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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
M01AH05 ETOXA G Etoricoxib - 60mg 60mg Tablet, film coated 1,109,630 L.L
N02BE01 ALGIVIC G Paracetamol - 250mg 250mg Suppository 215,015 L.L
N05AE05 LURABIL G Lurasidone - 40mg 40mg Tablet, film coated 2,535,831 L.L
N06AX21 DULOXETINE BIOGARAN G Duloxetine HCl - 30mg 30mg Capsule, gastro-resistant 573,821 L.L
R03BA02 BUDESONIDE ARROW G Budesonide - 0.5mg/2ml 0.5mg/2ml Inhalation suspension for nebuliser 1,342,499 L.L
S01CA01 OPTIDEX T G Dexamethasone - 1mg/ml, Tobramycin - 3mg/ml Drops suspension 266,081 L.L
A04AA01 ONDEMED G Ondansetron (HCl) - 4mg/5ml 4mg/5ml Solution 858,779 L.L
B05BC01 MANNITOL 20% INJECTION USP G Mannitol - 20% 20% Injectable solution 374,633 L.L
C09BB06 ENEAS G Enalapril maleate - 10mg, Nitrendipine - 20mg Tablet 2,009,045 L.L
C10AA05 TOVAST G Atorvastatin (calcium) - 20mg 20mg Tablet, film coated 1,127,484 L.L
D07CB01 POSITON G Triamcinolone acetonide - 100mg, Neomycin (sulfate) - 250mg, Nystatin - Cream 1,064,323 L.L
G04BE08 DURALIS G Tadalafil - 20mg 20mg Tablet, film coated 1,204,979 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM STRAGEN G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 7,820,986 L.L
L01EL01 DULLARMA G Ibrutinib - 140mg 140mg Capsule, hard 422,860,803 L.L
M01AH05 ETOXA G Etoricoxib - 60mg 60mg Tablet, film coated 369,877 L.L
N02BE01 ADOL G Paracetamol - 500mg 500mg Suppository 131,697 L.L
N05AE05 LAROZA G Lurasidone - 40mg 40mg Tablet, film coated 5,548,726 L.L
R03BA02 BUDENA G Budesonide - 50mcg/actuation 50mcg/actuation Inhalation suspension 823,775 L.L
S01CA01 API-TOBRASON G Dexamethasone - 1mg/ml, Tobramycin - 3mg/ml Drops suspension 294,302 L.L
A04AA01 NOZAMET G Ondansetron - 4mg 4mg Film, orodispersible 3,234,181 L.L
A10BD11 INAGLIMET G Metformin - 850mg, Linagliptin - 2.5mg Tablet, film coated 1,670,844 L.L
B05BC01 MANNITOL 20% INJECTION USP G Mannitol - 20% 20% Injectable solution 613,662 L.L
C02CA04 CURCARD G Doxazosin (mesylate) - 4mg 4mg Tablet 452,875 L.L
C09BB07 RAMIPRIL/AMLODIPINE GENERICON G Ramipril - 2.5mg, Amlodipine - 5mg Capsule, hard 1,358,625 L.L
C10AA05 LORVAST G Atorvastatin (calcium) - 20mg 20mg Tablet, film coated 1,128,828 L.L
G04BE08 RAVANA G Tadalafil - 20mg 20mg Tablet 500,421 L.L
J01CR05 YANOVEN G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 997,259 L.L
L04AA31 TERAGIO G Teriflunomide - 14mg 14mg Tablet 49,451,224 L.L
M01AH05 ARTRIX 60 G Etoricoxib - 60mg 60mg Tablet, film coated 1,054,596 L.L
N02BE01 ALGIVIC G Paracetamol - 500mg 500mg Suppository 147,183 L.L
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