Review
Insight into 2019 novel coronavirus — An updated interim review and lessons from SARS-CoV and MERS-CoV

https://doi.org/10.1016/j.ijid.2020.03.071Get rights and content
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Highlights

  • The COVID-19 has a high R0, a long incubation period, and a short serial interval.

  • The COVID-19 has a general low CFR, but much higher in patients with comorbidities.

  • The spike protein binding to ACE2 may explain the high R0 of COVID-19.

  • Autopsy showed more exudative lesions, and less fibrosis and consolidation.

  • Remdesivir, chloroquine, tocilizumab, and convalescent plasma may be effective.

Abstract

Background

The rapid spread of the coronavirus disease 2019 (COVID-19), caused by a zoonotic beta-coronavirus entitled 2019 novel coronavirus (2019-nCoV), has become a global threat. Awareness of the biological features of 2019-nCoV should be updated in time and needs to be comprehensively summarized to help optimize control measures and make therapeutic decisions.

Methods

Based on recently published literature, official documents and selected up-to-date preprint studies, we reviewed the virology and origin, epidemiology, clinical manifestations, pathology and treatment of 2019-nCoV infection, in comparison with severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infection.

Results

The genome of 2019-nCoV partially resembled SARS-CoV and MERS-CoV, and indicated a bat origin. The COVID-19 generally had a high reproductive number, a long incubation period, a short serial interval and a low case fatality rate (much higher in patients with comorbidities) than SARS and MERS. Clinical presentation and pathology of COVID-19 greatly resembled SARS and MERS, with less upper respiratory and gastrointestinal symptoms, and more exudative lesions in post-mortems. Potential treatments included remdesivir, chloroquine, tocilizumab, convalescent plasma and vaccine immunization (when possible).

Conclusion

The initial experience from the current pandemic and lessons from the previous two pandemics can help improve future preparedness plans and combat disease progression.

Keywords

2019- nCoV
COVID-19
SARS-CoV- 2
SARS-CoV
MERS- CoV

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