key: cord-281148-bbnbnwte
authors: Emara, Khaled; Emara, Ahmed K.; Farhan, Mona; Mahmoud, Shady
title: What orthopedic surgeons need to know about Covid-19 pandemic()
date: 2020-05-20
journal: J Orthop
DOI: 10.1016/j.jor.2020.05.016
sha: 
doc_id: 281148
cord_uid: bbnbnwte

The ongoing outbreak of COVID-19, also known as SARS-CoV-2 and coronavirus disease 2019, is considered a major public concern that propagates steadily by the increased number of the infected cases and the mortality rate. In this article, we provide a brief review for Orthopedic surgeons as regard COVID-19 virus microbiology, epidemiology, clinical picture, and diagnosis. Moreover, what measures should be taken amid this pandemic to assess its control, maintain the urgent duties, and protect health care workers (HCW) are also discussed.

The ongoing outbreak of COVID-19, also known as SARS-CoV-2 and coronavirus 21 disease 2019, is considered a major public concern that propagates steadily by the 22 increased number of the infected cases and the mortality rate. It began on December Coronaviruses are enveloped single stranded RNA viruses that range between 60-140 36 nm in diameter. They have crown appearance attributed to spike projections on their 37 surfaces and hence their name [3] . Coronaviruses are comprised of four subfamilies: 38 alpha, beta, gamma, and delta. Alpha Patients are infectious in asymptomatic period before the appearance of symptoms, 54 thorough the disease, and on clinical recovery [9] .

Incubation period between contacting the virus to the appearance of symptoms varies 56 widely between two days and 28 days with mean at five days [10] . Feco-oral 57 transmission has also been hypothesized [11] . All ages can be infected but the severity 58 of the disease depends on age, associated co-morbidities (as diabetes mellitus, 59 cardiovascular diseases, and renal failure), and smoking history. Surprisingly, 60 children showed mild forms of the disease [12]. However, no age is immune to severe 61 affection because progression is suggested to be attributed to the marked elevation of 62 inflammatory cytokines such as IL2, IL7, IL10, GCSF, and TNFα [13] .

Based on its highly infectivity and its severity among old smoker individuals with 64 multiple comorbidities, high burden is established on health care systems with depletion of the available resources augmenting the crises that is evident in Italy with 66 total cases more than 95,000 and total death over 5,400 up till now [2] . 

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