translated from Spanish: Coronavirus: seven big questions we still need to answer

Just a few months ago, we didn’t even know coronavirus existed, but thanks to some quick studies and data collected from millions of patients scientists were able to find out a lot about how the disease works and how it spreads across a population. However, many important questions remain unanswered.

How many people have already been infected with COVID-19?
For some people, getting coronavirus will feel a bit like a mild cold and others may not even show symptoms at all. For others, it’s a death sentence. At best, official figures from around the world count hospital admissions and deaths; but that leaves many cases of coronavirus undetected. Even places where mass testing is done do not give a completely accurate picture of how much the virus spread. The only way we’ll know is through antibody tests, a type of test that verifies, from a blood sample, whether our body has produced antibodies to the coronavirus, which would prove that we had the disease.How much transmission is asymptomatic?
Another issue with asymptomatic people has to do with the transmission of the virus. A study published in the journal Science estimated that up to 86% of cases could become undocumented as they have few or no symptoms. The only way to know is through widespread antibody tests, which are still far away. 
Does the infection give you lasting immunity?
When a virus first enters the body, it produces an immune response; that is, antibodies that will reject the virus for the body to recover and, in some cases, maintain immunity. But the body remembers how to fight some viruses better than others, so it’s unlikely, for example, that you get chickenpox twice in your life but the common cold twice a year. Of the virus that causes COVID-19, on the other hand, being relatively new and still in the stage of containing the pandemic, there was not enough time for scientists to understand for how long the immune system can remember it. It will take time, and multiple studies, to really understand if patients are immune after recovering from the virus and for how long.

Why do some people get so sick more than others?
Several studies sought to determine the risk factors for COVID-19. An analysis of 201 patients, published in the journal JAMA Internal Medicine, found that advanced age was one of the main factors of acute respiratory distress and death in coronavirus patients. Another study published in The Lancet estimated that the coronavirus mortality rate was 1.4% in children under 60 and 4.5% in older people over 60, showing that although older people are more likely to die with the disease, it does not mean that younger people will not. And even within age groups, there is a large variation in the severity of symptoms where genetic variations could increase the severity of the disease in some patients.What long-term effects cause COVID-19?
According to a report published in the journal Radiology on 70 patients who had survived the coronavirus, 66 had visible lung damage on CT scans. In turn, a study of 214 patients in Wuhan found that 36.4% had neurological symptoms such as headaches, dizziness and hallucinations. But it’s unclear what lasting effects these symptoms can have. In addition, another research in China that examined the blood of people had infection showed that this may have an impact on the heart and liver functions of some patients. While these findings are worrying, it will be necessary to study much larger groups in order to draw accurate conclusions.

According to doctors, those recovering from coronavirus may be left with reduced lung function.

Will there be a second wave?
Some say that a second wave is inevitable while others predict that the coronavirus will last up to two years and will come in a series of waves, such as the Spanish influenza pandemic of 1918, which occurred in three waves, the second being the deadliest. However, as with all predictions, models and speculations, it is impossible to know for sure whether there will be a second wave, how important it will be and the impact it will have.
Children are known to be great propagators of other viruses, such as the common cold and flu. But the vast majority of coronavirus cases in hospitals are adults. And while a study in China showed that children are rarely diagnosed with the virus, suggesting an unsuscient role in the spread of the disease, once again, there have not been enough studies or we have sufficient data on whether children, when returning to school, for example, could significantly accelerate the spread of coronavirus. In this note:

Original source in Spanish

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