– In an infected person, the highest density of the SARS-CoV-2 coronavirus occurs even before the first symptoms appear, which is why such people are the most contagious – warns the president of the Polish Society of Epidemiologists and Doctors of Infectious Diseases, Prof. Robert Flisiak.
The vast majority of people infected with the SARS-CoV-2 coronavirus, more than 80 percent, go through the infection without serious symptoms or are not felt at all.
— An infected person is at the highest density of the virus before symptoms develop, and so are the most contagious during this period. This is the biggest reason the epidemic is spreading so rapidly in an unmanageable way. Because we are not able to control people who do not yet have symptoms of infection, which is when it is most contagious. And when symptoms appear, we already have a decrease in the risk of infectivity – explains the president of the Polish Society of Epidemiologists and Doctors of Infectious Diseases, Prof. Robert Flisiak.
A specialist who is the head of the Department of Infectious Diseases and Hepatology at the Medical University of Bialystok, spoke about it during a virtual press conference. He admitted that it was a self-limiting infection.
– If the human organism itself or around it does not have circumstances conducive to the development of complications, the infection should end after a few days. And this is what happens in the vast majority of people – he added.
Before that happens, however, infected people can quickly spread the infection to others, especially when prophylaxis is not followed, such as wearing face masks, keeping an appropriate distance, and hand hygiene and disinfection. This is due to the specific pathomechanism of SARS-CoV-2 coronavirus infection.
– In the first stage, the cells of the mucosa of the respiratory tract epithelium are attacked. The virus multiplies and invades neighboring cells. This phase usually lasts about a week, sometimes even shorter – said prof. Robert Flisiak.
The second stage involves the involvement of pneumocytes, the respiratory epithelial cells in the alveoli. Then the immune system reacts. The so-called immunocompetent cells, mainly lymphocytes, monocytes, neutrophils and macrophages. The production of various cytokines (proteins that influence the development of cells involved in the immune response and haemopoietic cells) is triggered, mainly pro-inflammatory cytokines such as interelukin-1 and interleukin-6.
– The release of a large amount of these substances causes the so-called a cytokine storm, responsible for what is happening both in the airways and in the vascular endothelium. Inflammatory lesions intensify, interstitial tissue thickens, the permeability of the vascular endothelium increases, which in turn results in pulmonary edema – explained the president of the Polish Society of Epidemiologists and Doctors of Infectious Diseases.
He warned that many complications could develop during this period. – With increased inflammation, the coagulation system is activated and the risk of thromboembolic changes in the lungs and other organs is high. And this is the greatest threat – he emphasized.
- See also: Why do COVID-19 patients die of heart attacks, strokes and congestion?
During the first week of infection, the replicating virus is most active. Only after the seventh day, the viral load, i.e. the amount of virus in the mucus of the bronchial tree, drops significantly.
– On the tenth day, virus particles are hardly found. Before they completely disappear, they are still in a form that prevents them from replication, because they are fragments of a decayed virion (a single virus particle). Only until the fifth, seventh day can you talk about contagiousness – explains prof. Robert Flisiak.
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The specialist also noted that there is no need to test the infectivity of the patient, because virus particles detected by PCR genetic tests may be present for 2-3 weeks, sometimes even for a month.
“But that doesn’t mean the patient is contagious.” It ceases to be contagious after a few, at the latest ten days. The exception are patients with severe immunodeficiency, who may have complete virions by the 20th day – noted Prof. Robert Flisiak. (PAP)
Author: Zbigniew Wojtasiński / PAP
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