A new coronavirus associated with human respiratory disease in China. Wu Fan,Zhao Su,Yu Bin,Chen Yan-Mei,Wang Wen,Song Zhi-Gang,Hu Yi,Tao Zhao-Wu,Tian Jun-Hua,Pei Yuan-Yuan,Yuan Ming-Li,Zhang Yu-Ling,Dai Fa-Hui,Liu Yi,Wang Qi-Min,Zheng Jiao-Jiao,Xu Lin,Holmes Edward C,Zhang Yong-Zhen Nature Emerging infectious diseases, such as severe acute respiratory syndrome (SARS) and Zika virus disease, present a major threat to public health. Despite intense research efforts, how, when and where new diseases appear are still a source of considerable uncertainty. A severe respiratory disease was recently reported in Wuhan, Hubei province, China. As of 25 January 2020, at least 1,975 cases had been reported since the first patient was hospitalized on 12 December 2019. Epidemiological investigations have suggested that the outbreak was associated with a seafood market in Wuhan. Here we study a single patient who was a worker at the market and who was admitted to the Central Hospital of Wuhan on 26 December 2019 while experiencing a severe respiratory syndrome that included fever, dizziness and a cough. Metagenomic RNA sequencing of a sample of bronchoalveolar lavage fluid from the patient identified a new RNA virus strain from the family Coronaviridae, which is designated here 'WH-Human 1' coronavirus (and has also been referred to as '2019-nCoV'). Phylogenetic analysis of the complete viral genome (29,903 nucleotides) revealed that the virus was most closely related (89.1% nucleotide similarity) to a group of SARS-like coronaviruses (genus Betacoronavirus, subgenus Sarbecovirus) that had previously been found in bats in China. This outbreak highlights the ongoing ability of viral spill-over from animals to cause severe disease in humans. 10.1038/s41586-020-2008-3
    Chest CT for Typical Coronavirus Disease 2019 (COVID-19) Pneumonia: Relationship to Negative RT-PCR Testing. Xie Xingzhi,Zhong Zheng,Zhao Wei,Zheng Chao,Wang Fei,Liu Jun Radiology Some patients with positive chest CT findings may present with negative results of real-time reverse-transcription polymerase chain reaction (RT-PCR) tests for coronavirus disease 2019 (COVID-19). In this study, the authors present chest CT findings from five patients with COVID-19 infection who had initial negative RT-PCR results. All five patients had typical imaging findings, including ground-glass opacity (five patients) and/or mixed ground-glass opacity and mixed consolidation (two patients). After isolation for presumed COVID-19 pneumonia, all patients were eventually confirmed to have COVID-19 infection by means of repeated swab tests. A combination of repeated swab tests and CT scanning may be helpful for individuals with a high clinical suspicion of COVID-19 infection but negative findings at RT-PCR screening. 10.1148/radiol.2020200343
    Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Wu Joseph T,Leung Kathy,Leung Gabriel M Lancet (London, England) BACKGROUND:Since Dec 31, 2019, the Chinese city of Wuhan has reported an outbreak of atypical pneumonia caused by the 2019 novel coronavirus (2019-nCoV). Cases have been exported to other Chinese cities, as well as internationally, threatening to trigger a global outbreak. Here, we provide an estimate of the size of the epidemic in Wuhan on the basis of the number of cases exported from Wuhan to cities outside mainland China and forecast the extent of the domestic and global public health risks of epidemics, accounting for social and non-pharmaceutical prevention interventions. METHODS:We used data from Dec 31, 2019, to Jan 28, 2020, on the number of cases exported from Wuhan internationally (known days of symptom onset from Dec 25, 2019, to Jan 19, 2020) to infer the number of infections in Wuhan from Dec 1, 2019, to Jan 25, 2020. Cases exported domestically were then estimated. We forecasted the national and global spread of 2019-nCoV, accounting for the effect of the metropolitan-wide quarantine of Wuhan and surrounding cities, which began Jan 23-24, 2020. We used data on monthly flight bookings from the Official Aviation Guide and data on human mobility across more than 300 prefecture-level cities in mainland China from the Tencent database. Data on confirmed cases were obtained from the reports published by the Chinese Center for Disease Control and Prevention. Serial interval estimates were based on previous studies of severe acute respiratory syndrome coronavirus (SARS-CoV). A susceptible-exposed-infectious-recovered metapopulation model was used to simulate the epidemics across all major cities in China. The basic reproductive number was estimated using Markov Chain Monte Carlo methods and presented using the resulting posterior mean and 95% credibile interval (CrI). FINDINGS:In our baseline scenario, we estimated that the basic reproductive number for 2019-nCoV was 2·68 (95% CrI 2·47-2·86) and that 75 815 individuals (95% CrI 37 304-130 330) have been infected in Wuhan as of Jan 25, 2020. The epidemic doubling time was 6·4 days (95% CrI 5·8-7·1). We estimated that in the baseline scenario, Chongqing, Beijing, Shanghai, Guangzhou, and Shenzhen had imported 461 (95% CrI 227-805), 113 (57-193), 98 (49-168), 111 (56-191), and 80 (40-139) infections from Wuhan, respectively. If the transmissibility of 2019-nCoV were similar everywhere domestically and over time, we inferred that epidemics are already growing exponentially in multiple major cities of China with a lag time behind the Wuhan outbreak of about 1-2 weeks. INTERPRETATION:Given that 2019-nCoV is no longer contained within Wuhan, other major Chinese cities are probably sustaining localised outbreaks. Large cities overseas with close transport links to China could also become outbreak epicentres, unless substantial public health interventions at both the population and personal levels are implemented immediately. Independent self-sustaining outbreaks in major cities globally could become inevitable because of substantial exportation of presymptomatic cases and in the absence of large-scale public health interventions. Preparedness plans and mitigation interventions should be readied for quick deployment globally. FUNDING:Health and Medical Research Fund (Hong Kong, China). 10.1016/S0140-6736(20)30260-9
    A pneumonia outbreak associated with a new coronavirus of probable bat origin. Zhou Peng,Yang Xing-Lou,Wang Xian-Guang,Hu Ben,Zhang Lei,Zhang Wei,Si Hao-Rui,Zhu Yan,Li Bei,Huang Chao-Lin,Chen Hui-Dong,Chen Jing,Luo Yun,Guo Hua,Jiang Ren-Di,Liu Mei-Qin,Chen Ying,Shen Xu-Rui,Wang Xi,Zheng Xiao-Shuang,Zhao Kai,Chen Quan-Jiao,Deng Fei,Liu Lin-Lin,Yan Bing,Zhan Fa-Xian,Wang Yan-Yi,Xiao Geng-Fu,Shi Zheng-Li Nature Since the outbreak of severe acute respiratory syndrome (SARS) 18 years ago, a large number of SARS-related coronaviruses (SARSr-CoVs) have been discovered in their natural reservoir host, bats. Previous studies have shown that some bat SARSr-CoVs have the potential to infect humans. Here we report the identification and characterization of a new coronavirus (2019-nCoV), which caused an epidemic of acute respiratory syndrome in humans in Wuhan, China. The epidemic, which started on 12 December 2019, had caused 2,794 laboratory-confirmed infections including 80 deaths by 26 January 2020. Full-length genome sequences were obtained from five patients at an early stage of the outbreak. The sequences are almost identical and share 79.6% sequence identity to SARS-CoV. Furthermore, we show that 2019-nCoV is 96% identical at the whole-genome level to a bat coronavirus. Pairwise protein sequence analysis of seven conserved non-structural proteins domains show that this virus belongs to the species of SARSr-CoV. In addition, 2019-nCoV virus isolated from the bronchoalveolar lavage fluid of a critically ill patient could be neutralized by sera from several patients. Notably, we confirmed that 2019-nCoV uses the same cell entry receptor-angiotensin converting enzyme II (ACE2)-as SARS-CoV. 10.1038/s41586-020-2012-7
    Updates on Wuhan 2019 novel coronavirus epidemic. Kofi Ayittey Foster,Dzuvor Christian,Kormla Ayittey Matthew,Bennita Chiwero Nyasha,Habib Ahmed Journal of medical virology 10.1002/jmv.25695
    CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Chung Michael,Bernheim Adam,Mei Xueyan,Zhang Ning,Huang Mingqian,Zeng Xianjun,Cui Jiufa,Xu Wenjian,Yang Yang,Fayad Zahi A,Jacobi Adam,Li Kunwei,Li Shaolin,Shan Hong Radiology In this retrospective case series, chest CT scans of 21 symptomatic patients from China infected with the 2019 novel coronavirus (2019-nCoV) were reviewed, with emphasis on identifying and characterizing the most common findings. Typical CT findings included bilateral pulmonary parenchymal ground-glass and consolidative pulmonary opacities, sometimes with a rounded morphology and a peripheral lung distribution. Notably, lung cavitation, discrete pulmonary nodules, pleural effusions, and lymphadenopathy were absent. Follow-up imaging in a subset of patients during the study time window often demonstrated mild or moderate progression of disease, as manifested by increasing extent and density of lung opacities. 10.1148/radiol.2020200230
    Chest CT Findings in 2019 Novel Coronavirus (2019-nCoV) Infections from Wuhan, China: Key Points for the Radiologist. Kanne Jeffrey P Radiology 10.1148/radiol.2020200241
    Measures for diagnosing and treating infections by a novel coronavirus responsible for a pneumonia outbreak originating in Wuhan, China. Yu Fei,Du Lanying,Ojcius David M,Pan Chungen,Jiang Shibo Microbes and infection On 10 January 2020, a new coronavirus causing a pneumonia outbreak in Wuhan City in central China was denoted as 2019-nCoV by the World Health Organization (WHO). As of 24 January 2020, there were 887 confirmed cases of 2019-nCoV infection, including 26 deaths, reported in China and other countries. Therefore, combating this new virus and stopping the epidemic is a matter of urgency. Here, we focus on advances in research and development of fast diagnosis methods, as well as potential prophylactics and therapeutics to prevent or treat 2019-nCoV infection. 10.1016/j.micinf.2020.01.003
    Note from the editors: World Health Organization declares novel coronavirus (2019-nCoV) sixth public health emergency of international concern. Eurosurveillance Editorial Team Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 10.2807/1560-7917.ES.2020.25.5.200131e
    Novel coronavirus (2019-nCoV) early-stage importation risk to Europe, January 2020. Pullano Giulia,Pinotti Francesco,Valdano Eugenio,Boëlle Pierre-Yves,Poletto Chiara,Colizza Vittoria Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin As at 27 January 2020, 42 novel coronavirus (2019-nCoV) cases were confirmed outside China. We estimate the risk of case importation to Europe from affected areas in China via air travel. We consider travel restrictions in place, three reported cases in France, one in Germany. Estimated risk in Europe remains high. The United Kingdom, Germany and France are at highest risk. Importation from Beijing and Shanghai would lead to higher and widespread risk for Europe. 10.2807/1560-7917.ES.2020.25.4.2000057
    Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020. Riou Julien,Althaus Christian L Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin Since December 2019, China has been experiencing a large outbreak of a novel coronavirus (2019-nCoV) which can cause respiratory disease and severe pneumonia. We estimated the basic reproduction number of 2019-nCoV to be around 2.2 (90% high density interval: 1.4-3.8), indicating the potential for sustained human-to-human transmission. Transmission characteristics appear to be of similar magnitude to severe acute respiratory syndrome-related coronavirus (SARS-CoV) and pandemic influenza, indicating a risk of global spread. 10.2807/1560-7917.ES.2020.25.4.2000058
    Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Wang Manli,Cao Ruiyuan,Zhang Leike,Yang Xinglou,Liu Jia,Xu Mingyue,Shi Zhengli,Hu Zhihong,Zhong Wu,Xiao Gengfu Cell research 10.1038/s41422-020-0282-0
    RNA based mNGS approach identifies a novel human coronavirus from two individual pneumonia cases in 2019 Wuhan outbreak. Chen Liangjun,Liu Weiyong,Zhang Qi,Xu Ke,Ye Guangming,Wu Weichen,Sun Ziyong,Liu Fang,Wu Kailang,Zhong Bo,Mei Yi,Zhang Wenxia,Chen Yu,Li Yirong,Shi Mang,Lan Ke,Liu Yingle Emerging microbes & infections From December 2019, an outbreak of unusual pneumonia was reported in Wuhan with many cases linked to Huanan Seafood Market that sells seafood as well as live exotic animals. We investigated two patients who developed acute respiratory syndromes after independent contact history with this market. The two patients shared common clinical features including fever, cough, and multiple ground-glass opacities in the bilateral lung field with patchy infiltration. Here, we highlight the use of a low-input metagenomic next-generation sequencing (mNGS) approach on RNA extracted from bronchoalveolar lavage fluid (BALF). It rapidly identified a novel coronavirus (named 2019-nCoV according to World Health Organization announcement) which was the sole pathogens in the sample with very high abundance level (1.5% and 0.62% of total RNA sequenced). The entire viral genome is 29,881 nt in length (GenBank MN988668 and MN988669, Sequence Read Archive database Bioproject accession PRJNA601736) and is classified into β-coronavirus genus. Phylogenetic analysis indicates that 2019-nCoV is close to coronaviruses (CoVs) circulating in Rhinolophus (Horseshoe bats), such as 98.7% nucleotide identity to partial RdRp gene of bat coronavirus strain BtCoV/4991 (GenBank KP876546, 370 nt sequence of RdRp and lack of other genome sequence) and 87.9% nucleotide identity to bat coronavirus strain bat-SL-CoVZC45 and bat-SL-CoVZXC21. Evolutionary analysis based on ORF1a/1b, S, and N genes also suggests 2019-nCoV is more likely a novel CoV independently introduced from animals to humans. 10.1080/22221751.2020.1725399
    The Novel Coronavirus: A Bird's Eye View. Habibzadeh Parham,Stoneman Emily K The international journal of occupational and environmental medicine The novel coronavirus (2019-nCoV) outbreak, which initially began in China, has spread to many countries around the globe, with the number of confirmed cases increasing every day. With a death toll exceeding that of the SARS-CoV outbreak back in 2002 and 2003 in China, 2019-nCoV has led to a public health emergency of international concern, putting all health organizations on high alert. Herein, we present on an overview of the currently available information on the pathogenesis, epidemiology, clinical presentation, diagnosis, and treatment of this virus. 10.15171/ijoem.2020.1921
    The first two cases of 2019-nCoV in Italy: Where they come from? Giovanetti Marta,Benvenuto Domenico,Angeletti Silvia,Ciccozzi Massimo Journal of medical virology A novel Coronavirus, 2019-nCoV, has been identified as the causal pathogen of an ongoing epidemic, with the first cases reported in Wuhan, China, last December 2019, and has since spread to other countries worldwide, included Europe and very recently Italy. In this short report, phylogenetic reconstruction was used to better understand the transmission dynamics of the virus from its first introduction in China focusing on the more recent evidence of infection in a couple of Chinese tourists arrived in Italy on 23rd January 2020 and labeled as Coronavirus Italian cases. A maximum clade credibility tree has been built using a dataset of 54 genome sequences of 2019-nCoV plus two closely related bat strains (SARS-like CoV) available in GenBank. Bayesian time-scaled phylogenetic analysis was implemented in BEAST 1.10.4. The Bayesian phylogenetic reconstruction showed that 2019-2020 nCoV firstly introduced in Wuhan on 25 November 2019, started epidemic transmission reaching many countries worldwide, including Europe and Italy where the two strains isolated dated back 19 January 2020, the same that the Chinese tourists arrived in Italy. Strains isolated outside China were intermixed with strains isolated in China as evidence of likely imported cases in Rome, Italy, and Europe, as well. In conclusion, this report suggests that further spread of 2019-nCoV epidemic was supported by human mobility and that quarantine of suspected or diagnosed cases is useful to prevent further transmission. Viral genome phylogenetic analysis represents a useful tool for the evaluation of transmission dynamics and preventive action. 10.1002/jmv.25699
    Immunoinformatics-aided identification of T cell and B cell epitopes in the surface glycoprotein of 2019-nCoV. Baruah Vargab,Bose Sujoy Journal of medical virology The 2019 novel coronavirus (2019-nCoV) outbreak has caused a large number of deaths with thousands of confirmed cases worldwide, especially in East Asia. This study took an immunoinformatics approach to identify significant cytotoxic T lymphocyte (CTL) and B cell epitopes in the 2019-nCoV surface glycoprotein. Also, interactions between identified CTL epitopes and their corresponding major histocompatibility complex (MHC) class I supertype representatives prevalent in China were studied by molecular dynamics simulations. We identified five CTL epitopes, three sequential B cell epitopes and five discontinuous B cell epitopes in the viral surface glycoprotein. Also, during simulations, the CTL epitopes were observed to be binding MHC class I peptide-binding grooves via multiple contacts, with continuous hydrogen bonds and salt bridge anchors, indicating their potential in generating immune responses. Some of these identified epitopes can be potential candidates for the development of 2019-nCoV vaccines. 10.1002/jmv.25698
    2019 Novel Coronavirus-Important Information for Clinicians. Del Rio Carlos,Malani Preeti N JAMA 10.1001/jama.2020.1490
    Reporting, Epidemic Growth, and Reproduction Numbers for the 2019 Novel Coronavirus (2019-nCoV) Epidemic. Tuite Ashleigh R,Fisman David N Annals of internal medicine 10.7326/M20-0358
    The 2019 Novel Coronavirus (2019-nCoV): Novel Virus, Old Challenges. Duarte Raquel,Furtado Isabel,Sousa Luís,Carvalho Carlos Filipe Afonso Acta medica portuguesa 10.20344/amp.13547
    [Facing the pandemic of 2019 novel coronavirus infections: the pediatric perspectives]. Fang F,Luo X P Zhonghua er ke za zhi = Chinese journal of pediatrics 10.3760/cma.j.issn.0578-1310.2020.0001
    [First case of 2019 novel coronavirus infection in children in Shanghai]. Cai J H,Wang X S,Ge Y L,Xia A M,Chang H L,Tian H,Zhu Y X,Wang Q R,Zeng J S Zhonghua er ke za zhi = Chinese journal of pediatrics 10.3760/cma.j.issn.0578-1310.2020.0002
    [Suggestions for prevention of 2019 novel coronavirus infection in otolaryngology head and neck surgery medical staff]. Xu K,Lai X Q,Liu Z Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery The epidemic of the 2019 Novel Coronavirus (2019-nCoV) infection has presented as a grim and complex situation recently. More than 11,000 cases of 2019-nCoV infection has been confirmed in China until February 1 2020, which are causing great impact to economy and society, and seriously interfering with ordinary medical practice of otolaryngology and head and neck surgery. This advice guideline discusses the medical protection measures required in the outpatient clinic as well as in operation ward in otolaryngology head and neck department, which aims to protect medical staff from 2019-nCoV infection. 10.3760/cma.j.issn.1673-0860.2020.0001
    [Diagnosis and clinical management of 2019 novel coronavirus infection: an operational recommendation of Peking Union Medical College Hospital (V2.0)]. Zhonghua nei ke za zhi Since December 2019, China has been experiencing an outbreak of new infectious disease caused by 2019 novel coronavirus (2019-nCoV). The clinical features include fever, coughing, shortness of breath, and inflammatory pulmonary infiltration revealed by X ray. China rapidly identified 2019-nCoV-related pneumonia a statutory infectious disease. To standardize the diagnosis and treatment of this new infectious disease, operational guidelines for the diagnosis and management of 2019-nCoV infection is accomplished by Peking Union Medical College Hospital. 10.3760/cma.j.issn.0578-1426.2020.03.003
    [2019-nCoV: new challenges from coronavirus]. Tian H Y Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] The outbreak of pneumonia caused by the novel coronavirus 2019-nCoV in Wuhan, Hubei province of China, at the end of 2019 shaped tremendous challenges to China's public health and clinical treatment. The virus belongs to the β genus Coronavirus in the family Corornaviridae, and is closely related to SARS-CoV and MERS-CoV, causing severe symptoms of pneumonia. The virus is transmitted through droplets, close contact, and other means, and patients in the incubation period could potentially transmit the virus to other persons. According to current observations, 2019-nCoV is weaker than SARS in pathogenesis, but has stronger transmission competence; it's mechanism of cross-species spread might be related with angiotensin-converting enzyme Ⅱ (ACE2), which is consistent with the receptor SARS-CoV. After the outbreak of this disease, Chinese scientists invested a lot of energy to carry out research by developing rapid diagnostic reagents, identifying the characters of the pathogen, screening out clinical drugs that may inhibit the virus, and are rapidly developing vaccines. The emergence of 2019-nCoV reminds us once again of the importance of establishing a systematic coronavirus surveillance network. It also poses new challenges to prevention and control of the emerging epidemic and rapidly responses on scientific research. 10.3760/cma.j.issn.0253-9624.2020.0001
    [Prevention and control program on 2019 novel coronavirus infection in Children's digestive endoscopy center]. Zhonghua er ke za zhi = Chinese journal of pediatrics 10.3760/cma.j.issn.0578-1310.2020.0003
    [Efficient management of novel coronavirus pneumonia by efficient prevention and control in scientific manner]. Gao Z C Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases At the end of 2019, sporadic and clustered case with "pneumonia of unknown origin" emerged in Wuhan, Hubei province. The causative pathogen was quickly confirmed as "2019-nCoV" . The epidemic soon spread throughout the country and became a pandemic in over a month. Government and medical institutions across the country mobilized all kinds of resources and took a variety of measures to actively treat patients and stop the epidemic. Based on current studies, the author summarized the clinical characteristics and evolution of the novel viral pneumonia, and proposed the key points of diagnosis and treatment, the scientific management of both confirmed and suspected cases, and the scientific management of disease prevention and control. 10.3760/cma.j.issn.1001-0939.2020.0001
    [Potential antiviral therapeutics for 2019 Novel Coronavirus]. Li H,Wang Y M,Xu J Y,Cao B Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases The recent outbreak of respiratory illness in Wuhan, China is caused by a novel coronavirus, named 2019-nCoV, which is genetically close to a bat-derived coronavirus. 2019-nCoV is categorized as beta genus coronavirus, same as the two other strains - severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Antiviral drugs commonly used in clinical practice, including neuraminidase inhibitors (oseltamivir, paramivir, zanamivir, etc.), ganciclovir, acyclovir and ribavirin, are invalid for 2019-nCoV and not recommended. Drugs are possibly effective for 2019-nCoV include: remdesivir, lopinavir / ritonavir, lopinavir / ritonavir combined with interferon-β, convalescent plasma, and monoclonal antibodies. But the efficacy and safety of these drugs for 2019-nCoV pneumonia patients need to be assessed by further clinical trials. 10.3760/cma.j.issn.1001-0939.2020.0002
    [Early detection and disease assessment of patients with novel coronavirus pneumonia]. Zhou L,Liu H G Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases In December 2019, the outbreak of novel coronavirus (2019- nCoV) in wuhan, China, attracting attention worldwidely. The novel coronavirus has the characteristics of rapid transmission, atypical clinical symptoms, and easy to affect both lungs, leading to missed diagnosis and misdiagnosis, as well as difficult to detection and assessment at early stage. Fever, cough, myalgia, weakness, dyspnea and imagings may be helpful for the early detection of novel coronavirus pneumonia. At the same time, the rate of disease progression, fever, CT manifestations, hypoxia degree, age, basic diseases, and laboratory indicators can also be used to evaluate the severity of the novel coronavirus pneumonia. 10.3760/cma.j.issn.1001-0939.2020.0003
    [Pulmonary rehabilitation guidelines in the principle of 4S for patients infected with 2019 novel coronavirus (2019-nCoV)]. Yang F,Liu N,Wu J Y,Hu L L,Su G S,Zheng N S Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases A recent epidemic of pneumonia cases in Wuhan China was caused by a novel coronavirus with strong infectivity, the 2019 novel coronavirus (2019-nCoV). The article provides the pulmonary rehabilitation (PR) methods in the principle of 4S (simple, safe, satisfy, save) for patients with pneumonia caused by the novel coronavirus, shows how to establish a ventilative and convectional PR environment to prevent the spread of virus through droplets, how to guide the patients to carry out PR, how to carry out respiratory muscle training, effective cough, expectoration, sneeze, general exercise, digestive function rehabilitation and psychological rehabilitation, and how to clean and disinfect the PR environment. 10.3760/cma.j.issn.1001-0939.2020.0004
    An interim review of the epidemiological characteristics of 2019 novel coronavirus. Ryu Sukhyun,Chun Byung Chul, Epidemiology and health OBJECTIVES:The 2019 novel coronavirus (2019-nCoV) from Wuhan, China is currently recognized as a public health emergency of global concern. METHODS:We reviewed the currently available literature to provide up-to-date guidance on control measures to be implemented by public health authorities. RESULTS:Some of the epidemiological characteristics of 2019-nCoV have been identified. However, there remain considerable uncertainties, which should be considered when providing guidance to public health authorities on control measures. CONCLUSIONS:Additional studies incorporating more detailed information from confirmed cases would be valuable. 10.4178/epih.e2020006
    Estimating the Unreported Number of Novel Coronavirus (2019-nCoV) Cases in China in the First Half of January 2020: A Data-Driven Modelling Analysis of the Early Outbreak. Zhao Shi,Musa Salihu S,Lin Qianying,Ran Jinjun,Yang Guangpu,Wang Weiming,Lou Yijun,Yang Lin,Gao Daozhou,He Daihai,Wang Maggie H Journal of clinical medicine BACKGROUND:In December 2019, an outbreak of respiratory illness caused by a novel coronavirus (2019-nCoV) emerged in Wuhan, China and has swiftly spread to other parts of China and a number of foreign countries. The 2019-nCoV cases might have been under-reported roughly from 1 to 15 January 2020, and thus we estimated the number of unreported cases and the basic reproduction number, , of 2019-nCoV. METHODS:We modelled the epidemic curve of 2019-nCoV cases, in mainland China from 1 December 2019 to 24 January 2020 through the exponential growth. The number of unreported cases was determined by the maximum likelihood estimation. We used the serial intervals (SI) of infection caused by two other well-known coronaviruses (CoV), Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) CoVs, as approximations of the unknown SI for 2019-nCoV to estimate . RESULTS:We confirmed that the initial growth phase followed an exponential growth pattern. The under-reporting was likely to have resulted in 469 (95% CI: 403-540) unreported cases from 1 to 15 January 2020. The reporting rate after 17 January 2020 was likely to have increased 21-fold (95% CI: 18-25) in comparison to the situation from 1 to 17 January 2020 on average. We estimated the of 2019-nCoV at 2.56 (95% CI: 2.49-2.63). CONCLUSION:The under-reporting was likely to have occurred during the first half of January 2020 and should be considered in future investigation. 10.3390/jcm9020388
    A novel coronavirus (2019-nCoV) causing pneumonia-associated respiratory syndrome. Jiang Shibo,Xia Shuai,Ying Tianlei,Lu Lu Cellular & molecular immunology 10.1038/s41423-020-0372-4
    Novel coronavirus infection during the 2019-2020 epidemic: preparing intensive care units-the experience in Sichuan Province, China. Liao Xuelian,Wang Bo,Kang Yan Intensive care medicine 10.1007/s00134-020-05954-2
    Diagnosis and treatment of 2019 novel coronavirus infection in children: a pressing issue. Shen Kun-Ling,Yang Yong-Hong World journal of pediatrics : WJP 10.1007/s12519-020-00344-6
    Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus. Chen Zhi-Min,Fu Jun-Fen,Shu Qiang,Chen Ying-Hu,Hua Chun-Zhen,Li Fu-Bang,Lin Ru,Tang Lan-Fang,Wang Tian-Lin,Wang Wei,Wang Ying-Shuo,Xu Wei-Ze,Yang Zi-Hao,Ye Sheng,Yuan Tian-Ming,Zhang Chen-Mei,Zhang Yuan-Yuan World journal of pediatrics : WJP Since December 2019, an epidemic caused by novel coronavirus (2019-nCoV) infection has occurred unexpectedly in China. As of 8 pm, 31 January 2020, more than 20 pediatric cases have been reported in China. Of these cases, ten patients were identified in Zhejiang Province, with an age of onset ranging from 112 days to 17 years. Following the latest National recommendations for diagnosis and treatment of pneumonia caused by 2019-nCoV (the 4th edition) and current status of clinical practice in Zhejiang Province, recommendations for the diagnosis and treatment of respiratory infection caused by 2019-nCoV for children were drafted by the National Clinical Research Center for Child Health, the National Children's Regional Medical Center, Children's Hospital, Zhejiang University School of Medicine to further standardize the protocol for diagnosis and treatment of respiratory infection in children caused by 2019-nCoV. 10.1007/s12519-020-00345-5
    [Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia]. Chen L,Liu H G,Liu W,Liu J,Liu K,Shang J,Deng Y,Wei S Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases To analyze the clinical characteristics of 2019 novel coronavirus (2019-nCoV) pneumonia and to investigate the correlation between serum inflammatory cytokines and severity of the disease. 29 patients with 2019-ncov admitted to the isolation ward of Tongji hospital affiliated to Tongji medical college of Huazhong University of Science and Technology in January 2020 were selected as the study subjects. Clinical data were collected and the general information, clinical symptoms, blood test and CT imaging characteristics were analyzed. According to the relevant diagnostic criteria, the patients were divided into three groups: mild (15 cases), severe (9 cases) and critical (5 cases). The expression levels of inflammatory cytokines and other markers in the serum of each group were detected, and the changes of these indicators of the three groups were compared and analyzed, as well as their relationship with the clinical classification of the disease. (1) The main symptoms of 2019-nCoV pneumonia was fever (28/29) with or without respiratory and other systemic symptoms. Two patients died with underlying disease and co-bacterial infection, respectively. (2) The blood test of the patients showed normal or decreased white blood cell count (23/29), decreased lymphocyte count (20/29), increased hypersensitive C reactive protein (hs-CRP) (27/29), and normal procalcitonin. In most patients,serum lactate dehydrogenase (LDH) was significantly increased (20/29), while albumin was decreased(15/29). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (Tbil), serum creatinine (Scr) and other items showed no significant changes. (3) CT findings of typical cases were single or multiple patchy ground glass shadows accompanied by septal thickening. When the disease progresses, the lesion increases and the scope expands, and the ground glass shadow coexists with the solid shadow or the stripe shadow. (4) There were statistically significant differences in the expression levels of interleukin-2 receptor (IL-2R) and IL-6 in the serum of the three groups (P<0.05), among which the critical group was higher than the severe group and the severe group was higher than the mildgroup. However, there were no statistically significant differences in serum levels of tumor necrosis factor-alpha (TNF-α), IL-1, IL-8, IL-10, hs-CRP, lymphocyte count and LDH among the three groups (P>0.05). The clinical characteristics of 2019-nCoV pneumonia are similar to those of common viral pneumonia. High resolution CT is of great value in the differential diagnosis of this disease. The increased expression of IL-2R and IL-6 in serum is expected to predict the severity of the 2019-nCoV pneumonia and the prognosis of patients. 10.3760/cma.j.issn.1001-0939.2020.0005
    Genomic variance of the 2019-nCoV coronavirus. Ceraolo Carmine,Giorgi Federico M Journal of medical virology There is a rising global concern for the recently emerged novel coronavirus (2019-nCoV). Full genomic sequences have been released by the worldwide scientific community in the last few weeks to understand the evolutionary origin and molecular characteristics of this virus. Taking advantage of all the genomic information currently available, we constructed a phylogenetic tree including also representatives of other coronaviridae, such as Bat coronavirus (BCoV) and severe acute respiratory syndrome. We confirm high sequence similarity (>99%) between all sequenced 2019-nCoVs genomes available, with the closest BCoV sequence sharing 96.2% sequence identity, confirming the notion of a zoonotic origin of 2019-nCoV. Despite the low heterogeneity of the 2019-nCoV genomes, we could identify at least two hypervariable genomic hotspots, one of which is responsible for a Serine/Leucine variation in the viral ORF8-encoded protein. Finally, we perform a full proteomic comparison with other coronaviridae, identifying key aminoacidic differences to be considered for antiviral strategies deriving from previous anti-coronavirus approaches. 10.1002/jmv.25700
    Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak - United States, December 31, 2019-February 4, 2020. Patel Anita,Jernigan Daniel B, MMWR. Morbidity and mortality weekly report On December 31, 2019, Chinese health officials reported a cluster of cases of acute respiratory illness in persons associated with the Hunan seafood and animal market in the city of Wuhan, Hubei Province, in central China. On January 7, 2020, Chinese health officials confirmed that a novel coronavirus (2019-nCoV) was associated with this initial cluster (1). As of February 4, 2020, a total of 20,471 confirmed cases, including 2,788 (13.6%) with severe illness,* and 425 deaths (2.1%) had been reported by the National Health Commission of China (2). Cases have also been reported in 26 locations outside of mainland China, including documentation of some person-to-person transmission and one death (2). As of February 4, 11 cases had been reported in the United States. On January 30, the World Health Organization (WHO) Director-General declared that the 2019-nCoV outbreak constitutes a Public Health Emergency of International Concern. On January 31, the U.S. Department of Health and Human Services (HHS) Secretary declared a U.S. public health emergency to respond to 2019-nCoV. Also on January 31, the president of the United States signed a "Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus," which limits entry into the United States of persons who traveled to mainland China to U.S. citizens and lawful permanent residents and their families (3). CDC, multiple other federal agencies, state and local health departments, and other partners are implementing aggressive measures to slow transmission of 2019-nCoV in the United States (4,5). These measures require the identification of cases and their contacts in the United States and the appropriate assessment and care of travelers arriving from mainland China to the United States. These measures are being implemented in anticipation of additional 2019-nCoV cases in the United States. Although these measures might not prevent the eventual establishment of ongoing, widespread transmission of the virus in the United States, they are being implemented to 1) slow the spread of illness; 2) provide time to better prepare health care systems and the general public to be ready if widespread transmission with substantial associated illness occurs; and 3) better characterize 2019-nCoV infection to guide public health recommendations and the development of medical countermeasures including diagnostics, therapeutics, and vaccines. Public health authorities are monitoring the situation closely. As more is learned about this novel virus and this outbreak, CDC will rapidly incorporate new knowledge into guidance for action by CDC and state and local health departments. 10.15585/mmwr.mm6905e1
    2019-nCoV acute respiratory disease, Australia: Epidemiology Report 1 (Reporting week 26 January - 1 February 2020). Communicable diseases intelligence (2018) This is the first epidemiological report of novel coronavirus (2019-nCoV) acute respiratory disease infections reported in Australia at 19:00 Australian Eastern Daylight Time [AEDT] 1 February 2020. It includes data on Australian cases notified during the week 26 January to 1 February 2020 and in the previous week (19 to 25 January 2020), the international situation and current information on the severity, transmission and spread of the 2019-nCoV infection. 10.33321/cdi.2019.44.13
    Fighting the novel coronavirus: the publication of the Chinese expert consensus on the perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection (First edition). Annals of palliative medicine 10.21037/apm.2020.02.02
    A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Jin Ying-Hui,Cai Lin,Cheng Zhen-Shun,Cheng Hong,Deng Tong,Fan Yi-Pin,Fang Cheng,Huang Di,Huang Lu-Qi,Huang Qiao,Han Yong,Hu Bo,Hu Fen,Li Bing-Hui,Li Yi-Rong,Liang Ke,Lin Li-Kai,Luo Li-Sha,Ma Jing,Ma Lin-Lu,Peng Zhi-Yong,Pan Yun-Bao,Pan Zhen-Yu,Ren Xue-Qun,Sun Hui-Min,Wang Ying,Wang Yun-Yun,Weng Hong,Wei Chao-Jie,Wu Dong-Fang,Xia Jian,Xiong Yong,Xu Hai-Bo,Yao Xiao-Mei,Yuan Yu-Feng,Ye Tai-Sheng,Zhang Xiao-Chun,Zhang Ying-Wen,Zhang Yin-Gao,Zhang Hua-Min,Zhao Yan,Zhao Ming-Juan,Zi Hao,Zeng Xian-Tao,Wang Yong-Yan,Wang Xing-Huan, Military Medical Research In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province; and then named "2019 novel coronavirus (2019-nCoV)" by the World Health Organization (WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world's attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development; we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control (including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV. 10.1186/s40779-020-0233-6
    The First Case of 2019 Novel Coronavirus Pneumonia Imported into Korea from Wuhan, China: Implication for Infection Prevention and Control Measures. Kim Jin Yong,Choe Pyoeng Gyun,Oh Yoonju,Oh Kyung Joong,Kim Jinsil,Park So Jeong,Park Ji Hye,Na Hye Kyoung,Oh Myoung Don Journal of Korean medical science In December 2019, a viral pneumonia outbreak caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV), began in Wuhan, China. We report the epidemiological and clinical features of the first patient with 2019-nCoV pneumonia imported into Korea from Wuhan. This report suggests that in the early phase of 2019-nCoV pneumonia, chest radiography would miss patients with pneumonia and highlights taking travel history is of paramount importance for early detection and isolation of 2019-nCoV cases. 10.3346/jkms.2020.35.e61
    2019-novel Coronavirus (2019-nCoV): estimating the case fatality rate - a word of caution. Battegay Manuel,Kuehl Richard,Tschudin-Sutter Sarah,Hirsch Hans H,Widmer Andreas F,Neher Richard A Swiss medical weekly 10.4414/smw.2020.20203
    Evolving status of the 2019 novel coronavirus infection: Proposal of conventional serologic assays for disease diagnosis and infection monitoring. Xiao Shu-Yuan,Wu Yingjie,Liu Huan Journal of medical virology 10.1002/jmv.25702
    CT Manifestations of Two Cases of 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Fang Yicheng,Zhang Huangqi,Xu Yunyu,Xie Jicheng,Pang Peipei,Ji Wenbin Radiology 10.1148/radiol.2020200280
    Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. Wang Dawei,Hu Bo,Hu Chang,Zhu Fangfang,Liu Xing,Zhang Jing,Wang Binbin,Xiang Hui,Cheng Zhenshun,Xiong Yong,Zhao Yan,Li Yirong,Wang Xinghuan,Peng Zhiyong JAMA Importance:In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited. Objective:To describe the epidemiological and clinical characteristics of NCIP. Design, Setting, and Participants:Retrospective, single-center case series of the 138 consecutive hospitalized patients with confirmed NCIP at Zhongnan Hospital of Wuhan University in Wuhan, China, from January 1 to January 28, 2020; final date of follow-up was February 3, 2020. Exposures:Documented NCIP. Main Outcomes and Measures:Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked. Results:Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men. Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 [29%]) and hospitalized patients (17 [12.3%]). Common symptoms included fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]). Lymphopenia (lymphocyte count, 0.8 × 109/L [interquartile range {IQR}, 0.6-1.1]) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients (39.9%). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Most patients received antiviral therapy (oseltamivir, 124 [89.9%]), and many received antibacterial therapy (moxifloxacin, 89 [64.4%]; ceftriaxone, 34 [24.6%]; azithromycin, 25 [18.1%]) and glucocorticoid therapy (62 [44.9%]). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 [61.1%]), arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%] vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]). Of the 36 cases in the ICU, 4 (11.1%) received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17 (47.2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). As of February 3, 47 patients (34.1%) were discharged and 6 died (overall mortality, 4.3%), but the remaining patients are still hospitalized. Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7.0-14.0). Conclusions and Relevance:In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%. 10.1001/jama.2020.1585
    Molecular Diagnosis of a Novel Coronavirus (2019-nCoV) Causing an Outbreak of Pneumonia. Chu Daniel K W,Pan Yang,Cheng Samuel M S,Hui Kenrie P Y,Krishnan Pavithra,Liu Yingzhi,Ng Daisy Y M,Wan Carrie K C,Yang Peng,Wang Quanyi,Peiris Malik,Poon Leo L M Clinical chemistry BACKGROUND:A novel coronavirus of zoonotic origin (2019-nCoV) has recently been identified in patients with acute respiratory disease. This virus is genetically similar to SARS coronavirus and bat SARS-like coronaviruses. The outbreak was initially detected in Wuhan, a major city of China, but has subsequently been detected in other provinces of China. Travel-associated cases have also been reported in a few other countries. Outbreaks in health care workers indicate human-to-human transmission. Molecular tests for rapid detection of this virus are urgently needed for early identification of infected patients. METHODS:We developed two 1-step quantitative real-time reverse-transcription PCR assays to detect two different regions (ORF1b and N) of the viral genome. The primer and probe sets were designed to react with this novel coronavirus and its closely related viruses, such as SARS coronavirus. These assays were evaluated using a panel of positive and negative controls. In addition, respiratory specimens from two 2019-nCoV-infected patients were tested. RESULTS:Using RNA extracted from cells infected by SARS coronavirus as a positive control, these assays were shown to have a dynamic range of at least seven orders of magnitude (2x10-4-2000 TCID50/reaction). Using DNA plasmids as positive standards, the detection limits of these assays were found to be below 10 copies per reaction. All negative control samples were negative in the assays. Samples from two 2019-nCoV-infected patients were positive in the tests. CONCLUSIONS:The established assays can achieve a rapid detection of 2019n-CoV in human samples, thereby allowing early identification of patients. 10.1093/clinchem/hvaa029
    Racing Towards the Development of Diagnostics for a Novel Coronavirus (2019-nCoV). Lo Y M Dennis,Chiu Rossa W K Clinical chemistry 10.1093/clinchem/hvaa038
    Evolution of CT Manifestations in a Patient Recovered from 2019 Novel Coronavirus (2019-nCoV) Pneumonia in Wuhan, China. Shi Heshui,Han Xiaoyu,Zheng Chuansheng Radiology 10.1148/radiol.2020200269
    Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Xiang Yu-Tao,Yang Yuan,Li Wen,Zhang Ling,Zhang Qinge,Cheung Teris,Ng Chee H The lancet. Psychiatry 10.1016/S2215-0366(20)30046-8
    The Rate of Underascertainment of Novel Coronavirus (2019-nCoV) Infection: Estimation Using Japanese Passengers Data on Evacuation Flights. Nishiura Hiroshi,Kobayashi Tetsuro,Yang Yichi,Hayashi Katsuma,Miyama Takeshi,Kinoshita Ryo,Linton Natalie M,Jung Sung-Mok,Yuan Baoyin,Suzuki Ayako,Akhmetzhanov Andrei R Journal of clinical medicine From 29 to 31 January 2020, a total of 565 Japanese citizens were evacuated from Wuhan, China on three chartered flights. All passengers were screened upon arrival in Japan for symptoms consistent with novel coronavirus (2019-nCoV) infection and tested for presence of the virus. Assuming that the mean detection window of the virus can be informed by the mean serial interval (estimated at 7.5 days), the ascertainment rate of infection was estimated at 9.2% (95% confidence interval: 5.0, 20.0). This indicates that the incidence of infection in Wuhan can be estimated at 20,767 infected individuals, including those with asymptomatic and mildly symptomatic infections. The infection fatality risk (IFR)-the actual risk of death among all infected individuals-is therefore 0.3% to 0.6%, which may be comparable to Asian influenza pandemic of 1957-1958. 10.3390/jcm9020419
    [Interpretation of "Guidelines for the Diagnosis and Treatment of Novel Coronavirus (2019-nCoV) Infection by the National Health Commission (Trial Version 5)"]. Lin L,Li T S Zhonghua yi xue za zhi the National Health Commission of the People's Republic of China publish the guidelines for the diagnosis and treatment of novel coronavirus (2019-nCoV) infection (trial version 5) .With the awareness and understanding of the disease, the guidelines have been revised for recognize, treat, and prevent diseases. Then, what are the contents of the fifth edition of the guide issued updated compared to the fourth edition, now, learn together. 10.3760/cma.j.issn.0376-2491.2020.0001
    [Expert consensus for bronchoscopy during the epidemic of 2019 Novel Coronavirus infection (Trial version)]. Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases Infection with 2019 Novel Coronavirus (2019-nCoV) is mainly transmitted by respiratory droplets, airborne transmission and direct contact. However, conducting bronchoscopy on patients with 2019-nCoV is a high-risk procedure in which health care workers are directly exposed to the virus, and the protection and operation procedures need to be strictly regulated. According to the characteristics of bronchoscopy, it is necessary to formulate the procedure, requirements and precautions when conducting bronchoscopy in the current epidemic situation. Relevant standards for preventing from infections should be strictly implemented in the operation of bronchoscopy. It needs to emphasize that bronchoscopy should not be used as a routine means for the diagnosis of 2019-nCoV infection sampling. The indications for bronchoscopy for other diseases should be strictly mastered, and it is suggested that bronchoscopy should be postponed for those patients who is not in urgent situation. 10.3760/cma.j.issn.1001-0939.2020.0006
    Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts' consensus statement. Shen Kunling,Yang Yonghong,Wang Tianyou,Zhao Dongchi,Jiang Yi,Jin Runming,Zheng Yuejie,Xu Baoping,Xie Zhengde,Lin Likai,Shang Yunxiao,Lu Xiaoxia,Shu Sainan,Bai Yan,Deng Jikui,Lu Min,Ye Leping,Wang Xuefeng,Wang Yongyan,Gao Liwei, , , , , , , , , , World journal of pediatrics : WJP Since the outbreak of 2019 novel coronavirus infection (2019-nCoV) in Wuhan City, China, by January 30, 2020, a total of 9692 confirmed cases and 15,238 suspected cases have been reported around 31 provinces or cities in China. Among the confirmed cases, 1527 were severe cases, 171 had recovered and been discharged at home, and 213 died. And among these cases, a total of 28 children aged from 1 month to 17 years have been reported in China. For standardizing prevention and management of 2019-nCoV infections in children, we called up an experts' committee to formulate this experts' consensus statement. This statement is based on the Novel Coronavirus Infection Pneumonia Diagnosis and Treatment Standards (the fourth edition) (National Health Committee) and other previous diagnosis and treatment strategies for pediatric virus infections. The present consensus statement summarizes current strategies on diagnosis, treatment, and prevention of 2019-nCoV infection in children. 10.1007/s12519-020-00343-7
    Public responses to the novel 2019 coronavirus (2019-nCoV) in Japan: Mental health consequences and target populations. Shigemura Jun,Ursano Robert J,Morganstein Joshua C,Kurosawa Mie,Benedek David M Psychiatry and clinical neurosciences 10.1111/pcn.12988
    Genome Composition and Divergence of the Novel Coronavirus (2019-nCoV) Originating in China. Wu Aiping,Peng Yousong,Huang Baoying,Ding Xiao,Wang Xianyue,Niu Peihua,Meng Jing,Zhu Zhaozhong,Zhang Zheng,Wang Jiangyuan,Sheng Jie,Quan Lijun,Xia Zanxian,Tan Wenjie,Cheng Genhong,Jiang Taijiao Cell host & microbe An in-depth annotation of the newly discovered coronavirus (2019-nCoV) genome has revealed differences between 2019-nCoV and severe acute respiratory syndrome (SARS) or SARS-like coronaviruses. A systematic comparison identified 380 amino acid substitutions between these coronaviruses, which may have caused functional and pathogenic divergence of 2019-nCoV. 10.1016/j.chom.2020.02.001
    The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Kang Lijun,Li Yi,Hu Shaohua,Chen Min,Yang Can,Yang Bing Xiang,Wang Ying,Hu Jianbo,Lai Jianbo,Ma Xiancang,Chen Jun,Guan Lili,Wang Gaohua,Ma Hong,Liu Zhongchun The lancet. Psychiatry 10.1016/S2215-0366(20)30047-X
    [Suggestions for disinfection of ophthalmic examination equipment and protection of ophthalmologist against 2019 novel coronavirus infection]. Zhang M C,Xie H T,Xu K K,Cao Y [Zhonghua yan ke za zhi] Chinese journal of ophthalmology At present, the prevention and treatment of 2019 Novel Coronavirus (2019-nCoV) in China has reached a critical stage. It is extremely important to disinfect ophthalmic examination instruments and protect ophthalmic medical care during the epidemic period to reduce cross-infection in clinical practice and reduce the infection risk of ophthalmic medical staff. . 10.3760/cma.j.issn.0412-4081.2020.0001
    [Recommendations for the diagnosis, prevention and control of the 2019 novel coronavirus infection in children (first interim edition)]. , Zhonghua er ke za zhi = Chinese journal of pediatrics 10.3760/cma.j.issn.0578-1310.2020.0004
    Epidemiologic characteristics of early cases with 2019 novel coronavirus (2019-nCoV) disease in Korea. Ki Moran, Epidemiology and health In about 20 days since the diagnosis of the first case of the 2019 novel coronavirus (2019-nCoV) in Korea on January 20, 2020, 28 cases have been confirmed. Fifteen patients (53.6%) of them were male and median age of was 42 years (range, 20-73). Of the confirmed cases, 16, 9, and 3 were index (57.2%), first-generation (32.1%), and second-generation (10.7%) cases, respectively. All first-generation and second-generation patients were family members or intimate acquaintances of the index cases with close contacts. Fifteen among 16 index patients had entered Korea from January 19 to 24, 2020 while 1 patient had entered Korea on January 31, 2020. The average incubation period was 3.9 days (median, 3.0), and the reproduction number was estimated as 0.48. Three of the confirmed patients were asymptomatic when they were diagnosed. Epidemiological indicators will be revised with the availability of additional data in the future. Sharing epidemiological information among researchers worldwide is essential for efficient preparation and response in tackling this new infectious disease. 10.4178/epih.e2020007
    Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Kampf G,Todt D,Pfaender S,Steinmann E The Journal of hospital infection Currently, the emergence of a novel human coronavirus, SARS-CoV-2, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-10 days, facilitating its spread via droplets, contaminated hands or surfaces. We therefore reviewed the literature on all available information about the persistence of human and veterinary coronaviruses on inanimate surfaces as well as inactivation strategies with biocidal agents used for chemical disinfection, e.g. in healthcare facilities. The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62-71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. Other biocidal agents such as 0.05-0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are less effective. As no specific therapies are available for SARS-CoV-2, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread. 10.1016/j.jhin.2020.01.022
    Emerging novel coronavirus (2019-nCoV)-current scenario, evolutionary perspective based on genome analysis and recent developments. Malik Yashpal Singh,Sircar Shubhankar,Bhat Sudipta,Sharun Khan,Dhama Kuldeep,Dadar Maryam,Tiwari Ruchi,Chaicumpa Wanpen The veterinary quarterly Coronaviruses are the well-known cause of severe respiratory, enteric and systemic infections in a wide range of hosts including man, mammals, fish, and avian. The scientific interest on coronaviruses increased after the emergence of Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) outbreaks in 2002-2003 followed by Middle East Respiratory Syndrome CoV (MERS-CoV). This decade's first CoV, named 2019-nCoV, emerged from Wuhan, China, and declared as 'Public Health Emergency of International Concern' on January 30, 2020 by the World Health Organization (WHO). As on February 4, 2020, 425 deaths reported in China only and one death outside China (Philippines). In a short span of time, the virus spread has been noted in 24 countries. The zoonotic transmission (animal-to-human) is suspected as the route of disease origin. The genetic analyses predict bats as the most probable source of 2019-nCoV though further investigations needed to confirm the origin of the novel virus. The ongoing nCoV outbreak highlights the hidden wild animal reservoir of the deadly viruses and possible threat of spillover zoonoses as well. The successful virus isolation attempts have made doors open for developing better diagnostics and effective vaccines helping in combating the spread of the virus to newer areas. 10.1080/01652176.2020.1727993
    Critical care management of adults with community-acquired severe respiratory viral infection. Arabi Yaseen M,Fowler Robert,Hayden Frederick G Intensive care medicine With the expanding use of molecular assays, viral pathogens are increasingly recognized among critically ill adult patients with community-acquired severe respiratory illness; studies have detected respiratory viral infections (RVIs) in 17-53% of such patients. In addition, novel pathogens including zoonotic coronaviruses like the agents causing Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and the 2019 novel coronavirus (2019 nCoV) are still being identified. Patients with severe RVIs requiring ICU care present typically with hypoxemic respiratory failure. Oseltamivir is the most widely used neuraminidase inhibitor for treatment of influenza; data suggest that early use is associated with reduced mortality in critically ill patients with influenza. At present, there are no antiviral therapies of proven efficacy for other severe RVIs. Several adjunctive pharmacologic interventions have been studied for their immunomodulatory effects, including macrolides, corticosteroids, cyclooxygenase-2 inhibitors, sirolimus, statins, anti-influenza immune plasma, and vitamin C, but none is recommended at present in severe RVIs. Evidence-based supportive care is the mainstay for management of severe respiratory viral infection. Non-invasive ventilation in patients with severe RVI causing acute hypoxemic respiratory failure and pneumonia is associated with a high likelihood of transition to invasive ventilation. Limited existing knowledge highlights the need for data regarding supportive care and adjunctive pharmacologic therapy that is specific for critically ill patients with severe RVI. There is a need for more pragmatic and efficient designs to test different therapeutics both individually and in combination. 10.1007/s00134-020-05943-5
    Development of a one-run real-time PCR detection system for pathogens associated with porcine respiratory diseases. Sunaga Fujiko,Tsuchiaka Shinobu,Kishimoto Mai,Aoki Hiroshi,Kakinoki Mari,Kure Katsumasa,Okumura Hanako,Okumura Maho,Okumura Atsushi,Nagai Makoto,Omatsu Tsutomu,Mizutani Tetsuya The Journal of veterinary medical science The etiology of Porcine respiratory disease complex is complicated by infections with multiple pathogens, and multiple infections increase the difficulty in identifying the causal pathogen. In this present study, we developed a detection system of microbes from porcine respiratory by using TaqMan real-time PCR (referred to as Dempo-PCR) to screen a broad range of pathogens associated with porcine respiratory diseases in a single run. We selected 17 porcine respiratory pathogens (Actinobacillus pleuropneumoniae, Boldetella bronchiseptica, Haemophilus parasuis, Pasteurella multocida, Pasteurella multocida toxin, Streptococcus suis, Mycoplasma hyopneumoniae, Mycoplasma hyorhinis, Mycoplasma hyosynovie, porcine circovirus 2, pseudorabies virus, porcine cytomegalovirus, swine influenza A virus, porcine reproductive and respiratory virus US strain, EU strain, porcine respiratory coronavirus and porcine hemagglutinating encephalomyelitis virus) as detection targets and designed novel specific primer-probe sets for seven of them. In sensitivity test by using standard curves from synthesized DNA, all primer-probe sets showed high sensitivity. However, porcine reproductive and respiratory virus is known to have a high frequency of genetic mutations, and the primer and probe sequences will need to be checked at a considerable frequency when performing Dempo-PCR from field samples. A total of 30 lung samples from swine showing respiratory symptoms on six farms were tested by the Dempo-PCR to validate the assay's clinical performance. As the results, 12 pathogens (5 virus and 7 bacteria) were detected and porcine reproductive and respiratory virus US strain, Mycoplasma hyorhinis, Haemophilus parasuis, and porcine cytomegalovirus were detected at high frequency. These results suggest that Dempo-PCR assay can be applied as a screening system with wide detection targets. 10.1292/jvms.19-0063
    The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - The latest 2019 novel coronavirus outbreak in Wuhan, China. Hui David S,I Azhar Esam,Madani Tariq A,Ntoumi Francine,Kock Richard,Dar Osman,Ippolito Giuseppe,Mchugh Timothy D,Memish Ziad A,Drosten Christian,Zumla Alimuddin,Petersen Eskild International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 10.1016/j.ijid.2020.01.009
    Emerging coronaviruses: Genome structure, replication, and pathogenesis. Chen Yu,Liu Qianyun,Guo Deyin Journal of medical virology The recent emergence of a novel coronavirus (2019-nCoV), which is causing an outbreak of unusual viral pneumonia in patients in Wuhan, a central city in China, is another warning of the risk of CoVs posed to public health. In this minireview, we provide a brief introduction of the general features of CoVs and describe diseases caused by different CoVs in humans and animals. This review will help understand the biology and potential risk of CoVs that exist in richness in wildlife such as bats. 10.1002/jmv.25681
    A Novel Coronavirus from Patients with Pneumonia in China, 2019. Zhu Na,Zhang Dingyu,Wang Wenling,Li Xingwang,Yang Bo,Song Jingdong,Zhao Xiang,Huang Baoying,Shi Weifeng,Lu Roujian,Niu Peihua,Zhan Faxian,Ma Xuejun,Wang Dayan,Xu Wenbo,Wu Guizhen,Gao George F,Tan Wenjie, The New England journal of medicine In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.). 10.1056/NEJMoa2001017
    A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Chan Jasper Fuk-Woo,Yuan Shuofeng,Kok Kin-Hang,To Kelvin Kai-Wang,Chu Hin,Yang Jin,Xing Fanfan,Liu Jieling,Yip Cyril Chik-Yan,Poon Rosana Wing-Shan,Tsoi Hoi-Wah,Lo Simon Kam-Fai,Chan Kwok-Hung,Poon Vincent Kwok-Man,Chan Wan-Mui,Ip Jonathan Daniel,Cai Jian-Piao,Cheng Vincent Chi-Chung,Chen Honglin,Hui Christopher Kim-Ming,Yuen Kwok-Yung Lancet (London, England) BACKGROUND:An ongoing outbreak of pneumonia associated with a novel coronavirus was reported in Wuhan city, Hubei province, China. Affected patients were geographically linked with a local wet market as a potential source. No data on person-to-person or nosocomial transmission have been published to date. METHODS:In this study, we report the epidemiological, clinical, laboratory, radiological, and microbiological findings of five patients in a family cluster who presented with unexplained pneumonia after returning to Shenzhen, Guangdong province, China, after a visit to Wuhan, and an additional family member who did not travel to Wuhan. Phylogenetic analysis of genetic sequences from these patients were done. FINDINGS:From Jan 10, 2020, we enrolled a family of six patients who travelled to Wuhan from Shenzhen between Dec 29, 2019 and Jan 4, 2020. Of six family members who travelled to Wuhan, five were identified as infected with the novel coronavirus. Additionally, one family member, who did not travel to Wuhan, became infected with the virus after several days of contact with four of the family members. None of the family members had contacts with Wuhan markets or animals, although two had visited a Wuhan hospital. Five family members (aged 36-66 years) presented with fever, upper or lower respiratory tract symptoms, or diarrhoea, or a combination of these 3-6 days after exposure. They presented to our hospital (The University of Hong Kong-Shenzhen Hospital, Shenzhen) 6-10 days after symptom onset. They and one asymptomatic child (aged 10 years) had radiological ground-glass lung opacities. Older patients (aged >60 years) had more systemic symptoms, extensive radiological ground-glass lung changes, lymphopenia, thrombocytopenia, and increased C-reactive protein and lactate dehydrogenase levels. The nasopharyngeal or throat swabs of these six patients were negative for known respiratory microbes by point-of-care multiplex RT-PCR, but five patients (four adults and the child) were RT-PCR positive for genes encoding the internal RNA-dependent RNA polymerase and surface Spike protein of this novel coronavirus, which were confirmed by Sanger sequencing. Phylogenetic analysis of these five patients' RT-PCR amplicons and two full genomes by next-generation sequencing showed that this is a novel coronavirus, which is closest to the bat severe acute respiatory syndrome (SARS)-related coronaviruses found in Chinese horseshoe bats. INTERPRETATION:Our findings are consistent with person-to-person transmission of this novel coronavirus in hospital and family settings, and the reports of infected travellers in other geographical regions. FUNDING:The Shaw Foundation Hong Kong, Michael Seak-Kan Tong, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, Sanming Project of Medicine (Shenzhen), and High Level-Hospital Program (Guangdong Health Commission). 10.1016/S0140-6736(20)30154-9
    Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Huang Chaolin,Wang Yeming,Li Xingwang,Ren Lili,Zhao Jianping,Hu Yi,Zhang Li,Fan Guohui,Xu Jiuyang,Gu Xiaoying,Cheng Zhenshun,Yu Ting,Xia Jiaan,Wei Yuan,Wu Wenjuan,Xie Xuelei,Yin Wen,Li Hui,Liu Min,Xiao Yan,Gao Hong,Guo Li,Xie Jungang,Wang Guangfa,Jiang Rongmeng,Gao Zhancheng,Jin Qi,Wang Jianwei,Cao Bin Lancet (London, England) BACKGROUND:A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. METHODS:All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. FINDINGS:By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0-58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0-13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. INTERPRETATION:The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. FUNDING:Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission. 10.1016/S0140-6736(20)30183-5
    Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Chan Jasper Fuk-Woo,Kok Kin-Hang,Zhu Zheng,Chu Hin,To Kelvin Kai-Wang,Yuan Shuofeng,Yuen Kwok-Yung Emerging microbes & infections A mysterious outbreak of atypical pneumonia in late 2019 was traced to a seafood wholesale market in Wuhan of China. Within a few weeks, a novel coronavirus tentatively named as 2019 novel coronavirus (2019-nCoV) was announced by the World Health Organization. We performed bioinformatics analysis on a virus genome from a patient with 2019-nCoV infection and compared it with other related coronavirus genomes. Overall, the genome of 2019-nCoV has 89% nucleotide identity with bat SARS-like-CoVZXC21 and 82% with that of human SARS-CoV. The phylogenetic trees of their orf1a/b, Spike, Envelope, Membrane and Nucleoprotein also clustered closely with those of the bat, civet and human SARS coronaviruses. However, the external subdomain of Spike's receptor binding domain of 2019-nCoV shares only 40% amino acid identity with other SARS-related coronaviruses. Remarkably, its orf3b encodes a completely novel short protein. Furthermore, its new orf8 likely encodes a secreted protein with an alpha-helix, following with a beta-sheet(s) containing six strands. Learning from the roles of civet in SARS and camel in MERS, hunting for the animal source of 2019-nCoV and its more ancestral virus would be important for understanding the origin and evolution of this novel lineage B . These findings provide the basis for starting further studies on the pathogenesis, and optimizing the design of diagnostic, antiviral and vaccination strategies for this emerging infection. 10.1080/22221751.2020.1719902
    Return of the Coronavirus: 2019-nCoV. Gralinski Lisa E,Menachery Vineet D Viruses The emergence of a novel coronavirus (2019-nCoV) has awakened the echoes of SARS-CoV from nearly two decades ago. Yet, with technological advances and important lessons gained from previous outbreaks, perhaps the world is better equipped to deal with the most recent emergent group 2B coronavirus. 10.3390/v12020135
    The Extent of Transmission of Novel Coronavirus in Wuhan, China, 2020. Nishiura Hiroshi,Jung Sung-Mok,Linton Natalie M,Kinoshita Ryo,Yang Yichi,Hayashi Katsuma,Kobayashi Tetsuro,Yuan Baoyin,Akhmetzhanov Andrei R Journal of clinical medicine A cluster of pneumonia cases linked to a novel coronavirus (2019-nCoV) was reported by China in late December 2019. Reported case incidence has now reached the hundreds, but this is likely an underestimate. As of 24 January 2020, with reports of thirteen exportation events, we estimate the cumulative incidence in China at 5502 cases (95% confidence interval: 3027, 9057). The most plausible number of infections is in the order of thousands, rather than hundreds, and there is a strong indication that untraced exposures other than the one in the epidemiologically linked seafood market in Wuhan have occurred. 10.3390/jcm9020330
    Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Corman Victor M,Landt Olfert,Kaiser Marco,Molenkamp Richard,Meijer Adam,Chu Daniel Kw,Bleicker Tobias,Brünink Sebastian,Schneider Julia,Schmidt Marie Luisa,Mulders Daphne Gjc,Haagmans Bart L,van der Veer Bas,van den Brink Sharon,Wijsman Lisa,Goderski Gabriel,Romette Jean-Louis,Ellis Joanna,Zambon Maria,Peiris Malik,Goossens Herman,Reusken Chantal,Koopmans Marion Pg,Drosten Christian Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin BACKGROUND:The ongoing outbreak of the recently emerged novel coronavirus (2019-nCoV) poses a challenge for public health laboratories as virus isolates are unavailable while there is growing evidence that the outbreak is more widespread than initially thought, and international spread through travellers does already occur. AIM:We aimed to develop and deploy robust diagnostic methodology for use in public health laboratory settings without having virus material available. METHODS:Here we present a validated diagnostic workflow for 2019-nCoV, its design relying on close genetic relatedness of 2019-nCoV with SARS coronavirus, making use of synthetic nucleic acid technology. RESULTS:The workflow reliably detects 2019-nCoV, and further discriminates 2019-nCoV from SARS-CoV. Through coordination between academic and public laboratories, we confirmed assay exclusivity based on 297 original clinical specimens containing a full spectrum of human respiratory viruses. Control material is made available through European Virus Archive - Global (EVAg), a European Union infrastructure project. CONCLUSION:The present study demonstrates the enormous response capacity achieved through coordination of academic and public laboratories in national and European research networks. 10.2807/1560-7917.ES.2020.25.3.2000045
    Real-time tentative assessment of the epidemiological characteristics of novel coronavirus infections in Wuhan, China, as at 22 January 2020. Wu Peng,Hao Xinxin,Lau Eric H Y,Wong Jessica Y,Leung Kathy S M,Wu Joseph T,Cowling Benjamin J,Leung Gabriel M Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin A novel coronavirus (2019-nCoV) causing severe acute respiratory disease emerged recently in Wuhan, China. Information on reported cases strongly indicates human-to-human spread, and the most recent information is increasingly indicative of sustained human-to-human transmission. While the overall severity profile among cases may change as more mild cases are identified, we estimate a risk of fatality among hospitalised cases at 14% (95% confidence interval: 3.9-32%). 10.2807/1560-7917.ES.2020.25.3.2000044
    Note from the editors: novel coronavirus (2019-nCoV). Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 10.2807/1560-7917.ES.2020.25.3.2001231
    Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. Wang Weier,Tang Jianming,Wei Fangqiang Journal of medical virology To help health workers and the public recognize and deal with the 2019 novel coronavirus (2019-nCoV) quickly, effectively, and calmly with an updated understanding. A comprehensive search from Chinese and worldwide official websites and announcements was performed between 1 December 2019 and 9:30 am 26 January 2020 (Beijing time). A latest summary of 2019-nCoV and the current outbreak was drawn. Up to 24 pm, 25 January 2020, a total of 1975 cases of 2019-nCoV infection were confirmed in mainland China with a total of 56 deaths having occurred. The latest mortality was approximately 2.84% with a total of 2684 cases still suspected. The China National Health Commission reported the details of the first 17 deaths up to 24 pm, 22 January 2020. The deaths included 13 males and 4 females. The median age of the people who died was 75 (range 48-89) years. Fever (64.7%) and cough (52.9%) were the most common first symptoms among those who died. The median number of days from the occurence of the first symptom to death was 14.0 (range 6-41) days, and it tended to be shorter among people aged 70 years or more (11.5 [range 6-19] days) than those aged less than 70 years (20 [range 10-41] days; P = .033). The 2019-nCoV infection is spreading and its incidence is increasing nationwide. The first deaths occurred mostly in elderly people, among whom the disease might progress faster. The public should still be cautious in dealing with the virus and pay more attention to protecting the elderly people from the virus. 10.1002/jmv.25689
    Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. Li Qun,Guan Xuhua,Wu Peng,Wang Xiaoye,Zhou Lei,Tong Yeqing,Ren Ruiqi,Leung Kathy S M,Lau Eric H Y,Wong Jessica Y,Xing Xuesen,Xiang Nijuan,Wu Yang,Li Chao,Chen Qi,Li Dan,Liu Tian,Zhao Jing,Liu Man,Tu Wenxiao,Chen Chuding,Jin Lianmei,Yang Rui,Wang Qi,Zhou Suhua,Wang Rui,Liu Hui,Luo Yinbo,Liu Yuan,Shao Ge,Li Huan,Tao Zhongfa,Yang Yang,Deng Zhiqiang,Liu Boxi,Ma Zhitao,Zhang Yanping,Shi Guoqing,Lam Tommy T Y,Wu Joseph T,Gao George F,Cowling Benjamin J,Yang Bo,Leung Gabriel M,Feng Zijian The New England journal of medicine BACKGROUND:The initial cases of novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. METHODS:We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. RESULTS:Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). CONCLUSIONS:On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.). 10.1056/NEJMoa2001316
    Receptor Recognition by the Novel Coronavirus from Wuhan: an Analysis Based on Decade-Long Structural Studies of SARS Coronavirus. Wan Yushun,Shang Jian,Graham Rachel,Baric Ralph S,Li Fang Journal of virology Recently, a novel coronavirus (2019-nCoV) has emerged from Wuhan, China, causing symptoms in humans similar to those caused by severe acute respiratory syndrome coronavirus (SARS-CoV). Since the SARS-CoV outbreak in 2002, extensive structural analyses have revealed key atomic-level interactions between the SARS-CoV spike protein receptor-binding domain (RBD) and its host receptor angiotensin-converting enzyme 2 (ACE2), which regulate both the cross-species and human-to-human transmissions of SARS-CoV. Here, we analyzed the potential receptor usage by 2019-nCoV, based on the rich knowledge about SARS-CoV and the newly released sequence of 2019-nCoV. First, the sequence of 2019-nCoV RBD, including its receptor-binding motif (RBM) that directly contacts ACE2, is similar to that of SARS-CoV, strongly suggesting that 2019-nCoV uses ACE2 as its receptor. Second, several critical residues in 2019-nCoV RBM (particularly Gln493) provide favorable interactions with human ACE2, consistent with 2019-nCoV's capacity for human cell infection. Third, several other critical residues in 2019-nCoV RBM (particularly Asn501) are compatible with, but not ideal for, binding human ACE2, suggesting that 2019-nCoV has acquired some capacity for human-to-human transmission. Last, while phylogenetic analysis indicates a bat origin of 2019-nCoV, 2019-nCoV also potentially recognizes ACE2 from a diversity of animal species (except mice and rats), implicating these animal species as possible intermediate hosts or animal models for 2019-nCoV infections. These analyses provide insights into the receptor usage, cell entry, host cell infectivity and animal origin of 2019-nCoV and may help epidemic surveillance and preventive measures against 2019-nCoV. The recent emergence of Wuhan coronavirus (2019-nCoV) puts the world on alert. 2019-nCoV is reminiscent of the SARS-CoV outbreak in 2002 to 2003. Our decade-long structural studies on the receptor recognition by SARS-CoV have identified key interactions between SARS-CoV spike protein and its host receptor angiotensin-converting enzyme 2 (ACE2), which regulate both the cross-species and human-to-human transmissions of SARS-CoV. One of the goals of SARS-CoV research was to build an atomic-level iterative framework of virus-receptor interactions to facilitate epidemic surveillance, predict species-specific receptor usage, and identify potential animal hosts and animal models of viruses. Based on the sequence of 2019-nCoV spike protein, we apply this predictive framework to provide novel insights into the receptor usage and likely host range of 2019-nCoV. This study provides a robust test of this reiterative framework, providing the basic, translational, and public health research communities with predictive insights that may help study and battle this novel 2019-nCoV. 10.1128/JVI.00127-20
    The novel Chinese coronavirus (2019-nCoV) infections: Challenges for fighting the storm. Bassetti Matteo,Vena Antonio,Giacobbe Daniele Roberto European journal of clinical investigation 10.1111/eci.13209
    CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Lei Junqiang,Li Junfeng,Li Xun,Qi Xiaolong Radiology 10.1148/radiol.2020200236
    Novel Wuhan (2019-nCoV) Coronavirus. Carlos W Graham,Dela Cruz Charles S,Cao Bin,Pasnick Susan,Jamil Shazia American journal of respiratory and critical care medicine 10.1164/rccm.2014P7
    Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study. Ren Li-Li,Wang Ye-Ming,Wu Zhi-Qiang,Xiang Zi-Chun,Guo Li,Xu Teng,Jiang Yong-Zhong,Xiong Yan,Li Yong-Jun,Li Xing-Wang,Li Hui,Fan Guo-Hui,Gu Xiao-Ying,Xiao Yan,Gao Hong,Xu Jiu-Yang,Yang Fan,Wang Xin-Ming,Wu Chao,Chen Lan,Liu Yi-Wei,Liu Bo,Yang Jian,Wang Xiao-Rui,Dong Jie,Li Li,Huang Chao-Lin,Zhao Jian-Ping,Hu Yi,Cheng Zhen-Shun,Liu Lin-Lin,Qian Zhao-Hui,Qin Chuan,Jin Qi,Cao Bin,Wang Jian-Wei Chinese medical journal BACKGROUND:Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans. METHODS:We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Wuhan Jinyintan Hospital, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed. RESULTS:Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown β-CoV strain in all five patients, with 99.8% to 99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6% to 87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor. CONCLUSION:A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans. 10.1097/CM9.0000000000000722
    First Case of 2019 Novel Coronavirus in the United States. Holshue Michelle L,DeBolt Chas,Lindquist Scott,Lofy Kathy H,Wiesman John,Bruce Hollianne,Spitters Christopher,Ericson Keith,Wilkerson Sara,Tural Ahmet,Diaz George,Cohn Amanda,Fox LeAnne,Patel Anita,Gerber Susan I,Kim Lindsay,Tong Suxiang,Lu Xiaoyan,Lindstrom Steve,Pallansch Mark A,Weldon William C,Biggs Holly M,Uyeki Timothy M,Pillai Satish K, The New England journal of medicine An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient's initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection. 10.1056/NEJMoa2001191
    Full-genome evolutionary analysis of the novel corona virus (2019-nCoV) rejects the hypothesis of emergence as a result of a recent recombination event. Paraskevis D,Kostaki E G,Magiorkinis G,Panayiotakopoulos G,Sourvinos G,Tsiodras S Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases BACKGROUND:A novel coronavirus (2019-nCoV) associated with human to human transmission and severe human infection has been recently reported from the city of Wuhan in China. Our objectives were to characterize the genetic relationships of the 2019-nCoV and to search for putative recombination within the subgenus of sarbecovirus. METHODS:Putative recombination was investigated by RDP4 and Simplot v3.5.1 and discordant phylogenetic clustering in individual genomic fragments was confirmed by phylogenetic analysis using maximum likelihood and Bayesian methods. RESULTS:Our analysis suggests that the 2019-nCoV although closely related to BatCoV RaTG13 sequence throughout the genome (sequence similarity 96.3%), shows discordant clustering with the Bat_SARS-like coronavirus sequences. Specifically, in the 5'-part spanning the first 11,498 nucleotides and the last 3'-part spanning 24,341-30,696 positions, 2019-nCoV and RaTG13 formed a single cluster with Bat_SARS-like coronavirus sequences, whereas in the middle region spanning the 3'-end of ORF1a, the ORF1b and almost half of the spike regions, 2019-nCoV and RaTG13 grouped in a separate distant lineage within the sarbecovirus branch. CONCLUSIONS:The levels of genetic similarity between the 2019-nCoV and RaTG13 suggest that the latter does not provide the exact variant that caused the outbreak in humans, but the hypothesis that 2019-nCoV has originated from bats is very likely. We show evidence that the novel coronavirus (2019-nCov) is not-mosaic consisting in almost half of its genome of a distinct lineage within the betacoronavirus. These genomic features and their potential association with virus characteristics and virulence in humans need further attention. 10.1016/j.meegid.2020.104212
    The association between domestic train transportation and novel coronavirus (2019-nCoV) outbreak in China from 2019 to 2020: A data-driven correlational report. Zhao Shi,Zhuang Zian,Ran Jinjun,Lin Jiaer,Yang Guangpu,Yang Lin,He Daihai Travel medicine and infectious disease 10.1016/j.tmaid.2020.101568
    The next big threat to global health? 2019 novel coronavirus (2019-nCoV): What advice can we give to travellers? - Interim recommendations January 2020, from the Latin-American society for Travel Medicine (SLAMVI). Biscayart Cristian,Angeleri Patricia,Lloveras Susana,Chaves Tânia do Socorro Souza,Schlagenhauf Patricia,Rodríguez-Morales Alfonso J Travel medicine and infectious disease 10.1016/j.tmaid.2020.101567
    Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Chen Nanshan,Zhou Min,Dong Xuan,Qu Jieming,Gong Fengyun,Han Yang,Qiu Yang,Wang Jingli,Liu Ying,Wei Yuan,Xia Jia'an,Yu Ting,Zhang Xinxin,Zhang Li Lancet (London, England) BACKGROUND:In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. METHODS:In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. FINDINGS:Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. INTERPRETATION:The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. FUNDING:National Key R&D Program of China. 10.1016/S0140-6736(20)30211-7
    Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lu Roujian,Zhao Xiang,Li Juan,Niu Peihua,Yang Bo,Wu Honglong,Wang Wenling,Song Hao,Huang Baoying,Zhu Na,Bi Yuhai,Ma Xuejun,Zhan Faxian,Wang Liang,Hu Tao,Zhou Hong,Hu Zhenhong,Zhou Weimin,Zhao Li,Chen Jing,Meng Yao,Wang Ji,Lin Yang,Yuan Jianying,Xie Zhihao,Ma Jinmin,Liu William J,Wang Dayan,Xu Wenbo,Holmes Edward C,Gao George F,Wu Guizhen,Chen Weijun,Shi Weifeng,Tan Wenjie Lancet (London, England) BACKGROUND:In late December, 2019, patients presenting with viral pneumonia due to an unidentified microbial agent were reported in Wuhan, China. A novel coronavirus was subsequently identified as the causative pathogen, provisionally named 2019 novel coronavirus (2019-nCoV). As of Jan 26, 2020, more than 2000 cases of 2019-nCoV infection have been confirmed, most of which involved people living in or visiting Wuhan, and human-to-human transmission has been confirmed. METHODS:We did next-generation sequencing of samples from bronchoalveolar lavage fluid and cultured isolates from nine inpatients, eight of whom had visited the Huanan seafood market in Wuhan. Complete and partial 2019-nCoV genome sequences were obtained from these individuals. Viral contigs were connected using Sanger sequencing to obtain the full-length genomes, with the terminal regions determined by rapid amplification of cDNA ends. Phylogenetic analysis of these 2019-nCoV genomes and those of other coronaviruses was used to determine the evolutionary history of the virus and help infer its likely origin. Homology modelling was done to explore the likely receptor-binding properties of the virus. FINDINGS:The ten genome sequences of 2019-nCoV obtained from the nine patients were extremely similar, exhibiting more than 99·98% sequence identity. Notably, 2019-nCoV was closely related (with 88% identity) to two bat-derived severe acute respiratory syndrome (SARS)-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21, collected in 2018 in Zhoushan, eastern China, but were more distant from SARS-CoV (about 79%) and MERS-CoV (about 50%). Phylogenetic analysis revealed that 2019-nCoV fell within the subgenus Sarbecovirus of the genus Betacoronavirus, with a relatively long branch length to its closest relatives bat-SL-CoVZC45 and bat-SL-CoVZXC21, and was genetically distinct from SARS-CoV. Notably, homology modelling revealed that 2019-nCoV had a similar receptor-binding domain structure to that of SARS-CoV, despite amino acid variation at some key residues. INTERPRETATION:2019-nCoV is sufficiently divergent from SARS-CoV to be considered a new human-infecting betacoronavirus. Although our phylogenetic analysis suggests that bats might be the original host of this virus, an animal sold at the seafood market in Wuhan might represent an intermediate host facilitating the emergence of the virus in humans. Importantly, structural analysis suggests that 2019-nCoV might be able to bind to the angiotensin-converting enzyme 2 receptor in humans. The future evolution, adaptation, and spread of this virus warrant urgent investigation. FUNDING:National Key Research and Development Program of China, National Major Project for Control and Prevention of Infectious Disease in China, Chinese Academy of Sciences, Shandong First Medical University. 10.1016/S0140-6736(20)30251-8
    Novel coronavirus: From discovery to clinical diagnostics. Phan Tung Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases A novel coronavirus designated as 2019-nCoV first appeared in Wuhan, China in late December 2019. Dozens of people died in China, and thousands of people infected as 2019-nCoV continues to spread around the world. We have described the discovery, emergence, genomic characteristics, and clinical diagnostics of 2019-nCoV. 10.1016/j.meegid.2020.104211
    Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak. Zhao Shi,Lin Qianyin,Ran Jinjun,Musa Salihu S,Yang Guangpu,Wang Weiming,Lou Yijun,Gao Daozhou,Yang Lin,He Daihai,Wang Maggie H International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases BACKGROUNDS:An ongoing outbreak of a novel coronavirus (2019-nCoV) pneumonia hit a major city in China, Wuhan, December 2019 and subsequently reached other provinces/regions of China and other countries. We present estimates of the basic reproduction number, R, of 2019-nCoV in the early phase of the outbreak. METHODS:Accounting for the impact of the variations in disease reporting rate, we modelled the epidemic curve of 2019-nCoV cases time series, in mainland China from January 10 to January 24, 2020, through the exponential growth. With the estimated intrinsic growth rate (γ), we estimated R by using the serial intervals (SI) of two other well-known coronavirus diseases, MERS and SARS, as approximations for the true unknown SI. FINDINGS:The early outbreak data largely follows the exponential growth. We estimated that the mean R ranges from 2.24 (95%CI: 1.96-2.55) to 3.58 (95%CI: 2.89-4.39) associated with 8-fold to 2-fold increase in the reporting rate. We demonstrated that changes in reporting rate substantially affect estimates of R. CONCLUSION:The mean estimate of R for the 2019-nCoV ranges from 2.24 to 3.58, and is significantly larger than 1. Our findings indicate the potential of 2019-nCoV to cause outbreaks. 10.1016/j.ijid.2020.01.050
    History is repeating itself: Probable zoonotic spillover as the cause of the 2019 novel Coronavirus Epidemic Rodriguez-Morales Alfonso J,Bonilla-Aldana D Katterine,Balbin-Ramon Graciela Josefina,Rabaan Ali A,Sah Ranjit,Paniz-Mondolfi Alberto,Pagliano Pasquale,Esposito Silvano Le infezioni in medicina Pathogen transmission from a vertebrate animal to a human, also known as zoonotic spillover, represents a global public health burden, which while associated with multiple outbreaks, still remains a poorly understood phenomenon. Coronaviruses, like influenza viruses, circulate in nature in various animal species. Alpha-coronaviruses and beta-coronaviruses can infect mammals and gamma-coronaviruses and delta-coronaviruses tend to infect birds, but some of them can also be transmitted to mammals. Although still preliminary, current data suggest that bats are the most probable initial source of the current 2019 novel CoV (2019nCoV) outbreak, that begun on December 2019 in Wuhan, China, apparently spreading from a "wet market" to multiple cities and provinces in China. This epidemic of 2019nCoV, already reaching more than 6,000 cases to-day (end of January 2020) (>90% in China), will not be the last one linked to zoonotic spillover events.
    Travellers give wings to novel coronavirus (2019-nCoV). Wilson Mary E,Chen Lin H Journal of travel medicine 10.1093/jtm/taaa015
    Origin and Evolution of the 2019 Novel Coronavirus. Zhang Liangsheng,Shen Fu-Ming,Chen Fei,Lin Zhenguo Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 10.1093/cid/ciaa112
    2019 Novel Coronavirus (2019-nCoV) Pneumonia. Liu Peng,Tan Xian-Zheng Radiology 10.1148/radiol.2020200257