COVID-19—New Insights on a Rapidly Changing Epidemic

Abstract

Since first reported in Wuhan, China, in late December 2019, the outbreak of the novel coronavirus now known as SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has spread globally. As of February 27, 2020, more than 82 000 cases of coronavirus disease 2019 (COVID-19)(thediseasecausedbySARS-CoV-2)and2800 deaths have been reported, of which approximately 95% of cases and 97% of deaths are in China. 1 Cases have now been reported in 49 other countries. A particularly large outbreak occurred among the passengers and crew of the Diamond Princess cruise ship, where more than 700 infections are reported.The data surrounding the biology, epidemiology, and clinical characteristics of the SARS-CoV-2 virus have been growing daily, with more than 400 articles listed in PubMed. The virus genome was rapidly sequenced, which allowed the development of diagnostic tests and for research into vaccine and therapeutics to start. Meanwhile, the clinical spectrum of disease continues to be defined (including the potential for asymptomatic spread) and clinical trials evaluating treatments have begun. This Viewpoint updates previous guidance for clinicians 2 and summarizes what is known, what is unknown, and what are the next steps based on available evidence to address and halt the outbreak.

Clinical considerations for patients with diabetes in times of COVID-19 epidemic

“…COVID-19 (Coronavirus Disease-2019), a disease caused by the coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2), has emerged as a rapidly spreading communicable disease affecting more than 100 countries across the globe at present. The disease is primarily spread through large respiratory droplets, though the possibility of other routes of transmission cannot be ruled out, as the virus has been found in stool and urine of affected individuals [1]. The disease severity has varied from mild self-limiting flu-like illness to fulminant pneumonia, respiratory failure and death.…”

Integrated analyses of single-cell atlases reveal age, gender, and smoking status associations with cell type-specific expression of mediators of SARS-CoV-2 viral entry and highlights inflammatory programs in putative target cells

“…While true case fatality rate (CFR) is difficult to assess early in an epidemic [24][25][26] , estimates from modeling studies range from 0.9% -3.3% 27,28 . Disease severity and mortality rates show a striking rise with age 29 , with CFR estimates ranging from <0.1% for patients under 30 years old to >10% for those over 70 24 , with a slightly higher incidence and mortality in men 4,30 . Children are significantly less likely than adults to develop severe disease, and reported pediatric deaths are rare 31 .…”

Coronavirus Disease (COVID-19): A primer for emergency physicians

“…23 The current R 0 or basic reproduction number is estimated to be greater than 2.2; for every case of COVID-19 identified in the population, more than 2 additional cases are possible in the absence of adequate isolation. 20,[31][32][33] In an early epidemiologic analysis of 425 COVID-19 cases in Wuhan, China, the median patient age was 59 years, and 56% were male. 20 In the largest study to date of COVID-19, J o u r n a l P r e -p r o o f comprising over 72,000 patient records (up to from China, 86.6% of patients were 30-79 years of age.…”