COVID-19 Pandemic

COVID-19 Pandemic

On 30 December 2019, a report of a cluster of pneumonia of unknown etiology was published on ProMED-mail, possibly related to contact with a seafood market in WuhanChina 1).

Hospitals in the region held an emergency symposium, and support from federal agencies is reportedly helping to determine the source of infection and causative organism. The seafood market has since been closed, but purportedly sold a variety of live animal species. On 5 January 2019, the World Health Organization (WHO) published a document outlining their request for more information from Chinese public health authorities and detailed 44 patients had ‘pneumonia of unknown etiology’, with 121 close contacts under surveillance (www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/). The WHO reported that 11 patients were severely ill, and many affected individuals had contact with the Huanan Seafood market. Some patients were reported to have feverdyspnea and pulmonary infiltrates on chest radiography 2).

It was declared a public health emergency of international concern on Jan 30, 2020, by WHO 3).

By early January, terms like “the new coronavirus” and “Wuhan coronavirus” were in common use. On February 11, 2020, a taxonomic designation “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2) became the official means to refer to the virus strain, that was previously termed as 2019-nCoV and Wuhan coronavirus. Within a few hours on the same day, the WHO officially renamed the disease as COVID-19.

The infection spread quickly and was declared a pandemic by the World Health Organization (WHO) on March 11, 2019 4).

By March 30, more than 782 365 confirmed cases were reported and a third of the world population were living in confinement to try to contain the virus 5).

Epidemiology

COVID-19 Epidemiology

Etiology

COVID-19 has high homology to other pathogenic coronaviruses, such as those originating from bat-related zoonosis (SARS-CoV), which caused approximately 646 deaths in China at the start of the decade.

The COVID-19 generally had a high reproductive number, a long incubation period, a short serial interval and a low case fatality rate (much higher in patients with comorbidities) than SARS and MERS. Clinical presentation and pathology of COVID-19 greatly resembled SARS and MERS, with less upper respiratory and gastrointestinal symptoms, and more exudative lesions in post-mortems. Potential treatments included remdesivir, chloroquine, tocilizumab, convalescent plasma and vaccine immunization (when possible) 6).

Transmission

COVID-19 Transmission.

COVID-19 virus genome

The complete genome of SARS-CoV-2 from Wuhan, China was submitted on January 17, 2020 in the National Center for Biotechnology 7) (NCBI) database, with ID NC_045512. The genome of SARS-CoV-2 is a 29,903 bp single-stranded RNA (ss-RNA) coronavirus. It has now been shown that the virus causing COVID-19 is a SARS-like coronavirus that had previously been reported in bats in China.

COVID-19 and central nervous system

COVID-19 and central nervous system.

Essential care of critical illness

Essential care of critical illness must not be forgotten in the COVID-19 pandemic 8).

COVID-19 for neurologists

COVID-19 for neurologists.

COVID-19 for Neurosurgeons

see COVID-19 for neurosurgeons.

COVID-19 in Spinal Disorders

Effects of the COVID-19 Pandemic on the Management of Spinal Disorders.

COVID-19 for Vascular surgeons

see COVID-19 for Vascular surgeons.

COVID-19 for Dermatologists

COVID-19 for Dermatologists.

COVID-19 for Gastroenterologists

COVID-19 for Gastroenterologists

COVID-19 for Pediatricians

COVID-19 for Pediatricians

COVID-19 for Psychiatrists

COVID-19 for Psychiatrists.

COVID-19 for Oncologists

COVID-19 for Oncologists.

COVID-19 for Otolaryngologists

COVID-19 for Otolaryngologists.

COVID-19 for Cardiologists

COVID-19 for Cardiologists.

COVID-19 for Gynecologists

COVID-19 for Gynecologists.

Diagnosis

COVID-19 Diagnosis.

Treatment

COVID-19 Treatment.

Palliative Care

COVID-19 Palliative Care.

Prevention

COVID-19 Prevention.

Operating room preparation for COVID-19

see Operating room preparation for COVID-19.

Telemedicine in the COVID-19 era

see Telemedicine in the COVID-19 era.

Outcome

COVID-19 Outcome.

Case reports

2019 novel coronavirus infection in a three-month-old baby 9).


3 cases of SARS-CoV-2 infected children diagnosed from February 3 to February 17, 2020 in Tianjin, China. All of these three cases experienced mild illness and recovered soon after treatment, with the nucleic acid of throat swab turning negative within 14, 11, 7 days after diagnosis respectively. However, after been discharged, all the three cases were tested SARS-CoV-2 positive in the stool samples within 10 days, in spite of their remained negative nucleic acid in throat swab specimens. Therefore, it is necessary to be aware of the possibility of fecal-oral transmission of SARS-CoV-2 infection, especially for children cases 10).


Lv et al. reported the dynamic change process of target genes by RT-PCR testing of SARS-Cov-2 during the course of a COVID-19 patient: from successive negative results to successive single positive nucleocapsid gene, to two positive target genes (orf1ab and nucleocapsid) by RT-PCR testing of SARS-Cov-2, and describe the diagnosis, clinical course, and management of the case. In this case, negative results of RT-PCR testing was not excluded to diagnose a suspected COVID-19 patient, clinical signs and symptoms, other laboratory findings, and chest CT images should be taken into account for the absence of enough positive evidence. This case highlights the importance of successive sampling and testing SARS-Cov-2 by RT-PCR as well as the increased value of single positive target gene from pending to positive in two specimens to diagnose laboratory-confirmed COVID-19 11).

Literature

see COVID-19 Literature

References

1)

Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733.
2)

Bogoch II, Watts A, Thomas-Bachli A, Huber C, Kraemer MUG, Khan K. Pneumonia of unknown aetiology in Wuhan, China: potential for international spread via commercial air travel. J Travel Med. 2020 Mar 13;27(2). pii: taaa008. doi: 10.1093/jtm/taaa008. PubMed PMID: 31943059; PubMed Central PMCID: PMC7107534.
3)

WHO. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). Jan 30, 2020. https://www.who.int/newsroom/detail/30-01-2020-statement-on-thesecond-meeting-of-the-international-healthregulations-(2005)-emergency-committeeregarding-the-outbreak-of-novel-coronavirus- (2019-ncov) (accessed Feb 1, 2020).
4)

World Health Organization. WHO Director-General’s Opening Remarks at the Media Briefing on COVID-19—11 March 2020. World Health Organization. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarksat-the-media-briefing– on-covid-19–11-march-2020. Accessed March 30, 2020
5)

Center for Systems Science and Engineering, Johns Hopkins Coronavirus Resource Center. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University, March 2020. https://coronavirus.jhu.edu/map.html. Accessed March 30, 2020
6)

Xie M, Chen Q. Insight into 2019 novel coronavirus – an updated intrim review and lessons from SARS-CoV and MERS-CoV. Int J Infect Dis. 2020 Apr 1. pii: S1201-9712(20)30204-6. doi: 10.1016/j.ijid.2020.03.071. [Epub ahead of print] Review. PubMed PMID: 32247050.
7)

Wuhan seafood market pneumonia virus isolate Wuhan-Hu-1, complete genome. Nucleotide, National Center for Biotechnology Information (NCBI), National Library of Medicine (US), National Center for Biotechnology Information, Bethesda, MD, https://www. ncbi.nlm.nih.gov/nuccore/1798174254 (accessed on 2020-02-28).
8)

Baker T, Schell CO, Petersen DB, Sawe H, Khalid K, Mndolo S, Rylance J, McAuley DF, Roy N, Marshall J, Wallis L, Molyneux E. Essential care of critical illness must not be forgotten in the COVID-19 pandemic. Lancet. 2020 Apr 1. pii: S0140-6736(20)30793-5. doi: 10.1016/S0140-6736(20)30793-5. [Epub ahead of print] PubMed PMID: 32246914.
9)

Zhang YH, Lin DJ, Xiao MF, Wang JC, Wei Y, Lei ZX, Zeng ZQ, Li L, Li HA, Xiang W. [2019 novel coronavirus infection in a three-month-old baby]. Zhonghua Er Ke Za Zhi. 2020 Mar 2;58(3):182-184. doi: 10.3760/cma.j.issn.0578-1310.2020.03.004. Chinese. PubMed PMID: 32135587.
10)

Zhang T, Cui X, Zhao X, Wang J, Zheng J, Zheng G, Guo W, Cai C, He S, Xu Y. Detectable SARS-CoV-2 Viral RNA in Feces of Three Children during Recovery Period of COVID-19 Pneumonia. J Med Virol. 2020 Mar 29. doi: 10.1002/jmv.25795. [Epub ahead of print] PubMed PMID: 32222992.
11)

Lv DF, Ying QM, Weng YS, Shen CB, Chu JG, Kong JP, Sun DH, Gao X, Weng XB, Chen XQ. Dynamic change process of target genes by RT-PCR testing of SARS-Cov-2 during the course of a Coronavirus Disease 2019 patient. Clin Chim Acta. 2020 Mar 27. pii: S0009-8981(20)30134-0. doi: 10.1016/j.cca.2020.03.032. [Epub ahead of print] PubMed PMID: 32229107.
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