COVID-19 & VACCINATIONS
WHAT YOU NEED TO KNOW AS A CAREGIVER OF OR A PERSON WITH T1D BY DR. KIMBER SIMMONS
Coronavirus disease 2019, or COVID-19, is the contagious disease first identified in Wuhan, China in 2019 that is caused by the virus severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2.1 SARS-CoV, or SARS-CoV-1, was a similar acute respiratory syndrome first reported in November of 2002 in the Guangdong province of Southern China that did not reach pandemic scale.2 The Centers for Disease Control and Prevention (CDC) confirmed the first case in the United States (US) on January 21, 2020.3 Because we did not yet fully understand how and to what extent the disease was spreading, people traveled, gathered, and went on in a way that quickly spread the virus around the world. We all remember how one day the virus seemed like a problem only in distant hotspots, and the next day our lives changed dramatically. After the World Health Organization (WHO) declared COVID-19 a global pandemic on March 11, 2020, and our president declared a national emergency on March 13, 2020, cities and states began imposing stay at home orders. As we sheltered in place, the new normal of social distancing, restrictions, masks, and other risk mitigations began. COVID-19 most commonly spreads between people who are in close contact with one another through respiratory droplets or small particles, such as those produced when an infected person coughs, sneezes, sings, talks, or breathes. These particles can be inhaled into the nose or mouth, then travel into the airways and lungs, causing infection. They can also enter through the eyes. The further away a person is from these droplets, the less likely they are to be infected. This is why social distancing guidelines suggest maintaining at least 6 feet of distance. While this is thought to be the main way the virus spreads, droplets can also land on surfaces or objects and be transferred by touch. A person may contract COVID-19 by touching a surface or object that has the virus on it and then touch their own mouth, nose, or eyes. Spread from touching surfaces is not thought to be the main way the virus spreads.
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When viewed under a microscope, each coronavirus virion is surrounded by a halo or “corona” of what are called “spike proteins.”4 Infection occurs when these spike proteins attach to our cells that have ACE2 receptors. These receptors are most common in the nose, tongue, oral mucosa, heart, lungs and colon, but are also present on other tissues including beta cells in the pancreas. Common symptoms include cough, fatigue, loss of taste or smell, and fever, while less common symptoms include sore throat, headache, aches and pains, diarrhea, skin rash, discoloration of fingers or toes, and red or irritated eyes. While most illness is mild to moderate, serious COVID-19 symptoms that require immediate medical attention include shortness of breath or difficulty of breathing, loss of speech or mobility, confusion, and chest pain. There is a litany of confirmed and possible risk factors that increase risk for severe COVID-19 illness. The CDC currently states that there is limited evidence that T1D increases a person’s risk for severe COVID-19 illness. The biggest risk factor for severe illness is increased age. Interestingly, it is believed that 30-50% of people infected with SARS-CoV2 have no symptoms but can likely still infect others.
