This article is updated with the most recent and significant studies. Coronaviruses are a group of viruses that cause a significant proportion of all common colds in adults and children. COVID-19 (or ...

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This article is updated with the most recent and significant studies.

Coronaviruses are a group of viruses that cause a significant proportion of all common colds in adults and children. COVID-19 (or  2019-nCoV or SARS-CoV-2)  is the third coronavirus in the last two decades.

The Diagnosis and Treatment Programme (National Health Commission of the People's Republic of China)

1 - "The incubation period is from 1 to 14 days, mainly from 3 to 7 days".

2 - "Severe patients Dyspnea and/or hypoxemia occurred one week after initiation and severe cases progressed rapidly into acute respiratory distress syndrome, septic shock, difficult to correct metabolic acidosis and coagulopathy. "

3 - "Light patients showed only low fever, mild fatigue and no pneumonia".

4 - "The elderly and those with underlying chronic diseases have a poor prognosis".

5 - "Transfer suspicious patients to the designated hospital as soon as possible, while ensuring the safety of the transfer.

6 - "People who have close contact with the new coronavirus. Patients, even if common respiratory pathogens have tested positive, are advised to perform new coronavirus tests in a timely manner. "

7 - "Arterial blood gas analysis, if possible, cytokine detection, chest imaging review". (1).

The prevention and blocking of transmission (2).

Wash your hands often with soap for at least 20 seconds or 75% alcohol. 

Do not touch the mouth, nose or eyes before thoroughly cleaning your hands after returning from public places.

Prevent transmission from respiratory droplets and contact: cover your mouth and nose with a napkin or towel when coughing or sneezing. In this case masks are useful.

Mortality risk according to Japanese scientists

From 29 to 31 January 2020, 565 Japanese citizens were evacuated from Wuhan. This indicates that the incidence of infection in Wuhan can be estimated at 20,767 infected individuals, including asymptomatic and mild symptomatic infections. The risk of mortality from infection (IFR) (the actual risk of death among all infected individuals) is therefore 0.3% to 0.6%, which can be comparable to the Asian influenza pandemic of the years 1957-1958 (3).

Mortality risk according to the University of Shanghai as of February 4, 2020 

It appears that 2019-nCoV is less pathogenic than SARS-CoV (∼10%) and much less so than MERS-CoV (∼40%).  The total number of deaths from pneumonia related illnesses in the  is about 3%. In addition, most of those who died have basic conditions such as hypertension, diabetes or cardiovascular diseases which have affected the immune system (4).

Coronavirus and seasonal influenza mortality

Seasonal influenza 0.1%

COVID-19 3.5%

SARS 10%

In the United States the annual average of deaths, estimated with Poisson's regression models, were (5):

• 1990-1991 and 1998-1999 36,155 deaths
• 2002-2003 49,000 deaths 

NEWS

11-2-2020 To support the 2019-nCoV assumption of zoonotic origin from the Huanan seafood market, the index cases should have had a market-related exposure history and the virus should have been identified from animals sold on the market.  the index case should have had exposure history related to the market and the virus should have been identified from animals sold at the market. As these requirements remain unmet, zoonotic spillover at the market must not be overemphasized (6).

14-2-2020 Combination of Ribavirin and Interferon-α is recommended because of the effect on MERS (Middle East Respiratory Syndrome), and the effectiveness of Lopinavir/Ritonavir and Remdisivir needs to be confirmed by randomized controlled trial (RCT), given the situation of no specific antivirus drug on New Coronavirus Pneumonia (NCP, also named as COVID-19 by WHO on Feb 11 2020, is unavailable.  Systemic glucocorticosteroid is recommended as a short term use yet  randomized controlled trial are expected to confirm the effectiveness. Inappropriate application of antibiotics should be avoided, especially the combination of broad-spectrum antibiotics, for the New Coronavirus Pneumonia  is not often complicated with bacterial infection (7).

21-2-2020 As of 31 January 2020 the virus had spread to 18 countries with a number of confirmed cases: China 9,692, Thailand 14, Japan 11, Singapore 10, Australia 9, Malaysia 8, USA 6, France 5, Germany 5, Korea 4, United Arab Emirates 4, Canada 3, Vietnam 2, Nepal 1, Finland 1, Sri Lanka 1, India 1, Cambodia 1 (8).

27-2-2020 Worldwide there are 82,521 infected and 2,810 deaths.

4-3-2020   Worldwide there are 94,250 infected and 3,216 deaths.

Image from Johns Hopkins University 4-3-2020. Confirmed cases of  COVID-19

8-3-2020   Worldwide there are 107,758 infected and 3,658 deaths.

11-3-2020   Worldwide there are 119.132 infected and 4.284 deaths.

Image from Johns Hopkins University 11-3-2020. Confirmed cases of  COVID-19

30-3-2020   Worldwide there are 741.724 infected and 35.114 deaths.

7-4-2020   Worldwide there are 1.390.511 infected and 79.091 deaths.

12-4-2020   Worldwide there are 1.807.939 infected and 112.241 deaths.

References______________________________________________________________

(1) Lin Ling, Li Taisheng. Interpretation of "Guidelines for the Diagnosis and Treatment of Novel Coronavirus (2019-nCoV) Infection by the National Health Commission (Trial Version 5)" Chinese Medical Journal, 2020,100 (00): E001-E001. 10.3760 / cma.j.issn.0376-2491.2020.0001

(2) Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts' consensus statement.  Shen K, Yang Y, Wang T, Zhao D, Jiang Y, Jin R, Zheng Y, Xu B, Xie Z, Lin L, Shang Y, Lu X, Shu S, Bai Y, Deng J, Lu M, Ye L, Wang X, Wang Y, Gao L; China National Clinical Research Center for Respiratory Diseases; National Center for Children’s Health, Beijing, China; Group of Respirology, Chinese Pediatric Society, Chinese Medical Association; Chinese Medical Doctor Association Committee on Respirology Pediatrics; China Medicine Education Association Committee on Pediatrics; Chinese Research Hospital Association Committee on Pediatrics; Chinese Non-government Medical Institutions Association Committee on Pediatrics; China Association of Traditional Chinese Medicine, Committee on Children’s Health and Medicine Research; China News of Drug Information Association, Committee on Children’s Safety Medication; Global Pediatric Pulmonology Alliance.  World J Pediatr. 2020 Feb 7. doi: 10.1007/s12519-020-00343-7.

(3) The Rate of Underascertainment of Novel Coronavirus (2019-nCoV) Infection: Estimation Using Japanese Passengers Data on Evacuation Flights.  Nishiura H, Kobayashi T, Yang Y, Hayashi K, Miyama T, Kinoshita R, Linton NM, Jung SM, Yuan B, Suzuki A, Akhmetzhanov AR.  J Clin Med. 2020 Feb 4;9(2). pii: E419. doi: 10.3390/jcm9020419.

(4) Pathogenicity and Transmissibility of 2019-nCoV-A Quick Overview and Comparison with Other Emerging Viruses.  Chen J.  Microbes Infect. 2020 Feb 4. pii: S1286-4579(20)30026-5. doi: 10.1016/j.micinf.2020.01.004.

(5) Thompson WW, Weintraub E, Dhankhar P, et al. Estimates of US influenza-associated deaths made using four different methods. Influenza Other Respir Viruses. 2009;3(1):37–49. doi:10.1111/j.1750-2659.2009.00073.x

(6) Initial Cluster of Novel Coronavirus (2019-nCoV) Infections in Wuhan, China Is Consistent with Substantial Human-to-Human Transmission. Nishiura H, Linton NM, Akhmetzhanov AR. J Clin Med. 2020 Feb 11;9(2). pii: E488. doi: 10.3390/jcm9020488.

(7) Pharmacotherapeutics for the New Coronavirus Pneumonia.  Du B, Qiu HB, Zhan X, Wang YS, Kang HYJ, Li XY, Wang F, Sun B, Tong ZH.  Zhonghua Jie He He Hu Xi Za Zhi. 2020 Feb 14;43(0):E012. doi: 10.3760/cma.j.issn.1001-0939.2020.0012.

(8) 2019 Novel coronavirus: where we are and what we know.  Cheng ZJ, Shan J.  Infection. 2020 Feb 18. doi: 10.1007/s15010-020-01401-y

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