[deanhills]

Yesterday when I was listening to an interview with a scientist from China on the Corona Virus, discovered that quite a number of scientific papers have been published.  I thought the one below is very interesting.  Particularly for a complete different way of testing with CT for the internal organs.  But for me the greatest value of this paper are the references at the end which include almost every single paper that has been published yet:
https://osf.io/preprints/metaarxiv/fu9p8/

Up to now I think most of us - through the media - have been focusing on the lungs.  The above paper focuses on the colon and pancreas as the most important area for investigation during early stages of the virus.  Reminds me of an interview I saw on an International China Channel with a Dr. Zhang in Wuhan Province.  She said two of their earliest cases didn't show any symptoms.  However they were tested as they were family of a person who had serious symptoms.  However, they then decided to test the two cases on a deeper level and a CT scan was taken when the virus showed up in serious developed stage in the colon and pancreas.  

So maybe the tests we get are really mickey mouse tests.  The tests can't pick up asymptomatic cases that could have been seen with a CT scan.  We have people moving around with the virus and passing it on, who don't show symptoms but are carriers of the virus.

The study also suggests that 14 days quarantine is not enough.  It should be a minimum of 21 days.  And once the person has recovered, they are shedding the virus even when they have been tested negative.  They should be under quarantine for at least 37 days after they have recovered from the virus.

Early identification of Covid-19 asymptomatic individuals is the biggest challenge faced globally. This study recommends a longer quarantine period of 18 – 21 days instead of 14 days. Furthermore due to further viral shedding of survived individuals, actual full recovery period should extend up to 37 days. Shedding can be further monitored by testing stools, sweat and hair follicles. Another major way of disease spread is via excretion of urine and faeces. Proper hygiene practice and sanitary issues in poor countries need attention as Covid-19 virus indicates prolong survival period in the human excretory system.

Above biochemical investigations first should focus on families with infected individuals. Individuals with underline health issues and older generation need priority of testing.

Recommendations
The following biochemical and physical investigations can be suggested to identify the early onset of the disease
1. Mean Platelet Volume (MPV)
Indicator of thrombocytic activity, has been investigated in various proinflammatory and prothrombotic clinical states. Positive correlation between MPV and liver and pancreatic enzymes.
2. Platelet Activation Factor (PAF)
Serves as a primary mediator of inflammation in the pathogenesis pancreas and PAF contributes to local tissue damage and bleeding.
3. Serum Amylase
Inflammatory process associated with tissue damage of pancreas
4. Serum Lipase
Inflammatory process associated with tissue damage of pancreas
5. Trypsin Activation Peptide (TAP)
TAP activity increases early in the course of the pancreatic changes and attains maximal value within 24–48 hours.
6. Pancreatic Bicarbonate
Pancreatic secretion for acid balancing. May indicate cellular changes in pancreas.
7. Vasodilator Intestinal Peptide (VIP)
Concentration of this peptide (VIP) of ACE2 pathway determine specially with diarrhea patients for intestinal cellular damage.
8. Serum Angiotensin Level Effector peptide of Angiotensin II for pathogenesis of pancreas
9. Abdominal Investigations
1. contrast enhanced computed tomography (CECT) 2. magnetic resonance imaging (MRI) Observation of pancreatic, spleen and gastrointestinal tissue changes specifically hemorrhage within the tissues.