A Novel Coronavirus Emerging in China — Key Questions for Impact Assessment

Munster, Vincent J.; Koopmans, Marion; Doremalen, Neeltje van; Riel, Debby van; Wit, Emmie de

doi:10.1056/nejmp2000929

Cited by 1,293 publications

(1,134 citation statements)

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“…This was the most important lesson from SARS, let us hope that we can all benefit from it. 12 Recently, the COVID-19 infection occurred and spread in the mainland of China, but the proportion of mild and asymptomatic cases versus severe and fatal cases for COVID-19 infection is currently still unknown that hampers realistic assessment of the virus's epidemic potential and complicates the outbreak response, 5 furthermore, the recent publications on the epidemiological and clinical characteristics mainly came from Wuhan, 6 , 7 , 13 the information about the imported city is exceedingly rare. On the basis of this study, firstly we provided the proportion of severe versus common cases of the COVID-19 infection, which was approximately 1:4, the ratio of severe to mild, non-pneumonia and asymptomatic cases were 18%, 73%, 4% and 5% respectively, the changes and prognosis of those four categories should be future observed in hospitals.…”

Section: Discussionmentioning

confidence: 99%

“…3 The infected cases were also reported in Thailand, Japan, South Korea, Singapore, Vietnam, the US, and other 24 countries around the world. [4][5] Given that the current COVID-19 outbreak is moving rapidly, the recently published literatures on the epidemic features of COVID-19 mainly focus on Wuhan, China, 6-7 but the information on the imported city or region is exceedingly rare.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of COVID-19 infection in Beijing

Tian

Lou

et al. 2020

Journal of Infection

1,080

788

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s u m m a r yBackground: Since the first case of a novel coronavirus infection pneumonia was detected in Wuhan, China, a series of confirmed cases of the COVID-19 were found in Beijing. We analyzed the data of 262 confirmed cases to determine the clinical and epidemiological characteristics of COVID-19 in Beijing. Methods: We collected patients who were transferred by Beijing Emergency Medical Service to the designated hospitals. The information on demographic, epidemiological, clinical, laboratory test for the COVID-19 virus, diagnostic classification, cluster case and outcome were obtained. Furthermore we compared the characteristics between severe and common confirmed cases which including mild cases, no-pneumonia cases and asymptomatic cases, and we also compared the features between COVID-19 and 2003 SARS. Findings: By Feb 10, 2020, 262 patients were transferred from the hospitals across Beijing to the designated hospitals for special treatment of the COVID-19 infected by Beijing emergency medical service. Among of 262 patients, 46 (17.6%) were severe cases, 216 (82.4%) were common cases, which including 192 (73.3%) mild cases, 11(4.2%) non-pneumonia cases and 13 (5.0%) asymptomatic cases respectively. The median age of patients was 47.5 years old and 48.5% were male. 192 (73.3%) patients were residents of Beijing, 50 (26.0%) of which had been to Wuhan, 116 (60.4%) had close contact with confirmed cases, 21 (10.9%) had no contact history. The most common symptoms at the onset of illness were fever (82.1%), cough (45.8%), fatigue (26.3%), dyspnea (6.9%) and headache (6.5%). The median incubation period was 6.7 days, the interval time from between illness onset and seeing a doctor was 4.5 days. As of Feb 10, 17.2% patients have discharged and 81.7% patients remain in hospital in our study, the fatality of COVID-19 infection in Beijing was 0.9%. Interpretation: On the basis of this study, we provided the ratio of the COVID-19 infection on the severe cases to the mild, asymptomatic and non-pneumonia cases in Beijing. Population was generally susceptible, and with a relatively low fatality rate. The measures to prevent transmission was very successful at early stage, the next steps on the COVID-19 infection should be focused on early isolation of patients and quarantine for close contacts in families and communities in Beijing.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characteristics of COVID-19 infection in Beijing

Tian

Lou

et al. 2020

Journal of Infection

1,080

788

View full text Add to dashboard Cite

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“…It has been proved that SARS-CoV-2 uses ACE2 as a viral receptor for entry process [15,16]. ACE2 mRNA is highly expressed in the gastrointestinal system, providing a prerequisite for SARS-CoV-2…”

Section: Discussionmentioning

confidence: 99%

Arbidol combined with LPV/r versus LPV/r alone against Corona Virus Disease 2019: A retrospective cohort study

Deng

Zeng

et al. 2020

Journal of Infection

465

463

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Highlights Patients were given oral arbidol and LPV/r in the combination group and oral LPV/r only in the monotherapy group for 5-21 days  Our study shows that oral arbidol and LPV/r in the combination group is associated with a significant elevated negative conversion rate of coronavirus' test in 7-day and 14-day, compared with LPV/r only in the monotherapy group. Combination therapy is associated with a significantly improved the chest CT scans in 7-day. We suppose that reducing the viral load as soon as possible could benefit the delay of the progression of lung lesions. Abstract BackgroundCorona Virus Disease 2019 (COVID-19) due to the 2019 novel coronavirus (SARS-CoV-2) emerged in Wuhan city and rapidly spread throughout China. We aimed to compare arbidol and lopinavir/ritonavir(LPV/r) treatment for patients with COVID-19 with LPV/r only. MethodsIn this retrospective cohort study, we included adults (age≥18years) with laboratory-confirmed COVID-19 without Invasive ventilation, diagnosed between Jan 17, 2020, and Feb 13, 2020. Patients, diagnosed after Jan 17, 2020, were given oral arbidol and LPV/r in the combination group and oral LPV/r only in the monotherapy group for 5-21 days. The primary endpoint was a negative conversion rate of coronavirus from the date of COVID-19 diagnosis(day7, day14), and assessed whether the pneumonia was progressing or improving by chest CT (day7). ResultsWe analyzed 16 patients who received oral arbidol and LPV/r in the combination group and 17 who oral LPV/r only in the monotherapy group, and both initiated after diagnosis. Baseline clinical, laboratory, and chest CT characteristics were similar between groups. The SARS-CoV-2 could not be detected for 12(75%) of 16 patients' nasopharyngeal specimens in the combination group after seven days, compared with 6 (35%) of 17 in the monotherapy group (p<0·05). After 14 days, 15 (94%) of 16 and 9 (52·9%) of 17, respectively, SARS-CoV-2 could not be detected (p<0·05). The chest CT scans were improving for 11(69%) of 16 patients in the combination group after seven days, compared with 5(29%) of 17 in the monotherapy group (p<0·05). ConclusionIn patients with COVID-19, the apparent favorable clinical response with arbidol and LPV/r supports further LPV/r only.

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“…In this regard, identifying the possible route of infection will also have implications for the pathogenesis and treatment of disease caused by 2019-nCoV. Table 1 gives estimates of case fatality rate as well as R 0 value of several commonly known emerging virus infections based on data collected from literatures [16,17], WHO and CDC. It is clear that airborne viruses tend to have a higher R 0 value than those spread through contact.…”

Section: Relationship Between Viral Pathogenicity and Transmissibilitymentioning

confidence: 99%