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Coronavirus: invasive/novel

Generalities
Agent Coronaviruses belong to a large family of viruses that can cause diseases ranging from the common cold to Severe Acute Respiratory Syndrome (SARS).
1) Classical coronavirus: viruses that can infect humans and animals.
- Human coronavirus (HCoV): causing mild illness (229E, OC43, NL63, and HKU1...)
- Animal coronavirus: may infect pigs, domestic and wild birds, bats, rodents, dogs, cats and cattle. They cause acute and chronic diseases in animals such as respiratory and gastro-enteric diseases, neurologic diseases, and liver disease.
2) Novel coronavirus:
- Severe Acute Respiratory Syndrome (SARS-CoV) who caused a large outbreak in 2002-2003.
- Middle East respiratory syndrome–Novel Coronavirus (MERS-CoV): first identified in 2012
- Novel Coronavirus 2019 (COVID-19)
Incubation period - HCoV: 2-4 days
- SARS-CoV: 2-10 days (mean; 5 days)
- MERS-CoV: 2-14 days
- COVID-19: 4-7 days (up to 14 days)
Period of transmissibility - HCoV: during the active disease
- SARS-CoV: from onset to 21 days
- MERS-CoV: during illness. The duration of infectivity after resolution of symptoms is unknown.
- COVID-19: usually during illness
Reservoir - HCoV: Humans
- SARS-CoV: cave-dwelling bats (genus Rhinolophus), Himalayan masked palm civet (Paguma larvata), other wildlife animals
- MERS-CoV: may be camels and bats
Modes of transmission - HCoV: person-to-person transmission via repiratory droplets, aerosls, fecal oral route, fomites
- SARS-CoV: 1) Animal-to-person; 2) Person-to-person: while caring for, or living with a patient; via respiratory secretions, via body fluids; or airborne (aerosolized sewage, mechanical ventilation...)
- MERS-CoV: 1) Limited person-to-person transmission: close contact, when providing unprotected care to a patient; 2) Suspected animal-to-person transmission via droplet contact, fomite transmission, food-borne, airbone
- COVID-19: 1) Person-to-person: droplets (directly or indirectly), aerosol generating medical procedures, 2) Animal-to-peron
Clinical presentation - HCoV: usually self-limited illness as upper respiratory infection, otitis media, gastroenteritis. Complications: pneumonia, encephalitis, peritonitis...
- SARS-CoV: pneumonia, acute respiratory distress syndrome (ARDS). Global case fatality in 2003: 10%.
- MERS-CoV: usually, acute lower respiratory infection with or without gastrointestinal symptoms. It may be asymptomatic. The illness may be severe in people with chronic medical conditions. It may evolve to respiratory failure, organ failure (as renal failure), septic shock... Global case fatality: 27%.
- COVID-19: usually acute respiratory infection
Resources
Case definition - MOPH circular no. 35 (2012): SARS-CoV
- MOPH circular no. 37 (2014): MERS-CoV
- MOPH circular no. 42 (2020): COVID-19
Forms - General reporting form
- Novel Coronavirus reporting form
- Laboratory request form
- Patient transfert request form
- SARS-CoV investigation form
- MERS-CoV investigation form
Data - SARS-CoV: No SARS-CoV was detected in Lebanon in 2003
- MERS-CoV: 2 cases detected and confirmed in 2014 and 2017
- COVID-19: Daily report on COVID-19
Other Resources - Specimen collection for COVID-19
- Questions and Answers
- Presentation: coronavirus, A, E
- Presentation: resources, A, E
- Presentation: questions and answers, A, E
- Presentation: case definition, A, E
- Presentation: specimen collection, A, E
- Presentation: areas with community transmission, A, E
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ATC Name B/G Ingredients Dosage Form Price
A10BD07 JANUMET XR B Metformin HCl - 500mg, Sitagliptin - 50mg Tablet 4,777,360 L.L
C09AA01 ORBACE G Captopril - 50mg 50mg Tablet 949,649 L.L
G03GB02 CLOMID B Clomifene citrate - 50mg 50mg Tablet 274,144 L.L
L01EA02 APO-DASATINIB G Dasatinib - 20mg 20mg Tablet 57,771,855 L.L
L02BG03 APO-ANASTROZOLE G Anastrozole - 1mg 1mg Tablet 2,615,118 L.L
A10BD07 JANUMET XR B Metformin HCl - 1,000mg, Sitagliptin - 50mg Tablet 4,777,360 L.L
C09AA02 RENITEC B Enalapril maleate - 20mg 20mg Tablet 405,840 L.L
C10AA01 ZOCOR B Simvastatin - 20mg 20mg Tablet 976,526 L.L
G03GB02 CLOMIFERT G Clomifene citrate - 50mg 50mg Tablet 395,090 L.L
A10BD07 JANUMET XR B Metformin HCl - 1,000mg, Sitagliptin - 100mg Tablet 4,777,360 L.L
C09AA03 ZESTRIL B Lisinopril (dihydrate) - 5mg 5mg Tablet 295,645 L.L
G03GB02 CLOMIFERT G Clomifene citrate - 50mg 50mg Tablet 395,090 L.L
C09AA03 TENSIKEY G Lisinopril - 5mg 5mg Tablet 456,906 L.L
G03HB01 DIANE '35' B Ethinylestradiol - 0.035mg, Cyproterone acetate - 2mg Tablet 494,534 L.L
C09AA03 ZESTRIL B Lisinopril (dihydrate) - 10mg 10mg Tablet 592,635 L.L
G03XC01 EVA TABLET G Raloxifene HCl - 60mg 60mg Tablet 1,354,081 L.L
L02BG04 APO-LETROZOLE G Letrozole - 2.5mg 2.5mg Tablet 1,962,010 L.L
C09AA03 ZESTRIL B Lisinopril (dihydrate) - 20mg 20mg Tablet 636,981 L.L
C10AA01 STAVINE G Simvastatin - 20mg 20mg Tablet 207,336 L.L
J01FA10 APO-AZITHROMYCIN Z G Azithromycin - 250mg 250mg Tablet 481,096 L.L
C09AA03 TENSIKEY G Lisinopril - 20mg 20mg Tablet 460,938 L.L
C01DA08 ISDN G Isosorbide dinitrate - 10mg 10mg Tablet 311,771 L.L
C10AA01 ZOCOR B Simvastatin - 40mg 40mg Tablet 1,435,992 L.L
R06AE55 VOMINORE-JPM G Meclozine HCl - 25mg, Pyridoxine HCl - 50mg Tablet 259,362 L.L
L01EG02 EVEROLIMUS ARROW G Everolimus - 2.5mg 2.5mg Tablet L.L
C01DA08 ISODEX G Isosorbide dinitrate - 10mg 10mg Tablet 138,224 L.L
L01EG02 EVEROLIMUS ARROW G Everolimus - 5mg 5mg Tablet L.L
L01EG02 EVEROLIMUS ARROW G Everolimus - 10mg 10mg Tablet L.L
C09AA05 TRITACE B Ramipril - 2.5mg 2.5mg Tablet 263,393 L.L
N06AB04 CIPRAM B Citalopram - 20mg 20mg Tablet 2,280,501 L.L
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