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Long-term conditions and severe acute respiratory syndrome SARS-CoV-2 (COVID-19)

02 May 2020
Volume 25 · Issue 5


Observation of infection trends through the course of the ongoing COVID-19 pandemic has indicated that those with certain pre-existing chronic conditions, such as hypertension, chronic obstructive pulmonary disease and obesity, are particularly likely to develop severe infection and experience disastrous sequelae, including near-fatal pneumonia. This article aims to outline how SARS-CoV-2 affects people and to consider why individuals living with long-term conditions are at increased risk from infection caused by this virus. A summary of available clinical guidelines with recommendations is presented, to provide community nurses with the up-to-date information required for protecting individuals living with a number of long-term conditions. Additionally, special measures required are outlined, so that community nurses may reflect on how to best provide nursing care for individuals living with long-term conditions and understand protection measures for individuals at increased risk from severe COVID-19.

On 31 December 2019, the World Health Organization (WHO) China office was notified of cases of pneumonia of unknown aetiology originating in Wuhan, Hubei Province of China (WHO, 2020a). A previously unknown virus was identified in infected individuals, who presented with severe acute respiratory symptoms. The virus was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the condition it causes is designated COVID-19. The virus belongs to a large family of enveloped RNA viruses. This is the seventh member of the coronavirus family that is known to be caused by a zoonotic transmission from animals into humans. The initial outbreak was traced to a live animal market in Wuhan. The origin of the virus is assumed to be from an animal, but the exact mode of transmission to man is unknown (British Medical Journal, 2020).

The virus is similar to SARS-like coronaviruses transmitted from bats, but it is distinct from the severe respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory coronavirus (MERS-CoV), which caused epidemics earlier this century (Zhu et al, 2020). The transmission mode of SARS-CoV-2 is thought to be person-to-person, through respiratory droplets and physical contact (Public Health England (PHE), 2020).

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