2019-novel coronavirus outbreak: A new challenge

Highlights

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  In December 2019 has been recognized a novel beta-coronavirus named 2019-nCoV and has rapidly spread across continents.

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  71,333 cases (17 February 2020) have been reported among 29 countries in the four main continents with mortality of ∼2%.

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  Fever with respiratory symptoms (e.g. cough, dyspnea) are the first signs of disease (COVID-19).

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  High rate of radiological and clinical suspicious pneumonia were reported in reviewed cohorts of patients

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  Risk of bacterial superinfection and empirical antibiotic coverage have to be considered

Abstract

Objectives

Following the public health emergency declared by the World Health Organization and the recent outbreak by 2019-nCoV in China and through other 29 countries, we aimed to summarize the clinical aspects of novel beta-coronavirus infection and its possible clinical presentations together with suggested therapeutic algorithms for patients who may require antibiotic treatment.

Methods

We reviewed the currently available literature of microbiologically confirmed infections by 2019-ConV (or COVID-19) occurred at the time of writing (13 February 2020). A literature search was performed using the PubMed database and the Cochrane library. Search terms included "novel coronavirus" or "2019-nCoV" or “COVID-19”.

Results

Published cases occurred mostly in males (age ranged from 8 to 92). Cardiovascular, digestive and endocrine system diseases were commonly reported, except previous chronic pulmonary diseases (e.g., COPD, asthma, bronchiectasis) that were surprisingly underreported. Fever was presented in all the case series available, flanked by cough, dyspnea, myalgias and fatigue. Multiple bilateral lobular and subsegmental areas of consolidation or bilateral ground-glass opacities were the main reported radiological features of 2019-nCoV, at least in the early phases of disease.

Conclusions

The new 2019-nCoV epidemics is mainly associated with respiratory disease and few extrapulmonary signs. However, there is a low rate of associated pre-existing respiratory comorbidities.