Nima Rezaei - Coronavirus Disease - COVID-19

On March 2, 2020, I had an hour-long meeting with three of my colleagues, including the head of the hospital, head of infant intensive care unit (ICU), and the consultant of the hospital, at the head office of the Childrens Medical Center, the Pediatrics Center of Excellence (Tehran, Iran), to discuss the novel coronavirus disease 2019 (COVID-19) outbreak. A few days later, I realized that all of them were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), confirmed by real-time RT PCR (rRT-PCR) assays. Two of them presented with only low-grade fever and malaise, while the third one suffered from anosmia in addition to cough and myalgia. So, it raised several questions in my mind, while I also had some concerns about being affected by SARS-CoV-2, not only because of that meeting with three physicians who were positive for the virus, but also for meeting and talking closely with two other faculty members of our hospital, who were both recently infected by COVID-19. So, am I positive for COVID-19? Fortunately, in the 2 weeks after that meeting and after 8 months of working in the pediatric referral hospital during the pandemic, I had not presented any symptom of the disease, until October 2020, when I faced headache, backache, chills, and malaise, which made me to qurantine myself for 18 days. As I was quite sure about my symptoms, I did not test for SARS-CoV-2 during my quarantine. However, SARS-CoV-2 IgG had been incresead slightly, when I got back to the hospital. So, I am not among more than a hundred million of reported cases, which might show that the number of COVID-19 is understimated!

Meanwhile, the global challenges and concerns still remain, while many questions are yet to be answered! Is being asymptomatic not equal to being affected? How does the virus spread? Does the outbreak situation change by weather in different seasons? Who are at a higher risk of infection and mortality? Are healthy individuals without any underlying disease protected!? How can we protect ourselves? And the immune system: Friend or Foe?

We, the world outside of China, heard the news of a Chinese city affected by pneumonia of unknown origin in December 2019. We also saw this city, in response to the increasing number of patients presented with this unusual pneumonia, construct a temporary hospital in less than 2 weeks, but did not realize that this disease could spread far beyond its boundaries, strike near us, and provide an experience far worse than what happened in the city when affected the first time. Wuhan was that city, and with the discovery of a coronavirus as the pathogen behind that, COVID-19 was the name assigned to that unusual pneumonia.

This novel SARS-CoV-2 proved to be unique in terms of transmissibility and mortality. A proof of its being highly contagious is that while we were all obsessed with the movement of the SARS-CoV-2 from Wuhan to all territories worldwide, it has been very difficult for most of us to track the chronological order of its global spread after affecting Wuhan. However, its consequences are hitting us; 5 months have passed since the the World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020, while many countries are fighting the first and second wave of the disease. It should be mentioned that there were only about 100,000 diagnosed cases within a 3-month period since the beginning of the outbreak; in the month of April, about 3 million new cases were reported; now, there are more than 120 million officially reported cases and more than 2.5 million deaths from all over the world (mid-March 2021); and it's still unclear when the pandemic will end! The pandemic has profoundly affected not only human health but also human behavior and thought. No curative therapy so far! One of my aforementioned colleagues, who was positive for SARS-CoV-2 in March 2020 and cured, faced reinfection 2 months later with positive PCR again! There are some other reports, especially from healthcare workers who are exhausted from the continuous long-term fight against COVID-19, which shows the potential risk of reinfection after decreasing the SARS-CoV-2 antibody level. So, how effective will the vaccines be?