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      Updated understanding of the outbreak of 2019 novel coronavirus (2019‐nCoV) in Wuhan, China

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      Author(s): , MB 1 , 2 , , PhD 3 , , , PhD 1 ,
      Publication date (Electronic):
      Journal: Journal of Medical Virology
      Publisher: John Wiley and Sons Inc.
      Keywords: coronavirus, epidemiology, infection

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          Abstract

          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.

          Highlights

          • The 2019‐nCoV infection is spreading and its incidence is increasing nationwide.

          • The first occurred deaths were majorly elderly people who might have faster disease progression.

          • Although the current mortality is lower than that of the SARS‐CoV and the MERS‐CoV, it seems that the 2019‐nCoV is very contagious.

          • The public should still be cautious in dealing with the virus and pay more attention to protecting the elderly people from the virus.

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Chaolin Huang, Yeming Wang, Xingwang Li … (2020)
          Summary 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.
          Article 0 comments Cited 21814 times – based on 0 reviews     Review now
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            A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster

            Jasper Chan, Shuofeng Yuan, Kin-Hang Kok … (2020)
            Summary 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).
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              Emerging coronaviruses: Genome structure, replication, and pathogenesis

              Yu Chen, Qianyun Liu, Deyin Guo (2020)
              Abstract 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.
              Article 0 comments Cited 1331 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Jianming Tang: 15900792812@163.com
                Fangqiang Wei:
                ORCID: http://orcid.org/0000-0003-0871-2275
                wdfwfq@126.com
                Journal
                Journal ID (nlm-ta): J Med Virol
                Journal ID (iso-abbrev): J. Med. Virol
                Journal ID (doi): 10.1002/(ISSN)1096-9071
                Journal ID (publisher-id): JMV
                Title: Journal of Medical Virology
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 0146-6615
                ISSN (Electronic): 1096-9071
                Publication date (Electronic): 12 February 2020
                Publication date (Print): April 2020
                Volume: 92
                Issue: 4 , 2019 Novel Coronavirus Origin, Evolution, Disease, Biology and Epidemiology: Part‐I ( doiID: 10.1002/jmv.v92.4 )
                Pages: 441-447
                Affiliations
                [ 1 ] Department of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital Hangzhou Medical College Hangzhou Zhejiang China
                [ 2 ] Second Clinical Medical College Zhejiang Chinese Medical University Hangzhou Zhejiang China
                [ 3 ] Department of Radiation Oncology, Zhejiang Provincial People's Hospital Hangzhou Medical College Hangzhou Zhejiang China
                Author notes
                [*] [* ] Correspondence Jianming Tang, PhD, Department of Radiation Oncology, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, 310014 Zhejiang Province, China.

                Email: 15900792812@ 123456163.com

                Fangqiang Wei, PhD, Department of Hepatobiliary and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, 310014 Zhejiang Province, China.

                Email: wdfwfq@ 123456126.com

                Author information
                http://orcid.org/0000-0003-0871-2275
                Article
                Publisher ID: JMV25689
                DOI: 10.1002/jmv.25689
                PMC ID: 7167192
                PubMed ID: 31994742
                SO-VID: d80a6fa7-2844-4b05-a519-7f1fa0986707
                Copyright © © 2020 Wiley Periodicals, Inc.
                License:

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                Date received : 24 January 2020
                Date accepted : 27 January 2020
                Page count
                Figures: 1, Tables: 2, Pages: 7, Words: 4108
                Categories
                Subject: Research Article
                Subject: Research Articles
                Custom metadata
                source-schema-version-number 2.0
                cover-date April 2020
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.0 mode:remove_FC converted:16.04.2020

                ScienceOpen disciplines: Microbiology & Virology
                Keywords: coronavirus,epidemiology,infection
                Data availability:
                ScienceOpen disciplines: Microbiology & Virology
                Keywords: coronavirus, epidemiology, infection

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