navinnseab/khmer-wikipedia-article huggingface dataset:
ជំងឺកូរ៉ូណាវីរុស២០១៩: អាការៈ និង រោគសញ្ញា

អាការៈ និង រោគសញ្ញា

+ Symptoms of COVID-19 Symptom RangeFever83–99%Cough59–82%Loss of appetite 40–84%Fatigue44–70%Shortness of breath31–40%Coughing up sputum28–33%Muscle aches and pains11–35%
Fever is the most common symptom, although some older people and those with other health problems experience fever later in the disease. In one study, 44% of people had fever when they presented to the hospital, while 89% went on to develop fever at some point during their hospitalization.

Other common symptoms include cough, loss of appetite, fatigue, shortness of breath, sputum production, and muscle and joint pains. Symptoms such as nausea, vomiting, and diarrhoea have been observed in varying percentages. Less common symptoms include sneezing, runny nose, or sore throat.

Some cases in China initially presented with only chest tightness and palpitations.

A decreased sense of smell or disturbances in taste may occur. Loss of smell was a presenting symptom in 30% of confirmed cases in South Korea.

As is common with infections, there is a delay between the moment a person is first infected and the time he or she develops symptoms. This is called the incubation period. The incubation period for COVID‑19 is typically five to six days but may range from two to 14 days, although 97.5% of people who develop symptoms will do so within 11.5 days of infection.

A minority of cases do not develop noticeable symptoms at any point in time. These asymptomatic carriers tend not to get tested, and their role in transmission is not yet fully known. However, preliminary evidence suggests they may contribute to the spread of the disease. In March 2020, the Korea Centers for Disease Control and Prevention (KCDC) reported that 20% of confirmed cases remained asymptomatic during their hospital stay.

Complications

In some, the disease may progress to pneumonia, multi-organ failure, and death. Neurological manifestations include [kikilu[seizures]], stroke, encephalitis, and Guillain–Barré syndrome. Cardiovascular-related complications may include heart failure, irregular electrical activity, blood clots, and heart inflammation.

In some people, COVID‑19 may affect the lungs causing pneumonia. In those most severely affected, COVID-19 may rapidly progress to acute respiratory distress syndrome (ARDS) causing respiratory failure, septic shock, or multi-organ failure. Complications associated with COVID‑19 include sepsis, abnormal clotting, and damage to the heart, kidneys, and liver. Clotting abnormalities, specifically an increase in prothrombin time, have been described in 6% of those admitted to hospital with COVID-19, while abnormal kidney function is seen in 4% of this group. Approximately 20-30% of people who present with COVID‑19 demonstrate elevated liver enzymes (transaminases). Liver injury as shown by blood markers of liver damage is frequently seen in severe cases.
ជំងឺកូរ៉ូណាវីរុស២០១៩: Complications

Complications

In some, the disease may progress to pneumonia, multi-organ failure, and death. Neurological manifestations include [kikilu[seizures]], stroke, encephalitis, and Guillain–Barré syndrome. Cardiovascular-related complications may include heart failure, irregular electrical activity, blood clots, and heart inflammation.

In some people, COVID‑19 may affect the lungs causing pneumonia. In those most severely affected, COVID-19 may rapidly progress to acute respiratory distress syndrome (ARDS) causing respiratory failure, septic shock, or multi-organ failure. Complications associated with COVID‑19 include sepsis, abnormal clotting, and damage to the heart, kidneys, and liver. Clotting abnormalities, specifically an increase in prothrombin time, have been described in 6% of those admitted to hospital with COVID-19, while abnormal kidney function is seen in 4% of this group. Approximately 20-30% of people who present with COVID‑19 demonstrate elevated liver enzymes (transaminases). Liver injury as shown by blood markers of liver damage is frequently seen in severe cases.
ជំងឺកូរ៉ូណាវីរុស២០១៩: ការចំលង

ការចំលង

alt=Cough/sneeze droplets visualised in dark background using Tyndall scattering|thumb|Respiratory droplets produced when a man sneezes, visualised using Tyndall scattering
thumb|thumbtime=4:02|A video discussing the basic reproduction number and case fatality rate in the context of the pandemic

COVID-19 is a new disease, and the ways it spreads between people are under investigation, including: the role of small droplets, the extent and how it may be transmitted through air, and how long the virus remains infectious on surfaces. The disease is spread during close contact, often by small droplets produced during coughing, sneezing, or talking. During close contact, (1 to 2 metres, 3 to 6 feet), people catch the disease after breathing in contaminated droplets that were exhaled by infected people. However, the droplets are relatively heavy and usually fall to the ground or surfaces, as opposed to being infectious over large distances.

After the droplets fall to floors or surfaces, they still can infect other people, if they touch contaminated surfaces and then their eyes, nose or mouth with unwashed hands. On surfaces the amount of active virus decreases over time until it can no longer cause infection. However, experimentally, the virus can survive on various surfaces for some time, (for example copper or cardboard for a few hours, and plastic or steel for a few days). Surfaces are easily decontaminated with household disinfectants which kill the virus outside the human body or on the hands. Disinfectants or bleach are not a treatment for COVID-19, and cause health problems when not used properly, such as inside the human body.

Sputum and saliva carry large amounts of virus. Some medical procedures may result in the virus being transmitted easier than normal for such small droplets, known as airborne transmission.

The virus is most contagious during the first three days after onset of symptoms, although spread is known to occur up to two days before symptoms appear (presymptomatic transmission) and in later stages of the disease.Coronavirus disease 2019 (COVID-19) in the EU/EEA and the UK – ninth update, 23 April 2020. Stockholm: ECDC, p.8-9. Some people have been infected and recovered without showing symptoms, but uncertainties remain in terms of asymptomatic transmission.

Although COVID-19 is not a sexually transmitted infection, kissing, intimate contact, and faecal oral routes are suspected to transmit the virus.
ជំងឺកូរ៉ូណាវីរុស២០១៩: វីរុសវិទ្យា

វីរុសវិទ្យា

thumb|Illustration of SARSr-CoV virion

Severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) is a novel severe acute respiratory syndrome coronavirus, first isolated from three people with pneumonia connected to the cluster of acute respiratory illness cases in Wuhan. All features of the novel SARS-CoV-2 virus occur in related coronaviruses in nature.
Outside the human body, the virus is killed by household soap, which bursts its protective bubble.

SARS-CoV-2 is closely related to the original SARS-CoV. It is thought to have a zoonotic origin. Genetic analysis has revealed that the coronavirus genetically clusters with the genus Betacoronavirus, in subgenus Sarbecovirus (lineage B) together with two bat-derived strains. It is 96% identical at the whole genome level to other bat coronavirus samples (BatCov RaTG13). In February 2020, Chinese researchers found that there is only one amino acid difference in the binding domain of the S protein between the coronaviruses from pangolins and those from humans; however, whole-genome comparison to date found that at most 92% of genetic material was shared between pangolin coronavirus and SARS-CoV-2, which is insufficient to prove pangolins to be the intermediate host.
ជំងឺកូរ៉ូណាវីរុស២០១៩: Immunopathology

Immunopathology

Although SARS-COV-2 has a tropism for ACE2-expressing epithelial cells of the respiratory tract, patients with severe COVID‑19 have symptoms of systemic hyperinflammation. Clinical laboratory findings of elevated IL-2, IL-7, IL-6, granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-γ inducible protein 10 (IP-10), monocyte chemoattractant protein1 (MCP-1), macrophage inflammatory protein 1-α (MIP-1α), and tumour necrosis factor-α (TNF-α) indicative of cytokine release syndrome (CRS) suggest an underlying immunopathology.

Additionally, people with COVID‑19 and acute respiratory distress syndrome (ARDS) have classical serum biomarkers of CRS, including elevated C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer, and ferritin.

Systemic inflammation results in vasodilation, allowing inflammatory lymphocytic and monocytic infiltration of the lung and the heart. In particular, pathogenic GM-CSF-secreting T-cells were shown to correlate with the recruitment of inflammatory IL-6-secreting monocytes and severe lung pathology in COVID‑19 patients. Lymphocytic infiltrates have also been reported at autopsy.
ជំងឺកូរ៉ូណាវីរុស២០១៩: រោគវិទ្យា

រោគវិទ្យា

Few data are available about microscopic lesions and the pathophysiology of COVID‑19. The main pathological findings at autopsy are: 
 Macroscopy: pleurisy, pericarditis, lung consolidation and pulmonary oedema
 Four types of severity of viral pneumonia can be observed: 
 minor pneumonia: minor serous exudation, minor fibrin exudation
 mild pneumonia: pulmonary oedema, pneumocyte hyperplasia, large atypical pneumocytes, interstitial inflammation with lymphocytic infiltration and multinucleated giant cell formation 
 severe pneumonia: diffuse alveolar damage (DAD) with diffuse alveolar exudates. DAD is the cause of acute respiratory distress syndrome (ARDS) and severe hypoxemia.
 healing pneumonia: organisation of exudates in alveolar cavities and pulmonary interstitial fibrosis
 plasmocytosis in BAL
 Blood: disseminated intravascular coagulation (DIC); leukoerythroblastic reaction
 Liver: microvesicular steatosis
ជំងឺកូរ៉ូណាវីរុស២០១៩: Medications

Medications

Per the World Health Organization, as of April 2020, there is no specific treatment for COVID‑19. On May 1, 2020, the United States gave Emergency Use Authorization (not full approval) for remdesivir in people hospitalized with severe COVID-19 after a study suggested it reduced the duration of recovery.  Researchers continue working on more effective treatments and many vaccine candidates are in development or testing phases.

For symptoms, some medical professionals recommend paracetamol (acetaminophen) over ibuprofen for first-line use. The WHO and NIH do not oppose the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen for symptoms, and the FDA says currently there is no evidence that NSAIDs worsen COVID‑19 symptoms.

While theoretical concerns have been raised about ACE inhibitors and angiotensin receptor blockers, as of 19 March 2020, these are not sufficient to justify stopping these medications. One study from April 22 found that people with COVID-19 and hypertension had lower all-cause mortality when on these medications.

Steroids, such as methylprednisolone, are not recommended unless the disease is complicated by acute respiratory distress syndrome.

The Australasian Society of Clinical Immunology and Allergy recommend that tocilizumab should be considered as an off-label treatment option for those with COVID-19 related acute respiratory distress syndrome. It recommends this because of its known benefit in cytokine storm caused by a specific cancer treatment, and that cytokine storm may be a significant contributor to mortality in severe COVID-19.

Medications to prevent blood clotting have been suggested for treatment, and anticoagulant therapy with low molecular weight heparin appears to be associated with better outcomes in severe COVID‐19 showing signs of coagulopathy (elevated D-dimer).
ជំងឺកូរ៉ូណាវីរុស២០១៩: Protective equipment

Protective equipment

thumb|The CDC recommends four steps to putting on personal protective equipment (PPE).

Precautions must be taken to minimise the risk of virus transmission, especially in healthcare settings when performing procedures that can generate aerosols, such as intubation or hand ventilation. For healthcare professionals caring for people with COVID‑19, the CDC recommends placing the person in an Airborne Infection Isolation Room (AIIR) in addition to using standard precautions, contact precautions, and airborne precautions.

The CDC outlines the guidelines for the use of personal protective equipment (PPE) during the pandemic. The recommended gear is a PPE gown, respirator or facemask, eye protection, and medical gloves.

When available, respirators (instead of facemasks) are preferred. N95 respirators are approved for industrial settings but the FDA has authorised the masks for use under an Emergency Use Authorisation (EUA). They are designed to protect from airborne particles like dust but effectiveness against a specific biological agent is not guaranteed for off-label uses. When masks are not available, the CDC recommends using face shields or, as a last resort, homemade masks.
ជំងឺកូរ៉ូណាវីរុស២០១៩: Mechanical ventilation

Mechanical ventilation

Most cases of COVID‑19 are not severe enough to require mechanical ventilation or alternatives, but a percentage of cases are. The type of respiratory support for individuals with COVID‑19 related respiratory failure is being actively studied for people in the hospital, with some evidence that intubation can be avoided with a high flow nasal cannula or bi-level positive airway pressure. Whether either of these two leads to the same benefit for people who are critically ill is not known. Some doctors prefer staying with invasive mechanical ventilation when available because this technique limits the spread of aerosol particles compared to a high flow nasal cannula.

Severe cases are most common in older adults (those older than 60 years, and especially those older than 80 years). Many developed countries do not have enough hospital beds per capita, which limits a health system's capacity to handle a sudden spike in the number of COVID‑19 cases severe enough to require hospitalisation. This limited capacity is a significant driver behind calls to flatten the curve. One study in China found 5% were admitted to intensive care units, 2.3% needed mechanical support of ventilation, and 1.4% died. In China, approximately 30% of people in hospital with COVID‑19 are eventually admitted to ICU.
ជំងឺកូរ៉ូណាវីរុស២០១៩: Acute respiratory distress syndrome

Acute respiratory distress syndrome

Mechanical ventilation becomes more complex as acute respiratory distress syndrome (ARDS) develops in COVID‑19 and oxygenation becomes increasingly difficult. Ventilators capable of pressure control modes and high PEEP are needed to maximise oxygen delivery while minimising the risk of ventilator-associated lung injury and pneumothorax. High PEEP may not be available on older ventilators.

Options for ARDS Therapy Recommendations High-flow nasal oxygen For SpO2 <93%. May prevent the need for intubation and ventilation Tidal volume 6mL per kg and can be reduced to 4mL/kg Plateau airway pressure Keep below 30 cmH2O if possible (high respiratory rate (35 per minute) may be required) Positive end-expiratory pressure Moderate to high levels Prone positioning For worsening oxygenation Fluid management Goal is a negative balance of 0.5–1.0L per day Antibiotics For secondary bacterial infections Glucocorticoids Not recommended
ជំងឺកូរ៉ូណាវីរុស២០១៩: Experimental treatment

Experimental treatment

Research into potential treatments started in January 2020, and several antiviral drugs are in clinical trials. Remdesivir appears to be the most promising. Although new medications may take until 2021 to develop, several of the medications being tested are already approved for other uses or are already in advanced testing. Antiviral medication may be tried in people with severe disease. The WHO recommended volunteers take part in trials of the effectiveness and safety of potential treatments.

The FDA has granted temporary authorisation to convalescent plasma as an experimental treatment in cases where the person's life is seriously or immediately threatened. It has not undergone the clinical studies needed to show it is safe and effective for the disease.
ជំងឺកូរ៉ូណាវីរុស២០១៩: បច្ចេកវិទ្យាព័ត៌មាន

បច្ចេកវិទ្យាព័ត៌មាន

In February 2020, China launched a mobile app to deal with the disease outbreak. Users are asked to enter their name and ID number. The app can detect 'close contact' using surveillance data and therefore a potential risk of infection. Every user can also check the status of three other users. If a potential risk is detected, the app not only recommends self-quarantine, it also alerts local health officials.

Big data analytics on cellphone data, facial recognition technology, mobile phone tracking, and artificial intelligence are used to track infected people and people whom they contacted in South Korea, Taiwan, and Singapore. In March 2020, the Israeli government enabled security agencies to track mobile phone data of people supposed to have coronavirus. The measure was taken to enforce quarantine and protect those who may come into contact with infected citizens. Also in March 2020, Deutsche Telekom shared aggregated phone location data with the German federal government agency, Robert Koch Institute, to research and prevent the spread of the virus. Russia deployed facial recognition technology to detect quarantine breakers. Italian regional health commissioner Giulio Gallera said he has been informed by mobile phone operators that "40% of people are continuing to move around anyway". German government conducted a 48 hours weekend hackathon with more than 42.000 participants. Two million people in the UK used an app developed in March 2020 by King's College London and Zoe to track people with COVID‑19 symptoms. Also, the president of Estonia, Kersti Kaljulaid, made a global call for creative solutions against the spread of coronavirus.
ជំងឺកូរ៉ូណាវីរុស២០១៩: Psychological support

Psychological support

Individuals may experience distress from quarantine, travel restrictions, side effects of treatment, or fear of the infection itself. To address these concerns, the National Health Commission of China published a national guideline for psychological crisis intervention on 27 January 2020.

The Lancet published a 14-page call for action focusing on the UK and stated conditions were such that a range of mental health issues was likely to become more common. BBC quoted Rory O'Connor in saying, "Increased social isolation, loneliness, health anxiety, stress, and an economic downturn are a perfect storm to harm people's mental health and wellbeing."Coronavirus: 'Profound' mental health impact prompts calls for urgent research, BBC, Philippa Roxby, April 16, 2020.Multidisciplinary research priorities for the COVID‑19 pandemic: a call for action for mental health science, The Lancet, Emily Holmes, Rory O'Connor, Hugh Perry, et al., April 15, 2020, page 1: "A fragmented research response, characterised by small-scale and localised initiatives, will not yield the clear insights necessary to guide policymakers or the public."
ជំងឺកូរ៉ូណាវីរុស២០១៩: ភាពស៊ាំ

ភាពស៊ាំ

It is unknown (as of April 2020) if past infection provides effective and long-term immunity in people who recover from the disease. Some of the infected have been reported to develop protective antibodies, so acquired immunity is presumed likely, based on the behaviour of other coronaviruses. However, cases in which recovery from COVID‑19 was followed by positive tests for coronavirus at a later date have been reported. These cases are believed to be lingering infection rather than reinfection, or false positives due to remaining RNA fragments. Some other coronaviruses circulating in people are capable of reinfection after roughly a year.
ជំងឺកូរ៉ូណាវីរុស២០១៩: ប្រវត្តិ

ប្រវត្តិ

The virus is thought to be natural and has an animal origin, through spillover infection. The actual origin is unknown, but the first known cases of infection happened in China. By December 2019, the spread of infection was almost entirely driven by human-to-human transmission. A study of the first 41 cases of confirmed COVID‑19, published in January 2020 in The Lancet, revealed the earliest date of onset of symptoms as 1December 2019. Official publications from the WHO reported the earliest onset of symptoms as 8December 2019. Human-to-human transmission was confirmed by the WHO and Chinese authorities by 20 January 2020.
ជំងឺកូរ៉ូណាវីរុស២០១៩: Infection fatality rate

Infection fatality rate

Our World in Data states that as of March 25, 2020, the infection fatality rate (IFR) cannot be accurately calculated. In February, the World Health Organization estimated the IFR at 0.94%, with a confidence interval between 0.37 percent to 2.9 percent. The University of Oxford Centre for Evidence-Based Medicine (CEBM) estimated a global CFR of 0.72 percent and IFR of 0.1 percent to 0.36 percent. According to CEBM, random antibody testing in Germany suggested an IFR of 0.37% (0.12% to 0.87%) there, but there have been concerns about false positives. Firm lower limits of infection fatality rates have been established in a number of locations. In New York City, with a population of 8.4 million, as of April 25, 16,673 (0.20% of the population) have died from COVID-19, and 20,800 (0.25% of the population) excess deaths have occurred, and in Bergamo province, where 0.57% of the population has died. To get a better view on the number of people infected initial antibody testing have been carried out, but there are no valid scientific reports based on any of them as of yet.
ជំងឺកូរ៉ូណាវីរុស២០១៩: ភាពខុសគ្នាប្រាំមួយយ៉ាង

ភាពខុសគ្នាប្រាំមួយយ៉ាង

The impact of the pandemic and its mortality rate are different for men and women. Mortality is higher in men in studies conducted in China and Italy. The higher risk for men appears in their 50s, and begins to taper off only at 90. In China, the death rate was 2.8 percent for men and 1.7 percent for women. The exact reasons for this sex-difference are not known, but genetic and behavioural factors could be a reason. Sex-based immunological differences, a lower prevalence of smoking in women, and men developing co-morbid conditions such as hypertension at a younger age than women could have contributed to the higher mortality in men. In Europe, of those infected with COVID‑19, 57% were men; of those infected with COVID‑19 who also died, 72% were men. As of April 2020, the U.S. government is not tracking sex-related data of COVID‑19 infections. Research has shown that viral illnesses like Ebola, HIV, influenza, and SARS affect men and women differently. A higher percentage of health workers, particularly nurses, are women, and they have a higher chance of being exposed to the virus. School closures, lockdowns, and reduced access to healthcare following the 2019–20 coronavirus pandemic may differentially affect the genders and possibly exaggerate existing gender disparity.
ជំងឺកូរ៉ូណាវីរុស២០១៩: Ethnic differences

Ethnic differences

In the U.S., a greater proportion of deaths due to COVID-19 have occurred among African Americans. Structural factors that prevent African Americans from practicing social distancing include their concentration in crowded substandard housing and "essential" occupations such as public transit employees and health-care workers. Greater prevalence of lacking health insurance and care and of underlying conditions such as diabetes, hypertension and heart disease also increase their risk of death. Similar issues affect Native American and Latino communities. Leaders have called for efforts to research and address the disparities.