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====== SARS-CoV-2 ======


SARS-CoV-2, commonly known as Covid-19, is a novel coronavirus first identified in Wuhan, China in late 2019. It is a member of the family of coronaviruses that includes Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). The virus is thought to have originated in bats, and is spread mainly through close contact with an infected person through respiratory droplets, such as sneezing and coughing. There is open scientific discussion as to whether the virus may have escaped from a research lab.
[(ResearchRef1>>
title: Molecular Biology Clues Portray SARS-CoV-2 as a Gain-of-Function Laboratory Manipulation of Bat CoV RaTG13
url: https://pubs.acs.org/doi/10.1021/acsmedchemlett.1c00274
)]
[(ResearchRef2>>
title: The shifting sands of ‘gain-of-function’ research. The mystery of COVID’s origins has reignited a contentious debate about potentially risky studies and the fuzzy terminology that describes them.
url: https://www.nature.com/articles/d41586-021-02903-x
)]
[(RicercaRif3>>
title: A SARS-like cluster of circulating bat coronaviruses shows potential for human emergence
url: https://www.nature.com/articles/nm.3985
)]

The symptoms of Covid-19 vary from mild to severe, and can include fever, cough, and shortness of breath. In more severe cases, the infection can lead to pneumonia, severe acute respiratory syndrome, kidney failure, and even death. Several treatments and prevention measures that can help patients to recover faster in case of infection are currently available. It is important that a correct home therapy is begun as soon as possible, under the supervision of competent doctors, this makes a lot of difference to avoid complications. 
[(HomeTherapy2Ref>>
title: Covid: how is home care going in Piedmont
url: https://www.regione.piemonte.it/web/pinforma/notizie/covid-come-vanno-cure-domiciliari-piemonte
)]
[(HomeTherapyRef>>
title: Covid 19 Home Therapy
url: https://www.terapiadomiciliarecovid19.org/
)]

The World Health Organization declared Covid-19 a pandemic on March 11, 2020. Since then, the virus has spread rapidly, resulting in over 20 million confirmed cases. In countries where this new disease was not cured correctly and in a timely manner many thousands of people died.

Scientific studies have confirmed that in countries or regions where vitamin D levels in the population are good the severity of symptoms is very low. So this is suggested to public authority as the first way of prevention to be adopted.
[(VitD1Ref>>
title: Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths
url: https://www.mdpi.com/2072-6643/12/4/988
)]
[(VitD2Ref>>
title: The Impact of Vitamin D Deficiency on the Severity of Symptoms and Mortality Rate among Adult Patients with Covid-19: A Systematic Review and Meta-Analysis
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8793953/
)]
[(VitD3Ref>>
title: The Role of Vitamin D in Suppressing Cytokine Storm in COVID-19 Patients and Associated Mortality
url: https://doi.org/10.1101/2020.04.08.20058578
)]
[(NutrientsRef>>
title: Does Evidence Exist to Blunt Inflammatory Response by Nutraceutical Supplementation during COVID-19 Pandemic? An Overview of Systematic Reviews of Vitamin D, Vitamin C, Melatonin, and Zinc 
url: https://www.mdpi.com/2072-6643/13/4/1261
)]

This virus, as other coronaviruses, has a high rate of mutations, so during time many variants of the virus have been classified and for this reason the epidemy had several waves.

Co-infection led in early 2023 to 251 recombinant lineages, with XBB prevailing. XBB.1 and XBB.1.5 caused a surge in COVID-19 cases in Maharashtra, India. A highly transmissible XBB.1.16 sub-lineage with specific spike mutations was identified, explaining the outbreak. 
[(ArcturusRef>>
title: Chasing SARS-CoV-2 XBB.1.16 Recombinant Lineage in India and the Clinical Profile of XBB.1.16 cases in Maharashtra, India
url: https://www.medrxiv.org/content/10.1101/2023.04.22.23288965v1.full-text
)]

These variants completely escape antibodies obtained from artificial immunization, but usually the illness is very mild, when the immune system is efficient. As with flu or Omicron it can be useful, to have faster recovery, the intake of natural supplements like vit C, vit D and N-acetylcysteine. 
[(VC>>
title: Role of vitamin C in preventing of COVID-19 infection, progression and severity
url: http://www.aimspress.com/article/doi/10.3934/microbiol.2022010
)]
[(VD>>
title: Does vitamin D level have effect on COVID-19 outcomes?
url: http://www.aimspress.com/article/doi/10.3934/medsci.2023012
)]
[(VD2>>
title: The Role of Vitamin C, Vitamin D, and Selenium in Immune System against COVID-19
url: https://www.mdpi.com/1420-3049/25/22/5346
)]
[(NacRef>>
title: N-acetylcysteine for prevention and treatment of COVID-19: Current state of evidence and future directions
url: https://pubmed.ncbi.nlm.nih.gov/36410267/
)]

The advice of the family doctor is to be asked, choosing a good doctor. In 2023 more and more doctors are conscius that vaccination can bring problems like negative protection, headache, myocarditis, thrombosis, chronic fatigue or Bell's palsy to name some of the most often detected issues.
[(NegProt>>
title: Waning of vaccine effectiveness against moderate and severe covid-19 among adults in the US from the VISION network: test negative, case-control study
url: https://www.bmj.com/content/bmj/379/bmj-2022-072141.full.pdf
)]
[(AdvRef00>>
title: Spectrum of neurological complications following COVID-19 vaccination
url: https://link.springer.com/article/10.1007/s10072-021-05662-9
)]
[(AdvRef>>
title: Adverse events following administration of COVID-19 vaccines in Saudi Arabia
url: https://www.nature.com/articles/s41598-022-23471-8
)]
[(AdvRef02>>
title: Invisibili, the documentary about adverse reactions in Italy
url: https://rumble.com/v1zjboe-invisible-the-documentary-that-everyone-must-see.html
)]
 So the doctors who are up to date will in most cases suggest other ways of prevention, first of all checking that the patient has sufficient levels of vitamin D. This is one of the most important things that makes the real difference.
In fact patients with acceptable levels of vitamin (≥40 ng/mL) were 14 times less likely to have severe or critical disease than patients with insufficient levels (<20 ng/mL).
[(VD3>>
title: Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness
url: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0263069
)] Ask your doctor to read these studies in the case he is not yet aware of them. 

^ Name      ^Genetic lineage	^ First outbreak       ^ Date         ^
| Type A | A | China |  |
| Type B | B | China, Hubei, Wuhan | December 2019 |
| Alpha | B.1.1.7 | United Kingdom | September 2020 |
| Beta | B.1.351 | South Africa | May 2020 |
| Gamma | B.1.1.28.1 | Brazil | November 2020 |
| Delta | B.1.617.2 | India | Octoer 2020 |
| Omicron | B.1.1.529 | South Africa | November 2021 |
| Gryphon | XBB | USA | December 2022 |
| Kraken | XBB.1.5 | USA | December 2022 |
| Arcturus | XBB.1.16 | India | March 2023 |
| Eris | EG.5 | China | August 2023 |

Currently the older strains do not circulate anymore because they have been replaced by Omicron variants and derived descendents, for example Arcturus, which are milder and have higher contagiousness, also among people that received artificial immunization, because of the high pace of mutation of the virus. These new variants have a big evolutionary advantage compared to the original version of the virus. 
 
A Danish cohort study demonstrates that breakthrough infections can not be avoided. Artificial overstimulation of the immune system with older strains can even lead to negative protection, aftern some months, when new variants emerge.
[(ArtificialImmunizationRef1>>
author: Christian Holm Hansen, Astrid Blicher Schelde, Ida Rask Moustsen-Helm, Hanne-Dorthe Emborg, Tyra Grove Krause, Kåre Mølbak, Palle Valentiner-Branth
title: Vaccine effectiveness against SARS-CoV-2 infection with the Omicron or Delta variants following a two-dose or booster BNT162b2 or mRNA-1273 vaccination series. 
url: https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v2
)]

A new study on mice confirmed that repeated artificial immunization overturned the protective immune memories by promoting adaptive immune tolerance. This means that there can be risks with the continuous use of artificial immunization boosters.
[(ArtificialImmunizationRef2>>
url:https://www.cell.com/iscience/fulltext/S2589-0042(22)01751-5
title: Extended SARS-CoV-2 RBD booster vaccination induces humoral and cellular immune tolerance in mice
)]

It has been demonstrated that that natural immunity given by healing confers longer lasting and stronger protection against future infection and symptomatic disease. [(ArtificialImmunizationRef3>>
author: Sivan Gazit, Roei Shlezinger, Galit Perez, Roni Lotan, Asaf Peretz, Amir Ben-Tov, Dani Cohen, Khitam Muhsen, Gabriel Chodick, Tal Patalon
title: Comparing SARS-CoV-2 natural immunity to vaccine-induced immunity: reinfections versus breakthrough infections
url: https://doi.org/10.1101/2021.08.24.21262415
)]

Current Omicron variants cause much fewer risks than Delta strains, with symptoms that generally remain in the upper respiratory tract. Currently Omicron infection is less dangerous than seasonal influenza. [(ComparisonToFluRef>>
note-text : Infectivity versus fatality of SARS-CoV-2 mutations and influenza.
url       : https://doi.org/10.1016/j.ijid.2022.05.031
)] 

It is becoming apparent that the excess risk of serious adverse events following artificial immunization (more then 10 people affected every 10'000), does outweight the risk reduction for COVID-19 hospitalization relative to the placebo group (less then 7 people affected every 10'000). It is recommended then that other strategies should be followed by public institutions, after carrying out a correct risk-benefit analysis. [(DoshiRef>>
title: Serious adverse events of special interest following mRNA COVID-19 vaccination in randomized trials in adults
url: https://www.sciencedirect.com/science/article/pii/S0264410X22010283
)]
An increased risk of autoimmune antibodies and autoinflammatory mechanisms has been found. [(MariaCristinaRef>>
title: The Induction of De Novo Autoimmune Biomarkers Production in Healthcare Professionals Vaccinated with BNT162b2
url: https://www.scitcentral.com/article.php?journal=62&article=2741
)]

A high percentage of the world population has currently aquired natural immunization after encountering one or more variants of the virus, therefore it can be considered that this type of infection has become endemic like traditional flu and will be recurrent in the following years. Omicron has worked as a natural immunizer and this is helping to reach herd immunity. 
[(HerdRef>>
title: Calls to end Covid measures as top German virologist declares pandemic 'over'
url: https://www.thelocal.de/20221227/calls-for-end-to-covid-measures-as-top-german-virologist-declares-pandemic-over
)]

Natural way for preventing severe illness are now known, first of all the fact that population can receive a sufficient level of vitamin D from the sun and/or through supplementation.
[(:VitD1Ref)] [(:VitD2Ref)] [(:VitD3Ref)] [(:NutrientsRef)] 

Currently there is also a lot of experience in the medical community regarding correct treatment of patients. 
[(ShangaiRef>>
title: Shanghai Expert Consensus on Comprehensive Treatment of Coronavirus 2019 Disease
url: https://www.omnipedia.net/en/shanghai-expert-consensus-on-comprehensive-treatment-of-coronavirus-2019-disease
)]
[(
SuterRemuzziRef>>
title: A simple, home-therapy algorithm to prevent hospitalisation for COVID-19 patients: A retrospective observational matched-cohort study
url: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00221-2/fulltext
)]
[(NacVsPacRef>>
url: https://www.frontiersin.org/files/Articles/579944/fphar-11-579944-HTML/image_m/fphar-11-579944-g001.jpg
title: Paracetamol-Induced Glutathione Consumption: Is There a Link With Severe COVID-19 Illness?
Piero Sestili, Carmela Fimognari
)]
[(:HomeTherapyRef)]
[(Piemonte1Ref>>
title: The home care protocol for Covid has been updated
url: https://www.regione.piemonte.it/web/pinforma/notizie/aggiornato-protocollo-delle-cure-casa-per-covid
)]




 



===== References =====

~~REFNOTES~~

====== SARS-CoV-2 ======

SARS-CoV-2, ofte konata kiel Covid-19, estas nova koronavirus unue identigita en Vuhano, Ĉinio fine de 2019. Ĝi estas membro de la familio de koronavirusoj, kiu inkluzivas Mezorientan Spiran Sindromon (MERS-CoV) kaj Severan Akutan. Spira Sindromo (SARS-CoV). La viruso supozeble originis de vespertoj, kaj estas disvastigita plejparte per proksima kontakto kun infektita persono tra spiraj gutetoj, kiel ekzemple terno kaj tusado. Estas malferma scienca diskuto ĉu la viruso eble eskapis el esplorlaboratorio.
[(EsploroRef1>>
title: Molekulaj Biologiaj Indikoj Portregas SARS-CoV-2 kiel Gajno-de-Funkcia Laboratorio Manipulado de Vesperto CoV RaTG13
url: https://pubs.acs.org/doi/10.1021/acsmedchemlett.1c00274
)]
[(EsploroRef2>>
title: La ŝanĝiĝantaj sabloj de 'gajno-de-funkcio' esplorado. La mistero de la originoj de COVID reŝaltis disputigan debaton pri potenciale riskaj studoj kaj la malklara terminologio kiu priskribas ilin.
url: https://www.nature.com/articles/d41586-021-02903-x
)]
[(RicercaRif3>>
title: A SARS-like cluster of circulating bat coronaviruses shows potential for human emergence
url: https://www.nature.com/articles/nm.3985
)]

La simptomoj de Covid-19 varias de mildaj al severaj, kaj povas inkluzivi febron, tuson kaj spirmankon. En pli severaj kazoj, la infekto povas konduki al pulminflamo, severa akra spira sindromo, rena malsukceso kaj eĉ morto. Pluraj traktadoj kaj preventaj mezuroj kiuj povas helpi pacientojn resaniĝi pli rapide en kazo de infekto estas nuntempe haveblaj. Gravas, ke ĝusta hejma terapio estas komencita kiel eble plej baldaŭ, sub la superrigardo de kompetentaj kuracistoj, tio faras multe da diferenco por eviti komplikaĵojn.
[(Hejmterapio2Ref>>
title: Covid: kiel iras hejma prizorgado en Piemonto
url: https://www.regione.piemonte.it/web/pinforma/notizie/covid-come-vanno-cure-domiciliari-piemonte
)]
[(HejmterapioRef>>
title: Covid-19 Hejma Terapio
url: https://www.terapiadomiciliarecovid19.org/
)]

La Monda Organizo pri Sano deklaris Covid-19 pandemio la 11-an de marto 2020. Ekde tiam, la viruso rapide disvastiĝis, rezultigante pli ol 20 milionojn da konfirmitaj kazoj. En landoj, kie ĉi tiu nova malsano ne estis kuracita ĝuste kaj ĝustatempe multaj miloj da homoj mortis.

Sciencaj studoj konfirmis, ke en landoj aŭ regionoj, kie la manko de vitamino D en la loĝantaro estas ĝeneraligita, la severeco de simptomoj kaj mortoprocento estis la plej alta.
[(VitD1Ref>>
title: Indico, ke Vitamino D Suplemento Povus Redukti Riskon de Gripo kaj COVID-19-Infektoj kaj Mortoj
url: https://www.mdpi.com/2072-6643/12/4/988
)]
[(VitD2Ref>>
title: La Efiko de Vitamino D-Manko sur la Severeco de Simptomoj kaj Morteco Inter Plenkreskaj Pacientoj kun Covid-19: Sistema Revizio kaj Metaanalizo
url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8793953/
)]
[(VitD3Ref>>
title: La Rolo de Vitamino D en Subpremado de Citokino Ŝtormo en COVID-19-Pacientoj kaj Rilata Morteco
url: https://doi.org/10.1101/2020.04.08.20058578
)]
[(NutrajojRef>>
title: Ĉu Indico Ekzistas por Malakrigi Inflaman Respondon per Nutraceŭtika Suplemento dum COVID-19 Pandemio? Superrigardo de Sistemaj Recenzoj de Vitamino D, Vitamino C, Melatonino kaj Zinko
url: https://www.mdpi.com/2072-6643/13/4/1261
)]

Ĉi tiu viruso, kiel aliaj koronavirusoj, havas altan indicon de mutacioj, do dum tempo la sekvaj variaĵoj de la viruso estis klasifikitaj. Tial la epidemio havis plurajn ondojn:

^ Nomo ^ Genetika genlinio ^ Unua ekapero ^ Dato ^
| Tipo A | A | Ĉinio | |
| Tipo B | B | Ĉinio, Hubejo, Wuhan | Decembro 2019 |
| Alfa | B.1.1.7 | Unuiĝinta Reĝlando | Septembro 2020 |
| Beta | B.1.351 | Sudafriko | Majo 2020 |
| Gamo | B.1.1.28.1 | Brazilo | Novembro 2020 |
| Delta | B.1.617.2 | Barato | Oktobro 2020 |
| Omikrono | B.1.1.529 | Sudafriko | Novembro 2021 |