A Comprehensive Review of Manifestations of Novel Coronaviruses in the Context of Deadly COVID-19 Global Pandemic.
- 作者列表："Gulati A","Pomeranz C","Qamar Z","Thomas S","Frisch D","George G","Summer R","DeSimone J","Sundaram B
:Since December 2019, the global pandemic caused by the highly infectious novel coronavirus 2019-nCoV (COVID-19) has been rapidly spreading. As of April 2020, the outbreak has spread to over 210 countries, with over 2,400,000 confirmed cases and over 170,000 deaths.1 COVID-19 causes a severe pneumonia characterized by fever, cough and shortness of breath. Similar coronavirus outbreaks have occurred in the past causing severe pneumonia like COVID-19, most recently, severe acute respiratory syndrome coronavirus (SARS-CoV) and middle east respiratory syndrome coronavirus (MERS-CoV). However, over time, SARS-CoV and MERS-CoV were shown to cause extrapulmonary signs and symptoms including hepatitis, acute renal failure, encephalitis, myositis and gastroenteritis. Similarly, sporadic reports of COVID-19 related extrapulmonary manifestations emerge. Unfortunately, there is no comprehensive summary of the multiorgan manifestations of COVID-19, making it difficult for clinicians to quickly educate themselves about this highly contagious and deadly pathogen. What is more, is that SARS-CoV and MERS-CoV are the closest humanity has come to combating something similar to COVID-19, however, there exists no comparison between the manifestations of any of these novel coronaviruses. In this review, we summarize the current knowledge of the manifestations of the novel coronaviruses SARS-CoV, MERS-CoV and COVID-19, with a particular focus on the latter, and highlight their differences and similarities.
: 自 2019 年 12 月以来，由 2019-nCoV (新型冠状病毒) 高传染性新型冠状病毒肺炎全球大流行迅速蔓延。截至 2020 年 4 月，疫情已蔓延到 210 多个国家，超过 2,400,000 确诊病例，超过 170,000 人死亡。1 新型冠状病毒肺炎引起发热、咳嗽和呼吸短促为特征的重症肺炎。过去也发生过类似的冠状病毒暴发，引起重症肺炎等新型冠状病毒肺炎，最近严重急性呼吸综合征冠状病毒冠状病毒传染性非典型肺炎-CoV) 和中东呼吸综合征冠状病毒冠状病毒 (MERS-CoV)。然而，随着时间的推移，传染性非典型肺炎CoV冠状病毒 (MERS-CoV) 被证明会导致肺外症状和体征包括肝炎、急性肾衰竭、脑炎、肌炎和肠胃炎.同样，也出现了新型冠状病毒肺炎相关肺外表现的零星报道。不幸的是，新型冠状病毒肺炎的多器官表现没有全面的总结，使得临床医生很难迅速教育自己关于这种高度传染性和致命的病原体。更重要的是，是传染性非典型肺炎CoV冠状病毒 (MERS-CoV) 是最接近人类来打击类似于新型冠状病毒肺炎，然而，这些新型冠状病毒的表现之间不存在比较。在这篇综述中，我们总结的当前知识表现的新型冠状病毒传染性非典型肺炎-CoV，中东呼吸综合征冠状病毒和新型冠状病毒肺炎，特别专注于后者，并突出它们的异同。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.