Hey I read your virus post and I wanted to ask, maybe healthy individuals will recover but do you know whether they wonât have complications later on? What if the infection remains and comes every now and then? What if it acts like hiv? We canât risk it
Let me preface this with a disclaimer that Iâm not a virologist and my primary area of study is sepsis, but I know a lot of information about the subject. This is an excellent ask that deserves a detailed answer, so Iâm going to give it the attention it deserves. I realize this is going to be a long post, but Iâm not going to put it under a cut because I think people need to see it.
The 2019 coronavirus is part of the family Coronaviridae. These are enveloped, positive-sense viruses. This means that contain a single strand of RNA, already coded to the complementary sequence; they can start replicating as soon as they get inside human cells. The envelope comes from the fact that as the new viral particles (otherwise known as virions) leave the human cells theyâre inhabiting, they surround themselves with a tiny bit of the cell membrane rather than simply ripping the cell apart. This is a process known as âbudding.â
(Image from ScienceDirect . com.)
Coronaviruses have affinities for different parts of the body. SARS, MERS, and this coronavirus have affinities for the lungs. Theyâre very fond of causing excessive inflammation - in laymanâs terms, collateral damage includes making the body attack them too much, and then nonselectively attack itself. In very extreme cases, this is the beginning of a process known as sepsis, which involves excessive inflammation followed by not enough inflammation. This is why secondary infections are common after, for example, a severe flu that puts a 90-year-old in the hospital.
HIV, the virus you mentioned, works differently. Itâs a retrovirus, meaning it contains an enzyme (reverse transcriptase) that allows it to encode itself directly into the human genome. Thatâs why HIV has been, up until now (and in most cases, still) impossible to cure. Itâs always going to be in your DNA, ready to replicate more of itself - although modern medication means that you may live with it for decades and decades. The common expression now is that if youâre adequately treated, âyou die with HIV; you donât die of HIV.â
Two other viruses that stick around are varicella (chicken pox/shingles) and herpes. Both of these viruses infect, and later live in, nerve cells. During times of immunosuppression (insufficient immune function, such as pregnancy, extreme stress, or infection with something else), they travel along the nerve cells and re-emerge on the skin.
Coronaviruses donât work the same way. They are RNA viruses rather than DNA viruses like varicella and herpes. HIV is in the Reovirus family, sort of intermediate between RNA and DNA. While technically, bits of virus coding material will always be floating around in your body, itâs largely true that if you recover from any one virus, you canât get it again (although you can get others in the same family).
Could this coronavirus cause complications in healthy survivors and kill later on? Potentially, yes. The Hendra and Nipah viruses did, back in the early 2000s, and measles has been known to do so as well. However, donât panic. These viruses affect the brain very strongly to begin with, or cause long-lasting and devastating immunosuppression, unlike known coronaviruses. In addition, they come from entirely different families - the Paramyxovirus family, to which all three of the mentioned viruses belong, has long been known to be very nasty to humans.
Are coronaviruses such as SARS and MERS commonly known to cause long-lasting complications in healthy survivors? As far as I know or have read, no.
So what do healthy survivors have to worry about? Primarily, damage to lung tissue that leaves them vulnerable to secondary infections (such as pneumonia). If one survives the coronavirus and doesnât have any factors like chronic disease or immunosuppression, this person should still:
Treat themselves gently for a while (a few months), drink lots of water, and eat as healthily as they can to make sure they have all the necessary cofactors (helping vitamins) to keep their immune system healthy.
Not expose themselves, if possible, to people who have other infections during this time period. .
GET THEIR VACCINES. If they tell a doctor their history with the virus, the doctor should be able to work with them and determine if theyâre still safe to get live virus vaccines like the MMR. Most likely, they will be. Killed virus or bacterial vaccines should be okay.
Go to the doctor if they start feeling weird, or have symptoms that canât be attributed to something else theyâve caught (such as the flu).
This coronavirus can be frightening, and it may be more vicious than other viruses such as those causing the common cold, and Iâm glad you sent me this ask. I wonât lie; there may be a global pandemic. However, the 2009 swine flu was a pandemic as well, and current medical science and good monitoring ensured that almost everyone who got the virus recovered without complications. I had what was probably this flu in 2011, and got pneumonia on top of it. I recovered with no negative effects whatsoever, because I went to the doctor, got treated, and wore a mask so I wouldnât infect anyone else. In addition, I was probably a bit more vulnerable to begin with because I have asthma.
Here is a scientific article about the coronavirus and what it does. From what these data say, those who died mainly died of sepsis, which tends to be far worse in people who have wonky immune systems to begin with (such as the elderly, the very young, or those who have comorbid conditions that affect their ability to mount an effective immune response). Lastly, please note that the majority (2/3) of these patients had been exposed at the very beginning, and thus likely didnât come to the hospital until their symptoms were very severe. Pure viral sepsis is rare.
Itâs difficult to make inferences about the exact scope of this virus, because a lot of information coming out of China has been suppressed. But this coronavirus is not smallpox. It is not measles. It is not bubonic plague or the 1918 flu (by the way, that last pandemic likely started in Kansas, so donât be racist to Asian people). I know the prospect of getting sick is frightening. But if you watch yourself carefully, follow good hygiene practices, and make sure to get treated even if you do get sick, overwhelming evidence says that youâll most likely be 100% okay in the end.
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