- 作者列表："Ren LL","Wang YM","Wu ZQ","Xiang ZC","Guo L","Xu T","Jiang YZ","Xiong Y","Li YJ","Li XW","Li H","Fan GH","Gu XY","Xiao Y","Gao H","Xu JY","Yang F","Wang XM","Wu C","Chen L","Liu YW","Liu B","Yang J","Wang XR","Dong J","Li L","Huang CL","Zhao JP","Hu Y","Cheng ZS","Liu LL","Qian ZH","Qin C","Jin Q","Cao B","Wang JW
BACKGROUND:Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans. METHODS:We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Wuhan Jinyintan Hospital, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed. RESULTS:Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown β-CoV strain in all five patients, with 99.8% to 99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6% to 87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor. CONCLUSION:A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.
背景: 人类感染人畜共患冠状病毒 (CoVs)，包括严重急性呼吸道症候群 (传染性非典型肺炎) CoV中东呼吸综合征-CoV，引起了公众极大的健康问题在全球范围内.在此，我们报道了一种引起人类严重和致死性肺炎的新型蝙蝠源CoV。 方法: 收集湖北省武汉市金银滩医院 5 例重症肺炎患者的临床资料和支气管肺泡灌洗 (BAL) 标本。提取BAL的核酸并进行新一代测序。进行了病毒分离，构建了最大似然系统进化树。 结果: 2019 年 12 月 18 日至 12 月 29 日住院的 5 例患者出现发热、咳嗽、呼吸困难，伴有急性呼吸窘迫综合征并发症。胸片显示弥漫性混浊和实变。其中一名患者死亡。序列结果显示，在所有 5 例患者中存在一种以前未知的 β-CoV菌株，分离株中有 99.8% ~ 99.9% 个核苷酸同源性。这些菌株显示出 79.0% 的核苷酸同一性的序列的传染性非典型肺炎冠状病毒 (GenBank NC_004718) 和 51.8% 同一性的序列的中东呼吸综合征冠状病毒 (GenBank NC_019843).该病毒在系统发育上最接近蝙蝠传染性非典型肺炎样冠状病毒 (SL-ZC45，GenBank MG772933)，具有 87.6% 至 87.7% 个核苷酸同源性，但处于单独的分支中。此外，这些病毒具有单一完整的开放阅读框基因 8，作为bat起源CoVs的进一步指标。然而，暂定受体结合域的氨基酸序列与传染性非典型肺炎-CoV相似，表明这些病毒可能使用相同的受体。 结论: 发现了一种新的蝙蝠传播的冠状病毒，它与人类严重和致命的呼吸道疾病有关。
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.