COVID-19
Updates to Article Attributes
Novel coronavirus-infected pneumonia (NCIP) is an emerging zoonotic illness caused by a hitherto unknown coronavirus, which has provisionally been called 2019 novel coronavirus or 2019-nCoV by the World Health Organization (WHO). The first cases were seen in the city of Wuhan, China in December 2019, and have been linked to the Huanan Seafood Wholesale Market 1,2,10. Person-to-person transmission can occur.
The infection was declared a Public Health Emergency of International Concern (PHEIC) on January 30th 2020 by the WHO 7.
Epidemiology
As of February 910th 2020, over 3740,500 cases of novel coronavirus-infected pneumonia have been identified worldwide, with the vast majority (~99%) in China, according to a Johns Hopkins online virus tracker 5.
On January 13th January 2020 2020, the first confirmed case outside China was diagnosed, a Chinese tourist in Thailand 10. On January 20th, the first infected person in the United States was confirmed to be a man in the State of Washington who had recently returned from a visit to Wuhan 9. The disease has now been diagnosed in 28 territories, including Macau and Hong Kong, in five continents 5,13.
The mortality rate is about 2-3% 2,5 with currently 814910 confirmed deaths (February 910th, 2020) 5. Only two confirmed deaths have been outside mainland China, one in Hong Kong, and a second one in the Philippines 5.
A recent modelling study suggested that the true number of cases of infection is much higher than published official figures, being greater than 75,000 infected persons in Wuhan 8.
In an article examining the first 425 infected cases in Wuhan, 56% of the infectees were male and the median age was 59 years 12. Using this dataset, the group estimated that the R0 (basic reproduction number) of the novel coronavirus was 2.2, that is each infected individual - on average - causes 2.2 new cases of the disease 12. The incubation period in this group has been calculated to be 5.2 days on average 12.
Clinical presentation
The novel coronavirus primarily presents as pneumonia, however, its full spectrum of clinical effects remains to be determined 1,2. Symptoms are non-specific:
- fever
- myalgia
- malaise
- cough
- pleuritic pain
- dyspnoea
Complications
- acute respiratory distress syndrome (ARDS)
- acute cardiac injury
- secondary infections
- sepsis
Pathology
The recently identified 2019-nCoV is the confirmed cause of novel coronavirus-infected pneumonia. It is a member of the Betacoronavirus genus, one of the genera of the Coronaviridae family of viruses. Coronaviruses are enveloped single-stranded RNA viruses, that are found in humans, many other mammals and birds. These viruses are responsible for pulmonary, hepatic, CNS and intestinal disease.
The natural animal host of 2019-nCoV remains undetermined 11.
Hitherto, six coronaviruses have been known to be responsible for human diseases, two are zoonoses, the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), both of which may sometimes be fatal. The remaining four viruses are widespread in human society and cause mild coryzal illnesses.
Radiographic features
The primary findings on chest radiograph and CT are those of pneumonia 3. 75% of cases have presented with bilateral pneumonia 6.
Treatment and prognosis
No specific treatment or vaccine exists for this emerging illness (as of February 2020). Therefore in the meantime, resources have been concentrated on public health measures, to prevent further interhuman transmission of the virus. This has required a multipronged approach and for individuals includes meticulous personal hygiene, fitted masks, and the avoidance of large crowds/crowded environments 11.
In healthcare facilities, concerted efforts are required to effect rapid diagnosis, quarantine infected cases and provide effective supportive therapies. This will encompass empirical treatments with antibiotics, antivirals, steroids and supportive measures. Mechanical ventilation and extracorporeal membrane oxygenation (ECMO) have also been used where clinically necessary.
Vaccines for the coronaviruses have been under development since the SARS outbreak, but none are yet available for human patients 11.
-<p><strong>Novel coronavirus-infected pneumonia</strong> (<strong>NCIP</strong>) is an emerging <a href="/articles/zoonosis">zoonotic</a> illness caused by a hitherto unknown <a href="/articles/human-coronavirus-1">coronavirus</a>, which has provisionally been called <strong>2019 novel coronavirus</strong> or <strong>2019-nCoV</strong> by the <a href="/articles/world-health-organisation-who">World Health Organization (WHO)</a>. The first cases were seen in the city of Wuhan, China in December 2019, and have been linked to the Huanan Seafood Wholesale Market <sup>1,2,10</sup>. Person-to-person transmission can occur.</p><p>The infection was declared a Public Health Emergency of International Concern (PHEIC) on January 30<sup>th</sup> 2020 by the WHO <sup>7</sup>.</p><h4>Epidemiology</h4><p>As of February 9<sup>th </sup>2020, over 37,500 cases of novel coronavirus-infected pneumonia have been identified worldwide, with the vast majority (~99%) in China, according to a Johns Hopkins online virus tracker <sup>5</sup>.</p><p>On 13<sup>th</sup> January 2020, the first confirmed case outside China was diagnosed, a Chinese tourist in Thailand <sup>10</sup>. On January 20<sup>th</sup>, the first infected person in the United States was confirmed to be a man in the State of Washington who had recently returned from a visit to Wuhan <sup>9</sup>. The disease has now been diagnosed in 28 territories, including Macau and Hong Kong <sup>5</sup>. </p><p>The mortality rate is about 2-3% <sup>2,5 </sup>with currently 814 confirmed deaths (February 9<sup>th</sup>, 2020) <sup>5</sup>. Only two confirmed deaths have been outside mainland China, one in Hong Kong, and a second one in the Philippines <sup>5</sup>. </p><p>A recent modelling study suggested that the true number of cases of infection is much higher than published official figures, being greater than 75,000 infected persons in Wuhan <sup>8</sup>.</p><h4>Clinical presentation</h4><p>The novel coronavirus primarily presents as <a href="/articles/pneumonia">pneumonia</a>, however, its full spectrum of clinical effects remains to be determined <sup>1,2</sup>. Symptoms are non-specific:</p><ul>- +<p><strong>Novel coronavirus-infected pneumonia</strong> (<strong>NCIP</strong>) is an emerging <a href="/articles/zoonosis">zoonotic</a> illness caused by a hitherto unknown <a href="/articles/human-coronavirus-1">coronavirus</a>, which has provisionally been called <strong>2019 novel coronavirus</strong> or <strong>2019-nCoV</strong> by the <a href="/articles/world-health-organisation-who">World Health Organization (WHO)</a>. The first cases were seen in the city of Wuhan, China in December 2019, and have been linked to the Huanan Seafood Wholesale Market <sup>1,2,10</sup>. Person-to-person transmission can occur.</p><p>The infection was declared a Public Health Emergency of International Concern (PHEIC) on January 30<sup>th</sup> 2020 by the WHO <sup>7</sup>.</p><h4>Epidemiology</h4><p>As of February 10<sup>th </sup>2020, over 40,500 cases of novel coronavirus-infected pneumonia have been identified worldwide, with the vast majority (~99%) in China, according to a Johns Hopkins online virus tracker <sup>5</sup>.</p><p>On January 13<sup>th</sup> 2020, the first confirmed case outside China was diagnosed, a Chinese tourist in Thailand <sup>10</sup>. On January 20<sup>th</sup>, the first infected person in the United States was confirmed to be a man in the State of Washington who had recently returned from a visit to Wuhan <sup>9</sup>. The disease has now been diagnosed in 28 territories, including Macau and Hong Kong, in five continents <sup>5,13</sup>. </p><p>The mortality rate is about 2-3% <sup>2,5 </sup>with currently 910 confirmed deaths (February 10<sup>th</sup>, 2020) <sup>5</sup>. Only two confirmed deaths have been outside mainland China, one in Hong Kong, and a second one in the Philippines <sup>5</sup>. </p><p>A recent modelling study suggested that the true number of cases of infection is much higher than published official figures, being greater than 75,000 infected persons in Wuhan <sup>8</sup>.</p><p>In an article examining the first 425 infected cases in Wuhan, 56% of the infectees were male and the median age was 59 years <sup>12</sup>. Using this dataset, the group estimated that the <a title="R0 (basic reproduction number)" href="/articles/r0-basic-reproduction-number">R<sub>0</sub> (basic reproduction number)</a> of the novel coronavirus was 2.2, that is each infected individual - on average - causes 2.2 new cases of the disease <sup>12</sup>. The <a title="Incubation period" href="/articles/incubation-period">incubation period</a> in this group has been calculated to be 5.2 days on average <sup>12</sup>.</p><h4>Clinical presentation</h4><p>The novel coronavirus primarily presents as <a href="/articles/pneumonia">pneumonia</a>, however, its full spectrum of clinical effects remains to be determined <sup>1,2</sup>. Symptoms are non-specific:</p><ul>
References changed:
- 5. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) <a href="https://gisanddata.maps.arcgis.com/apps/dashboards/bda7594740fd40299423467b48e9ecf6" target="_blank">Case Dashboard</a>. [accessed 9 May 2023].
- 12. Li Q, Guan X, Wu P et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382(13):1199-207. <a href="https://doi.org/10.1056/NEJMoa2001316">doi:10.1056/NEJMoa2001316</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/31995857">Pubmed</a>
- 13. Wang D, Hu B, Hu C et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. <a href="https://doi.org/10.1001/jama.2020.1585">doi:10.1001/jama.2020.1585</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/32031570">Pubmed</a>
- 13. Wang D, Hu B, Hu C et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. <a href="https://doi.org/10.1001/jama.2020.1585">doi:10.1001/jama.2020.1585</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/32031570">Pubmed</a>
- 5. Wuhan Coronavirus (2019-nCoV) Global Cases (by Johns Hopkins CSSE). <a href="https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6" target="_blank">Case Dashboard</a>. [accessed 9th February 2020].
- 13.
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