The Indian Practitioner

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

The 2019 Novel Coronavirus/COVID-19–An Update


Affiliations
1 Consultant Pediatrics and Infectious Disease Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
     

   Subscribe/Renew Journal


There is a new public health crisis threatening the world with the emergence of the novel coronavirus-19 or COVID-19 in Wuhan, China and its subsequent global spread. It is believed to have originated in bats and transmitted to humans through yet unknown intermediary animals. There have been more than 1 million cases and 50000 deaths till date (3/4/2020). The disease is transmitted through inhalation or contact with infected droplets and the usual incubation period is 5 days (range 2-14 days). The symptoms are mild in most people but 15-20 % of patients (usually the elderly and those with comorbidities) may suffer from severe disease. The case fatality rate is estimated to range between 2-3 %. Diagnosis is by specific molecular tests in respiratory samples. Treatment is essentially supportive. The role of antiviral agents (remdesiwir, lopinavir-ritonavir) and anti inflammatory agents (chloroquine, hydroxychloroquine, tocilizumab) is being explored. Prevention at the community level includes hand hygiene, cough etiquette, social distancing, travel restrictions and even lock downs. Strict infection control measures need to be instituted in hospitals to prevent spread to health care workers and other patients.

Keywords

No Keywords.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern Lancet 2020; S0140-6736(20)30185-9.

  • Ayittey FK, Ayittey MK, Chiwero NB, Kamasah JS, Dzuvor C. Economic Impacts of Wuhan 2019-nCoV on China and the World. J Med Virol. 2020;10.1002/jmv.25706. Coronavirus Outbreak. Available at https://www.worldometers.info/coronavirus/. Accessed on February 16,2020.

  • Coronavirus Outbreak. Available at https://www.worldometers.info/coronavirus/. Accessed on March April 3, 2020.

  • World Health Organization. Novel Coronavirus(2019-nCoV) Situation Report - 22. Available at https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200211-sitrep22-ncov.pdf?sfvrsn=fb6d49b1_2. Accessed on February 16, 2020.

  • Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species Severe acute respiratory syndromerelated coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;10.1038/s41564-020-0695-z.

  • Chan-Yeung M, Xu RH. SARS: epidemiology. Respirology. 2003; 8 Suppl: S9-S14.

  • Middle East Respiratory Syndrome Coronavirus. Available at https://www.who.int/emergencies/mers-cov/en/. Accessed on February 16, 2020.

  • Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;10.1056/NEJMoa2001316.

  • World Health Organization. Situation reports. Available at https://www.who.int/emergencies/diseases/novel-coronavirus2019/situation-reports/. Accessed on February 16, 2020.

  • An update on the epidemiologic characteristics of novel coronavirus pneumonia (COVID-19). Special Expert Group for Control of the Epidemic of Novel Coronavirus Pneumonia of the Chinese Preventive Medicine Association. Zhonghua Liu Xing Bing Xue Za Zhi. 2020;41(2):139-144.

  • Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020; 10.1056/NEJMoa2001316.

  • Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents. J Hosp Infect. 2020; S0195-6701(20)30046-3. doi:10.1016/j.jhin.2020.01.022

  • Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patient. Can J Anaesth. 2020;10.1007/s12630-020-01591-x.

  • Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med. 2020; 10.1056/NEJMc2001468.

  • Zou L, Ruan F, Huang M, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020; 382(12):1177-1179. doi:10.1056/NEJMc2001737

  • Wölfel R, Corman VM, Guggemos W, et al. Virological assessment of hospitalized patients with COVID-2019. Nature. 2020; 10.1038/s41586-020-2196-x. doi:10.1038/s41586-020-2196-x

  • Joynt GM, Wu WK. Understanding COVID-19: what does viral RNA load really mean?. Lancet Infect Dis. 2020; S1473-3099(20)30237-1. doi:10.1016/S1473-3099(20)30237-1

  • Iceland lab’s testing suggests 50% of coronavirus cases have no symptoms. Available at https://edition.cnn.com/2020/04/01/europe/iceland-testing-coronavirus-intl/index.html. Accessed on April 3, 2020.

  • Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention JAMA. 2020; 10.1001/jama.2020.2648.

  • Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 10.1056/NEJ-Moa2002032.

  • Zhang L, Jiang Y, Wei M, et al. Analysis of the Pregnancy Outcomes in Pregnant Women With COVID-19 in Hubei Province. Zhonghua Fu Chan Ke Za Zhi. 2020;55(0):E009. doi:10.3760/cma.j.cn112141-20200218-00111.

  • Wang S, Guo L, Chen L, et al. A case report of neonatal COVID-19 infection in China. Clin Infect Dis. 2020; ciaa 225. doi:10.1093/cid/ciaa225

  • Dong Y, Mo X, Hu Y, et al. Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China. Pediatrics. 2020; e20200702. doi:10.1542/peds.2020-0702

  • Brodin P. Why is COVID-19 so mild in children? Acta Paediatr. 2020;10.1111/apa.15271. doi:10.1111/apa.15271.

  • Sommer P, Lukovic E, Fagley E, et al. Initial Clinical Impressions of the Critical Care of COVID-19 Patients in Seattle, New York City, and Chicago. Anesth Analg. 2020; 10.1213/ANE.0000000000004830.

  • CDC COVID-19 Response Team. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) - United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(12):343-346.

  • Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. doi:10.1001/jama.2020.3786.

  • Zhao J, Yuan Q, Wang H, et al. Antibody responses to SARSCoV2 in patients of novel coronavirus disease 2019. Clin Infect Dis. 2020; ciaa344. doi:10.1093/cid/ciaa344

  • Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020;/j/cclm.ahead-of-print/cclm-2020-0198/cclm-2020-0198.xml.

  • Huang P, Liu T, Huang L, et al. Use of Chest CT in Combination with Negative RT-PCR Assay for the 2019 Novel Coronavirus but High Clinical Suspicion. Radiology. 2020; 200330.

  • Government of India Ministry of Health & Family Welfare Directorate General of Health Services (EMR Division) Revised Guidelines on Clinical Management of COVID - 19. Available at https://www.mohfw.gov.in/pdf/RevisedNationalClinicalManagementGuidelineforCOVID1931032020.pdf. Accessed on April 3,2020.

  • Alhazzani W, Møller MH, Arabi YM, et al. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Crit Care Med. 2020;10.1097/CCM.0000000000004363. doi:10.1097/CCM.0000000000004363.

  • Danser AHJ, Epstein M, Batlle D. Renin-Angiotensin System Blockers and the COVID-19 Pandemic: At Present There Is No Evidence to Abandon Renin-Angiotensin System Blockers [published online ahead of print, 2020 Mar 25]. Hypertension. 2020;HYPERTENSIONAHA12015082. doi:10.1161/HYPERTENSIONAHA.120.15082

  • Cao B, Wang Y, Wen D, et al. A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med. 2020;10.1056/NEJMoa2001282. doi:10.1056/NEJMoa2001282

  • Holshue ML, DeBolt C, Lindquist S, et al. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med. 2020; 10.1056/NEJMoa2001191.

  • Zhang L, Liu Y. Potential Interventions for Novel Coronavirus in China: A Systemic Review. J Med Virol. 2020; 10.1002/jmv.25707.

  • Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-n CoV lung injury.Lancet. 2020;395[10223]:473-475.

  • Zhao JP, Hu Y, Du RH, et al. Expert Consensus on the Use of Corticosteroid in Patients With 2019-nCoV Pneumonia. Zhonghua Jie He He Hu Xi Za Zhi. 2020; 43[0]:E007.

  • Gautret P, Lagier JC, Parola P, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020; 105949. doi:10.1016/j.ijantimicag.2020.105949

  • Zhang C, Wu Z, Li JW, Zhao H, Wang GQ. The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality. Int J Antimicrob Agents. 2020; 105954. doi:10.1016/j.ijantimicag.2020.105954

  • World Health Organization. Coronavirus disease (COVID-19) technical guidance: Infection prevention and control. Available at https://www.who.int/emergencies/diseases/novel-coronavirus2019/technical-guidance/infection-prevention-and-control. Accessed on Feb 20,2020.

  • Udawdia ZF, Raju SR. How to protect the protectors: 10 lessons to learn for doctors fighting the COVID-19 Coronavirus. Medical Journal Armed Forces India April 2020. Available at https://doi.org/10.1016/j.mjafi.2020.03.009. Accessed April 3,2020.

  • Wang J, Zhou M, Liu F. Exploring the reasons for healthcare workers infected with novel coronavirus disease 2019 (COVID-19) in China. J Hosp Infect. 2020; S0195-6701(20)3010-18.

  • Recommendations for empiric use of hydroxy-chloroquine for prophylaxis of SARS-CoV-2 infection. Available at https://icmr.nic.in/sites/default/files/upload_documents/HCQ_Recommendation_ 22March_final_MM_V2.pdf. Accessed March 25,2020.

  • Li J, Li JJ, Xie X, et al. Game consumption and the 2019 novel coronavirus. Lancet Infect Dis. 2020; 20(3):275-276. doi:10.1016/S1473-3099(20)30063-3.


Abstract Views: 257

PDF Views: 0




  • The 2019 Novel Coronavirus/COVID-19–An Update

Abstract Views: 257  |  PDF Views: 0

Authors

Tanu Singhal
Consultant Pediatrics and Infectious Disease Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India

Abstract


There is a new public health crisis threatening the world with the emergence of the novel coronavirus-19 or COVID-19 in Wuhan, China and its subsequent global spread. It is believed to have originated in bats and transmitted to humans through yet unknown intermediary animals. There have been more than 1 million cases and 50000 deaths till date (3/4/2020). The disease is transmitted through inhalation or contact with infected droplets and the usual incubation period is 5 days (range 2-14 days). The symptoms are mild in most people but 15-20 % of patients (usually the elderly and those with comorbidities) may suffer from severe disease. The case fatality rate is estimated to range between 2-3 %. Diagnosis is by specific molecular tests in respiratory samples. Treatment is essentially supportive. The role of antiviral agents (remdesiwir, lopinavir-ritonavir) and anti inflammatory agents (chloroquine, hydroxychloroquine, tocilizumab) is being explored. Prevention at the community level includes hand hygiene, cough etiquette, social distancing, travel restrictions and even lock downs. Strict infection control measures need to be instituted in hospitals to prevent spread to health care workers and other patients.

Keywords


No Keywords.

References