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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
J01CR02 CURAM G Amoxicillin (trihydrate) - 500mg, Clavulanic Acid (potassium) - 125mg 625mg Tablet, film coated 366,234 L.L
L04AA06 IMUNOCELL G Mycophenolate mofetil - 500mg 500mg Tablet, film coated 3,791,428 L.L
C10AA05 LORVAST G Atorvastatin (calcium) - 10mg 10mg Tablet, film coated 1,114,045 L.L
G04BE03 VONTA G Sildenafil citrate - 50mg 50mg Tablet, film coated 90,037 L.L
J01MA02 CIPRODAR G Ciprofloxacine (HCl) - 500mg 500mg Tablet, film coated 392,402 L.L
M01AE51 FLUMIX BENTA G Ibuprofen - 200mg, Guaifenesin - 200mg, Chlorpheniramine maleate - 2mg, Phenylephrine HCl - 5mg Tablet, film coated 875,417 L.L
J01CR02 KLAVOX G Amoxicillin (trihydrate) - 875mg, Clavulanic Acid (potassium) - 125mg 1g Tablet, film coated 338,648 L.L
L04AA10 SIROMUNE G Sirolimus - 1mg 1mg Tablet, film coated 18,729,193 L.L
M01AE51 FLUMIX BENTA G Ibuprofen - 200mg, Guaifenesin - 200mg, Chlorpheniramine maleate - 2mg, Phenylephrine HCl - 5mg Tablet, film coated 460,746 L.L
N02BE01 DOLOPAN G Paracetamol - 500mg 500mg Tablet, film coated 317,403 L.L
C10AA05 TULIP G Atorvastatin (calcium) - 10mg 10mg Tablet, film coated 899,031 L.L
G04BE03 VIGOR-50 G Sildenafil (citrate) - 50mg 50mg Tablet, film coated 332,761 L.L
L04AA13 ARAVA B Leflunomide - 10mg 10mg Tablet, film coated 2,230,779 L.L
M01AG01 PONSTAN FORTE B Mefenamic acid - 500mg 500mg Tablet, film coated 219,046 L.L
A10BD07 SAGIMET G Metformin HCl - 850mg, Sitagliptin (HCl monohydrate) - 50mg Tablet, film coated 1,463,892 L.L
C10AA05 ATORVA TAD G Atorvastatin - 10mg 10mg Tablet, film coated 677,297 L.L
L04AA13 AROTAN G Leflunomide - 10mg 10mg Tablet, film coated 1,527,949 L.L
M01AG01 PANGESIC FORTE G Mefenamic acid - 500mg 500mg Tablet, film coated 327,898 L.L
N02BE01 DOLOPAN G Paracetamol - 500mg 500mg Tablet, film coated 380,115 L.L
L01EA04 BOSULIF B Bosutinib - 400mg 400mg Tablet, film coated L.L
A10BD07 SITAMET G Metformin - 850mg, Sitagliptin - 50mg Tablet, film coated 2,178,345 L.L
C01EB17 PROCORALAN B Ivabradin (HCl) - 5mg 5mg Tablet, film coated 1,890,786 L.L
G04BE03 VIAGRA B Sildenafil (citrate) - 100mg 100mg Tablet, film coated 2,089,675 L.L
J01MA02 CIPROMID G Ciprofloxacine (HCl) - 500mg 500mg Tablet, film coated 331,929 L.L
L04AA13 ARAVA B Leflunomide - 20mg 20mg Tablet, film coated 3,346,168 L.L
N02BE01 DOLOPAN G Paracetamol - 500mg 500mg Tablet, film coated 317,403 L.L
L01EA04 BOSULIF B Bosutinib - 500mg 500mg Tablet, film coated L.L
A10BD08 GALVUS MET B Metformin HCl - 1,000mg, Vildagliptin - 50mg Tablet, film coated 1,816,875 L.L
C10AA05 ORVASTA G Atorvastatin - 10mg 10mg Tablet, film coated 834,526 L.L
G04BE03 VIRECTA G Sildenafil - 100mg 100mg Tablet, film coated 584,571 L.L
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