ERS | monograph Introduction Aurelie Fabre 1 , John R. Hurst 2 and Sheila Ramjug3 @ERSpublications The COVID-19 ERS Monograph details the immense achievement of the respiratory community in this evolving area. It offers a comprehensive understanding of the virus, its pathological consequences, potential long-term sequelae, and current best practice. In March 2020, Sheila distinctly remembers sitting in a hospital lecture theatre in Lausanne, Switzerland, for a European Respiratory Society (ERS) masterclass on pulmonary vascular disease, where the course facilitator announced, “it is unfortunate that the Chinese delegates are unable to attend”. This was the last face-to-face conference Sheila attended. At the time of writing, 265 million people had been affected worldwide by the COVID-19 virus and 5.2 million people had died. At the start of the pandemic, there was an overwhelming amount of information, especially on social media, about: the different methods countries were employing to help reduce transmission of the virus asymptomatic carriers which countries had the lowest rates of morbidity and mortality and the best strategies to help manage patients with COVID-19. For clinicians, in the initial stages of the pandemic, it seemed very unnatural to be relying solely on supportive measures, without evidence-based, disease-modifying interventions. There was an eagerness for knowledge and to be informed of other health professionals’ experiences with this unknown entity. This Monograph is a reflection of the immense work the respiratory and wider medical community has achieved in this ever-evolving area. It aims to give the reader a comprehensive understanding of the virus itself, its pathological consequences, current best clinical practice, and the potential long-term consequences not only for the patient but for society as a whole, concluding with strategies to combat the virus. The first section of the Monograph explores the history of coronavirus [1], the virus itself [2], its effects upon the immune system [3] and the pathological consequences of infection [4]. Coronaviruses are a common cause of upper respiratory tract infections, particularly in children. Historically though, it was not until 2002 (with SARS-CoV-1) and again in 2012 (with MERS) that the virus developed severe and potentially lethal capabilities. The COVID-19 virus is a positive-sense, single-stranded RNA virus. Both the innate and adaptive immune system are affected by the virus, but it is an impaired host immune response that is Copyright ©ERS 2021. Print ISBN: 978-1-84984-148-1. Online ISBN: 978-1-84984-149-8. Print ISSN: 2312-508X. Online ISSN: 2312-5098. Correspondence: Sheila Ramjug ( 1 Dept of Histopathology, St Vincent’s University Hospital and School of Medicine, University College Dublin, Dublin, Ireland. 2 Centre for Inflammation and Tissue Repair, University College London, London, UK. 3 Respiratory Medicine, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK. ix
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