The 2019 Novel Coronavirus: A Crown Jewel of Pandemics?
Identifieur interne : 000918 ( Pmc/Corpus ); précédent : 000917; suivant : 000919The 2019 Novel Coronavirus: A Crown Jewel of Pandemics?
Auteurs : Razvan AzamfireiSource :
- The Journal of Critical Care Medicine [ 2393-1809 ] ; 2020.
Url:
DOI: 10.2478/jccm-2020-0013
PubMed: 32104726
PubMed Central: 7029402
Links to Exploration step
PMC:7029402Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The 2019 Novel Coronavirus: A Crown Jewel of Pandemics?</title><author><name sortKey="Azamfirei, Razvan" sort="Azamfirei, Razvan" uniqKey="Azamfirei R" first="Razvan" last="Azamfirei">Razvan Azamfirei</name><affiliation><nlm:aff id="j_jccm-2020-0013_aff_001"><institution>Johns Hopkins School of Medicine</institution>,<addr-line>1800 Orleans Street</addr-line>,<city>Baltimore</city>,<addr-line>MD 21287</addr-line>,<country country="US">USA</country></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32104726</idno><idno type="pmc">7029402</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029402</idno><idno type="RBID">PMC:7029402</idno><idno type="doi">10.2478/jccm-2020-0013</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000918</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000918</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The 2019 Novel Coronavirus: A Crown Jewel of Pandemics?</title><author><name sortKey="Azamfirei, Razvan" sort="Azamfirei, Razvan" uniqKey="Azamfirei R" first="Razvan" last="Azamfirei">Razvan Azamfirei</name><affiliation><nlm:aff id="j_jccm-2020-0013_aff_001"><institution>Johns Hopkins School of Medicine</institution>,<addr-line>1800 Orleans Street</addr-line>,<city>Baltimore</city>,<addr-line>MD 21287</addr-line>,<country country="US">USA</country></nlm:aff></affiliation></author></analytic><series><title level="j">The Journal of Critical Care Medicine</title><idno type="ISSN">2393-1809</idno><idno type="eISSN">2393-1817</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lu, R" uniqKey="Lu R">R Lu</name></author><author><name sortKey="Zhao, X" uniqKey="Zhao X">X Zhao</name></author><author><name sortKey="Li, J" uniqKey="Li J">J Li</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chen, N" uniqKey="Chen N">N Chen</name></author><author><name sortKey="Zhou, M" uniqKey="Zhou M">M Zhou</name></author><author><name sortKey="Dong, X" uniqKey="Dong X">X Dong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Li, Q" uniqKey="Li Q">Q Li</name></author><author><name sortKey="Guan, X" uniqKey="Guan X">X Guan</name></author><author><name sortKey="Wu, P" uniqKey="Wu P">P Wu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Munster, Vj" uniqKey="Munster V">VJ Munster</name></author><author><name sortKey="Koopmans, M" uniqKey="Koopmans M">M Koopmans</name></author><author><name sortKey="Doremalen, Nv" uniqKey="Doremalen N">NV Doremalen</name></author><author><name sortKey="Riel, Dv" uniqKey="Riel D">DV Riel</name></author><author><name sortKey="Wit, Ed" uniqKey="Wit E">ED Wit</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Huang, C" uniqKey="Huang C">C Huang</name></author><author><name sortKey="Wang, Y" uniqKey="Wang Y">Y Wang</name></author><author><name sortKey="Li, X" uniqKey="Li X">X Li</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Crit Care Med (Targu Mures)</journal-id><journal-id journal-id-type="iso-abbrev">J Crit Care Med (Targu Mures)</journal-id><journal-id journal-id-type="publisher-id">jccm</journal-id><journal-id journal-id-type="pmc">jccm</journal-id><journal-title-group><journal-title>The Journal of Critical Care Medicine</journal-title></journal-title-group><issn pub-type="ppub">2393-1809</issn><issn pub-type="epub">2393-1817</issn><publisher><publisher-name>Sciendo</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32104726</article-id><article-id pub-id-type="pmc">7029402</article-id><article-id pub-id-type="publisher-id">jccm-2020-0013</article-id><article-id pub-id-type="doi">10.2478/jccm-2020-0013</article-id><article-categories><subj-group subj-group-type="heading"><subject>Editorial</subject></subj-group></article-categories><title-group><article-title>The 2019 Novel Coronavirus: A Crown Jewel of Pandemics?</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Azamfirei</surname><given-names>Razvan</given-names></name><xref ref-type="corresp" rid="jccm-2020-0013_cor_001">*</xref><xref ref-type="aff" rid="j_jccm-2020-0013_aff_001"><sup>1</sup></xref></contrib><aff id="j_jccm-2020-0013_aff_001"><label>1</label><institution>Johns Hopkins School of Medicine</institution>,<addr-line>1800 Orleans Street</addr-line>,<city>Baltimore</city>,<addr-line>MD 21287</addr-line>,<country country="US">USA</country></aff></contrib-group><author-notes><corresp id="jccm-2020-0013_cor_001"><label>*</label> E-mail: <email xlink:href="mailto:razvan.azamfirei@jhmi.edu">razvan.azamfirei@jhmi.edu</email></corresp></author-notes><pub-date pub-type="collection"><month>1</month><year>2020</year></pub-date><pub-date pub-type="epub"><day>31</day><month>1</month><year>2020</year></pub-date><volume>6</volume><issue>1</issue><fpage>3</fpage><lpage>4</lpage><history><date date-type="received"><day>31</day><month>1</month><year>2020</year></date><date date-type="accepted"><day>31</day><month>1</month><year>2020</year></date></history><permissions><copyright-statement>© 2020 Razvan Azamfirei, published by Sciendo</copyright-statement><copyright-year>2019</copyright-year><copyright-holder>Razvan Azamfirei, published by Sciendo</copyright-holder><license license-type="open-access" specific-use="rights-object-archive-dnb" xlink:href="http://creativecommons.org/licenses/by-nc-nd/4.0"><license-p>This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.</license-p></license></permissions><counts><page-count count="2"></page-count></counts></article-meta></front><body><p>Starting from the December 2019 identification of the 2019 novel coronavirus (2019-nCoV), an overwhelming sense of panic has enveloped public discourse. This is likely to be amplified by WHO recently declaring the novel coronavirus outbreak a public health emergency of international concern. It is the third significant occurrence of a zoonotic coronavirus crossing the species barrier to infect humans, and it likely will not be the last. Hope is not lost; and a measured approach, one that is cognizant of the seriousness of this public health crisis without giving into hysteria, is imperative.</p><p>The coronavirus was identified in a wet food market in Wuhan, China, and has been the subject of a robust public health response by both Chinese authorities and the international community ever since. While debates about the primary reservoir of the virus are still ongoing, the virus is closely related to several bat corona-viruses. Coronaviruses (CoV) are positive-sense, single-stranded RNA viruses, possessing the largest viral RNA genome known to-date [<xref rid="j_jccm-2020-0013_ref_001" ref-type="bibr">1</xref>]. They are known for their rapid spread, unpredictable emergence, and their threat to human health, magnified by the wide range of animal reservoirs and the lack of preventive or curative treatments [<xref rid="j_jccm-2020-0013_ref_001" ref-type="bibr">1</xref>, <xref rid="j_jccm-2020-0013_ref_002" ref-type="bibr">2</xref>, <xref rid="j_jccm-2020-0013_ref_003" ref-type="bibr">3</xref>, <xref rid="j_jccm-2020-0013_ref_004" ref-type="bibr">4</xref>].</p><p>The 2019-nCoV is a beta-CoV similar in sequence (80%) with the severe acute respiratory syndrome coronavirus (SARS-CoV), the coronavirus strain implicated in the 2002 SARS outbreak, but even more closely related to several bat coronaviruses [<xref rid="j_jccm-2020-0013_ref_001" ref-type="bibr">1</xref>,<xref rid="j_jccm-2020-0013_ref_004" ref-type="bibr">4</xref>]. Bats were also identified as the primary reservoir for SARS-CoV, although coronaviruses are found in many species [<xref rid="j_jccm-2020-0013_ref_001" ref-type="bibr">1</xref>]. The Middle East respiratory syndrome coronavirus (MERS-CoV), another highly pathogenic CoV responsible for the 2012 MERS outbreak, has been transmitted through contact with camels, although with a different human tropism. The novel coronavirus is believed to infect human cells through its interaction with the human angiotensin-converting enzyme 2 (ACE2) receptor, similarly to SARS-CoV [<xref rid="j_jccm-2020-0013_ref_001" ref-type="bibr">1</xref>,<xref rid="j_jccm-2020-0013_ref_004" ref-type="bibr">4</xref>]. Despite the differences between the SARS, MERS and novel coronavirus, the similarities within the beta-CoV genus allow us to extrapolate from our previous experience with corona-virus outbreaks and increase our understanding of the current one.</p><p>The infection affects patients with and without underlying diseases, although the majority of the fatalities are older patients or patients with significant comorbidities [<xref rid="j_jccm-2020-0013_ref_002" ref-type="bibr">2</xref>]. The vast majority of reported cases have been in adults, decreasing our ability to draw inferences and make recommendations for pediatric patients. Despite its apparent increased infectivity (R<sub>0</sub>=2.2) the 2019-nCoV strain appears to be less virulent than SARS-CoV (case-fatality rate=9.5%) and MERS-CoV (case-fatality rate=34.4%); currently reported case-fatality rate of 2019-nCoV is 2.2% [<xref rid="j_jccm-2020-0013_ref_003" ref-type="bibr">3</xref>, <xref rid="j_jccm-2020-0013_ref_004" ref-type="bibr">4</xref>]. Superspreaders (R<sub>0</sub>>10) have been identified in both MERS-CoV and SARS-CoV outbreaks and there are similar reports of 2019-nCoV superspreaders [<xref rid="j_jccm-2020-0013_ref_004" ref-type="bibr">4</xref>]. One should be mindful of the possibility of systematic underreporting in our current dataset, but the numbers represent our best estimates as of January 31, 2020, 02:30 GMT. (For updated information see: <ext-link ext-link-type="uri" xlink:href="http://https://tinyurl.com/Hopkin-sCSSE">https://tinyurl.com/Hopkin-sCSSE</ext-link>)</p><p>Recent case reports of human to human transmission, including in patients who have not visited Wuhan, are concerning but not surprising. Transmission is believed to occur only after symptoms of lower respiratory tract infections present, due to its tropism for intrapulmonary epithelial cells. A crucial lesson learned from our experience with SARS-CoV and MERS-CoV is that community transmission occurs primarily through large droplets, not aerosols. Transmission is also to a large degree nosocomial, which is why a measured approach, one that prevents overutilization of medical resources and panic in the general population [<xref rid="j_jccm-2020-0013_ref_004" ref-type="bibr">4</xref>].</p><p>From an infection-control perspective, medical professionals should exercise droplet and contact precautions, as well as airborne precautions when performing procedures that generate aerosols (i.e. endotracheal suctioning, intubation) in patients suspected of having 2019-nCoV [<xref rid="j_jccm-2020-0013_ref_005" ref-type="bibr">5</xref>]. From a public-health perspective, patients presenting with acute respiratory illness require screening according to the WHO criteria. Patients suspected of being infected with 2019-nCoV should be managed according to governmental protocols. Patients who do not meet the criteria are unlikely to be infected with 2019-nCoV. Patients with acute respiratory illness, without positive WHO criteria, should not have their management changed solely based on unspecific symptoms. For patients without exposure to the virus, the immediate health risk is low; this should be communicated to both providers and patients.</p><p>Patients infected with 2019-nCoV typically present with symptoms indicative of viral pneumonia such as fever, cough, fatigue, and dyspnea [<xref rid="j_jccm-2020-0013_ref_002" ref-type="bibr">2</xref>,<xref rid="j_jccm-2020-0013_ref_005" ref-type="bibr">5</xref>,<xref rid="j_jccm-2020-0013_ref_006" ref-type="bibr">6</xref>]. This is similar to the Middle East respiratory syndrome corona-virus (MERS-CoV) and the severe acute respiratory syndrome coronavirus (SARS-CoV) outbreaks [<xref rid="j_jccm-2020-0013_ref_006" ref-type="bibr">6</xref>]. Patients typically exhibit radiographic findings of bilateral multiple lobular and subsegmental consolidations, progressing to ground-glass opacities on chest CT images [<xref rid="j_jccm-2020-0013_ref_002" ref-type="bibr">2</xref>,<xref rid="j_jccm-2020-0013_ref_006" ref-type="bibr">6</xref>]. Secondary complications of 2019-nCoV include acute respiratory distress syndrome (ARDS), RNAemia (viremia), acute cardiac injury as well as secondary infections, with 23% requiring admission to the intensive care unit [<xref rid="j_jccm-2020-0013_ref_002" ref-type="bibr">2</xref>].</p><p>The competent critical care provider should not fear 2019-nCoV. While this is a new, incompletely understood strain, its management remains similar to previous CoV outbreaks. Patients may present with clinical pictures including uncomplicated respiratory infections, pneumonia, ARDS, sepsis or septic shock [<xref rid="j_jccm-2020-0013_ref_005" ref-type="bibr">5</xref>]. Despite 2019-nCoV being a viral infection, patients meeting sepsis criteria should receive the customary treatment, including early initiation of broad-spectrum antibiotic therapy, due to the potential of secondary infections [<xref rid="j_jccm-2020-0013_ref_005" ref-type="bibr">5</xref>]. The usage of corticosteroids for viral pneumonia or ARDS is discouraged in patients suspected of having 2019-nCoV unless otherwise indicated [<xref rid="j_jccm-2020-0013_ref_005" ref-type="bibr">5</xref>]. With that being said, our current guidance is interim and good clinical judgment is still necessary when managing patients with 2019-nCoV. While 2019-nCV is novel, coronaviruses are not and the general principles of managing viral pneumonia still apply. Both local reporting guidelines, as well as WHO guidance on the management of 2019-nCoV, will continue to evolve as we better understand the outbreak.</p><p>Is the novel coronavirus the crown-jewel of pandemics? No. It is a serious infectious disease, but not one that is incredibly unusual. In the recent past, we have managed SARS, MERS, Ebola, and Zika. Our scientific community is prepared and vigilant, which is evidenced in the incredibly fast response to the current outbreak. This is also not the last time we will hear about coronaviruses. They have a significant infectivity potential, and more scientific resources should be devoted to understanding and reducing the severity of future outbreaks. However, due to our experience with managing coronaviruses outbreaks in the past, we are well prepared to tackle the current one. Despite the high infectivity, the case-fatality rate remains low; state governments and the WHO are implementing the necessary measures to reduce the spread of the infection.</p></body><back><fn-group><fn fn-type="COI-statement" id="j_jccm-2020-0013_fn_001"><p><bold>Conflict of interest</bold></p><p>None to declare.</p></fn></fn-group><ref-list><title>References</title><ref id="j_jccm-2020-0013_ref_001"><label>1</label><element-citation publication-type="other"><name><surname>Lu</surname><given-names>R</given-names></name><name><surname>Zhao</surname><given-names>X</given-names></name><name><surname>Li</surname><given-names>J</given-names></name><comment>et al</comment><article-title>Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding</article-title><source>The Lancet</source><year>2020</year><pub-id pub-id-type="doi">10.1016/s0140-6736(20)30251-8</pub-id></element-citation></ref><ref id="j_jccm-2020-0013_ref_002"><label>2</label><element-citation publication-type="other"><name><surname>Chen</surname><given-names>N</given-names></name><name><surname>Zhou</surname><given-names>M</given-names></name><name><surname>Dong</surname><given-names>X</given-names></name><comment>et al</comment><article-title>Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study</article-title><source>The Lancet</source><year>2020</year><pub-id pub-id-type="doi">10.1016/s0140-6736(20)30211-7</pub-id></element-citation></ref><ref id="j_jccm-2020-0013_ref_003"><label>3</label><element-citation publication-type="other"><name><surname>Li</surname><given-names>Q</given-names></name><name><surname>Guan</surname><given-names>X</given-names></name><name><surname>Wu</surname><given-names>P</given-names></name><comment>et al</comment><article-title>Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia</article-title><source>New England Journal of Medicine</source><year>2020</year><pub-id pub-id-type="doi">10.1056/nejmoa2001316</pub-id></element-citation></ref><ref id="j_jccm-2020-0013_ref_004"><label>4</label><element-citation publication-type="other"><name><surname>Munster</surname><given-names>VJ</given-names></name><name><surname>Koopmans</surname><given-names>M</given-names></name><name><surname>Doremalen</surname><given-names>NV</given-names></name><name><surname>Riel</surname><given-names>DV</given-names></name><name><surname>Wit</surname><given-names>ED</given-names></name><article-title>A Novel Coronavirus Emerging in China — Key Questions for Impact Assessment</article-title><source>New England Journal of Medicine</source><year>2020</year><pub-id pub-id-type="doi">10.1056/nejmp2000929</pub-id></element-citation></ref><ref id="j_jccm-2020-0013_ref_005"><label>5</label><element-citation publication-type="other"><source>Clinical Management of Severe Acute Respiratory Infection When Novel Coronavirus (2019-NCoV) Infection Is Suspected Interim Guidance. World Health Organization</source><year>2020</year><ext-link ext-link-type="uri" xlink:href="htps://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected">htps://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected</ext-link></element-citation></ref><ref id="j_jccm-2020-0013_ref_006"><label>6</label><element-citation publication-type="other"><name><surname>Huang</surname><given-names>C</given-names></name><name><surname>Wang</surname><given-names>Y</given-names></name><name><surname>Li</surname><given-names>X</given-names></name><comment>et al</comment><article-title>Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China</article-title><source>The Lancet</source><year>2020</year><pub-id pub-id-type="doi">10.1016/s0140-6736(20)30183-5</pub-id></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/CovidV2/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000918 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 000918 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= CovidV2
|flux= Pmc
|étape= Corpus
|type= RBID
|clé= PMC:7029402
|texte= The 2019 Novel Coronavirus: A Crown Jewel of Pandemics?
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i -Sk "pubmed:32104726" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a CovidV2
| This area was generated with Dilib version V0.6.33. |  |