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      Diagnosing COVID-19: The Disease and Tools for Detection

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          Abstract

          COVID-19 has spread globally since its discovery in Hubei province, China in December 2019. A combination of computed tomography imaging, whole genome sequencing, and electron microscopy were initially used to screen and identify SARS-CoV-2, the viral etiology of COVID-19. The aim of this review article is to inform the audience of diagnostic and surveillance technologies for SARS-CoV-2 and their performance characteristics. We describe point-of-care diagnostics that are on the horizon and encourage academics to advance their technologies beyond conception. Developing plug-and-play diagnostics to manage the SARS-CoV-2 outbreak would be useful in preventing future epidemics.

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)
          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            A Novel Coronavirus from Patients with Pneumonia in China, 2019

            Na Zhu, Dingyu Zhang, Wenling Wang … (2020)
            Summary 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.)
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              A pneumonia outbreak associated with a new coronavirus of probable bat origin

              Peng Zhou, Xing-Lou Yang, Xian-Guang Wang … (2020)
              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 1–4 . Previous studies have shown that some bat SARSr-CoVs have the potential to infect humans 5–7 . 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.
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                Author and article information

                Journal
                Journal ID (nlm-ta): ACS Nano
                Journal ID (iso-abbrev): ACS Nano
                Journal ID (publisher-id): nn
                Journal ID (coden): ancac3
                Title: ACS Nano
                Publisher: American Chemical Society
                ISSN (Print): 1936-0851
                ISSN (Electronic): 1936-086X
                Publication date (Electronic): 30 March 2020
                Electronic Location Identifier: acsnano.0c02624
                Affiliations
                [† ]Institute of Biomaterials and Biomedical Engineering, University of Toronto , Toronto, Ontario M5S 3G9, Canada
                [‡ ]Terrence Donnelly Center for Cellular and Biomolecular Research, University of Toronto , Toronto, Ontario M5S 3E1, Canada
                [§ ]Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto , Toronto, Ontario M5S 1A1, Canada
                [∥ ]Biological Sciences, Sunnybrook Research Institute , Toronto, Ontario M4N 3M5, Canada
                [⊥ ]Public Health Ontario , Toronto, Ontario M5G 1V2, Canada
                [# ]Hospital for Sick Children , Toronto, Ontario M5G 1V2, Canada
                [∇ ]Department of Chemistry, University of Toronto , Toronto, Ontario M5S 3H6, Canada
                [○ ]Materials Science and Engineering, University of Toronto , Toronto, Ontario M5S 3G9, Canada
                Author notes
                Article
                DOI: 10.1021/acsnano.0c02624
                PMC ID: 7144809
                PubMed ID: 32223179
                SO-VID: 74bea4b3-650c-4bb4-a2ce-f739cbd045df
                Copyright © Copyright © 2020 American Chemical Society
                License:

                This article is made available via the PMC Open Access Subset for unrestricted RESEARCH re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date received : 27 March 2020
                Date accepted : 30 March 2020
                Categories
                Subject: Review
                Custom metadata
                document-id-old-9 nn0c02624
                document-id-new-14 nn0c02624
                ccc-price

                ScienceOpen disciplines: Nanotechnology
                Keywords: sars-cov-2,diagnostics,covid-19,pcr,surveillance,pandemic
                Data availability:
                ScienceOpen disciplines: Nanotechnology
                Keywords: sars-cov-2, diagnostics, covid-19, pcr, surveillance, pandemic

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