciliated airway epithelia: role of ciliated cells in viral spread in the conducting airways of the lungs. J Viral 2005; 79: 15511–15524. Reyfman PA, Walter JM, Joshi N, et al. Single-cell transcriptomics analysis of human lung provides insights into the pathobiology of pulmonary fibrosis. Am J Respir Crit Care Med 2019; 199: 1517–1536. Tang NL, Chan PK, Wong CK, et al. Early enhanced expression of interferon-inducible protein-10 (CXCL-10) and other chemokines predicts adverse outcome in severe acute respiratory syndrome. Clin Chem 2005; 51: 2333–2340. Hancock AS, Stairiker CJ, Boesteanu AC, et al. Transcriptome analysis of infected and bystander type 2 alveolar epithelial cells during influenza A virus infection reveals in vivo Wnt pathway downregulation. J Virol 2018; 92: e01325-18

41. Sign, Symptoms& Prevention.

42. Shortness of breath High Fever Vomiting (In Some Case) Diarrhea (In Some Case) Coughing Pneumonia CORONA VIRUS (COVID-19)

43. Majority of cases have milder disease, with some having severe disease. Severe cases develop pneumonia and respiratory failure. Deaths have generally occurred in people who are older and who have underlying health conditions - reports of severe disease in children are uncommon

44. PREVENTION IF YOU ARE INFECTED Wash Hands with water and soap/Sanitizer, at least 20 Seconds Don’t eat raw food, thoroughly cook meat and eggs Avoid contact with animals and animal products Stay at home Avoid contact with sick people Don’t touch eyes, nose or mouth with unwashed hands Cover your nose and mouth when sneezing Wear a surgical mask ( N95 Respirator) Keep objects and surface clean Avoid Contact with others CORONA VIRUS(COVID-19)

45. 6 FT SAFE DISTANCING Maintain a social distance of about 6FT. COVID-19 PREVENTION

46. TRAVEL ADVICE Avoid travelling to affected areas unless necessary . Make sure you have all necessary vaccination and travel medication . If you become sick while travelling seek medical care immediately Seek advice from your healthcare provider Don’t travel if you have fever and cough COVID-19 Prevention

47. CORONAVIRUS PREVENTION Stay at h ome and try to do more work from home, to avoid contact from infected people.

48. Reference: https://www.cdc.gov/.../social-distancing.html https://www.cdc.gov/coronavirus/2019-ncov/prevent... https://www.gov.uk/guidance/travel-advice-novel-coronavirus

49. Covid-19 Death and Cases.

50. DEC 31 China alerts WHO to several pneumonia cases Jan 13 WHO reports case in Thailand, the first outside Chania Jan 11 China announces first death from corona virus Jan 7 France confirms Europe's first corona virus case Jan 30 China alerts WHO to several pneumonia cases Feb 2 First death outside china recorded in the Philippines Feb 7 Chinese doctor & whistle blower Li Wenliang dies Feb 14 Egypt confirms Africa’s first case Feb 11 WHO names virus COVID-19 Corona virus first case origin.

51. Covid-19 Disease(Death & Cases) Name Cases-Cumulative total CASES-NEWLY REPORTED IN LAST 24 HOURS DEATHS-CUMULATIVE TOTAL DEATHS-NEWLY REPORTED IN LAST 24 HOURS TRANSMISSION CLASSIFICATION Global 87,273,380 787,944 1,899,440 14,533 USA 21,447,670 277,195 362,287 4,176 Community transmission India 10,413,417 150,570 Cluster of cases Cluster of cases Community transmission Pakistan 497,510 2,435 10,558 47 Iran 1,274,514 6,251 56,018 85 Faroe islands 643 Tonga 3 1 Sporadic cases No cases

52. Cases rate-Worldwide Death rate-Worldwide

53. COUNTRIES WITH THE HIGHEST INFECTION RATE These are the countries with the highest amount of confirmed cases over time: United States, Spain, Italy and China (where this virus first originated ) ORIGIN

54. 50,958,070 Total recovered people from COVID-19 as of January 2021

55. Reference: https://covid19.who.int/table https://www.worldometers.info/coronavirus https://www.cnn.com/interactive/2020/health/coronavirus-maps-and-cases

56. Advance Researches & Recent Evidence regarding Covid-19

57. A prophylactic nasal spray? Evidence published between 4/11/2020 and 10/11/2020 A team from Columbia University has released preliminary results (not yet peer-reviewed) showing that intranasal administration of a lipopeptide that binds to the virus Spike protein completely prevents SARS-CoV-2 infection in ferrets. These lipopeptides are inexpensive, highly stable and non-toxic . If they work in humans, they could be used as a prophylactic to prevent infection by SARS-CoV-2.

58. Evidence published between 12 /11/2020 and 17/11/2020 A drug for rheumatoid arthritis Artificial intelligence analyses have identified baricitinib , an immunosuppressor used for rheumatoid arthritis, as a potential drug for COVID-19 . In a small trial in hospitalized COVID-19 patients, the drug reduced inflammation , progression to severe disease, and mortality

59. Evidence published between 18 /11/2020 and 24/11/2020 Antibodies in breast milk. Milk from COVID-19 recovered mothers contains antibodies that can neutralize the virus (specially IgA antibodies ) and that could protect the babies from infection, according to a study

60. Evidence published between 25 /11/2020 and 1/12/2020 Understanding the loss of smell. Cells that provide support to our olfactory neurons express receptors that allow SARS-CoV-2 , providing the virus with a potential ‘entry door’ into the brain, according to a  study  that analyzed gene expression in the olfactory system. Accordingly, another  study  (not yet peer-reviewed) reveals viral presence in olfactory mucosa of COVID-19 patients who lost their sense of smell.

61. Evidence published between 25 /11/2020 and 1/12/2020 Convalescent Plasma. A controlled  clinical trial of convalescent plasma  for the treatment of COVID-19 severe pneumonia showed no benefit in terms of clinical outcomes or mortality, despite the fact that levels of IgG antibodies to SARS-CoV-2 were controlled before transfusion .

62. Evidence published between 10 /12/2020 and 15/12/2020 Evidence of early circulation? An  Italian team  found SARS-CoV-2 RNA in a throat swab collected from a child in early December 2019, around 3 months before the first identified coronavirus disease case in Italy . The child had not travelled, so this finding raises the possibility that the virus was circulating outside China earlier than thought. Impact on male fertility? A small  study on testis biopsies  from COVID-19 patients reveals the virus can infect germ cells and affect the production of spermatozoids . These findings raise the possibility that the virus may affect male fertility.

63. Evidence published between 10 /12/2020 and 15/12/2020 No benefit for an antibiotic The  UK RECOVERY trial  found no benefit from azithromycin in patients hospitalized with COVID-19 . Pfizer /BioNTech The  final Phase 3 results  for the Pfizer-BioNTech vaccine were published this week. The two doses, given 21 days apart, were safe and 95% effective against COVID-19. Mixing vaccines? A trial may start soon to find out whether  mixing COVID vaccines   gives better protection than 2 doses of the same one .

64. Avoid social gatherings, theatres etc. Stay abreast with developments related to the epidemic. Cancel non-essential travel for few days. Consider distance learning or e-learning. Stay home when sick and limit visitors. Consider staggering work schedules at offices. Explore work from home opportunity. Short term holidays of schools. Limit large work-gatherings like meeting and training. Conclusion

65. Reference: https://covid19.nih.gov/research-highlights/accelerating-covid-19-research https://www.isglobal.org/en/covid-19-novedades-cientificas

66. Thank-you.