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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
R03AK07 FORACORT 400 G Formoterol fumarate - 4.5mcg/inhalation, Budesonide - 400mcg/inhalation Metered dose inhaler 3,104,276 L.L
R03AK08 INUVER B Formoterol fumarate - 6mcg/dose, Beclometasone dipropionate - 100mcg/dose Inhalation solution 3,493,991 L.L
R03AK08 INUVER NEXTHALER B Formoterol fumarate dihydrate - 6mcg/dose, Beclometasone dipropionate - 100mcg/dose Inhalation powder 4,380,927 L.L
R03AK10 RELVAR ELLIPTA B Vilanterol (trifenatate) - 25mcg/dose, Fluticasone furoate - 200mcg/dose Inhalation powder 3,928,052 L.L
R03AK10 RELVAR ELLIPTA B Vilanterol (trifenatate) - 25mcg/dose, Fluticasone furoate - 100mcg/dose Inhalation powder 3,928,052 L.L
R03AK12 ZEPHIRUS B Salmeterol - 20mcg, Budesonide - 120mcg Capsule, inhalation 1,412,378 L.L
R03AK12 ZEPHIRUS B Salmeterol - 20mcg, Budesonide - 240mcg Capsule, inhalation 1,678,459 L.L
R03AK13 BUTOSOL G Salbutamol (sulfate) - 100mcg/dose, Beclometasone dipropionate - 50mcg/dose Metered dose inhaler 548,288 L.L
R03AK13 AEROCORT-A HFA G Salbutamol - 100mcg/dose, Beclometasone - 50mcg/dose Metered dose inhaler 541,569 L.L
R03AL01 ATROVENT COMP. HFA B Fenoterol Hydrobromide - 20mcg/actuation, Ipratropium bromide - 50mcg/actuation Inhalation aerosol metered dose 847,965 L.L
R03AL02 COMBIVENT B Salbutamol (sulfate) - 2.5mg/2.5ml, Ipratropium bromide - 500mcg/2.5ml Inhaltion solution with nebuliser 745,833 L.L
R03AL02 DUOLIN RESPULES G Salbutamol (sulfate) - 2.5mg/2.5ml, Ipratropium bromide (monohydrate) - 500mcg/2.5ml Inhaltion solution with nebuliser 417,935 L.L
R03AL02 IPRASAL VEM G Salbutamol (sulfate) - 2.5mg/2.5ml, Ipratropium bromide (monohydrate) - 0.5mg/2.5ml Inhaltion solution with nebuliser 417,935 L.L
R03AL03 ANORO ELLIPTA B Vilanterol - 25mcg, Umeclidinium bromide - 62.5mcg Inhalation powder 5,181,575 L.L
R03AL04 ULTIBRO BREEZHALER B Indacaterol - 110mcg, Glycopyronium - 50mcg Capsule, inhalation 4,031,528 L.L
R03AL06 SPIOLTO RESPIMAT B Olodaterol HCl - 2.5mcg/puff, Tiotropium bromide monohydrate - 2.5mcg/puff Inhalation solution 5,736,866 L.L
R03AL06 SPIOLTO RESPIMAT B Olodaterol HCl - 2.5mcg/puff, Tiotropium bromide monohydrate - 2.5mcg/puff Inhalation solution 3,332,393 L.L
R03AL11 BREZTRI AEROSPHERE B Formoterol fumarate dihydrate - 5mcg, Glycopyrronium Bromide - 7.2mcg, Budesonide - 160mcg Inhalation suspension 6,705,774 L.L
R03BA01 CLENIL 250 MCG SPRAY B Beclometasone dipropionate - 250mcg/actuation 250mcg/actuation Inhalation solution 1,166,455 L.L
R03BA01 CORTIS G Beclometasone dipropionate - 250mcg/actuation 250mcg/actuation Inhalation solution 674,609 L.L
R03BA02 BUDECORT 200 G Budesonide - 200mcg/actuation 200mcg/actuation Metered dose inhaler 808,993 L.L
R03BA02 PULMICORT B Budesonide - 0.5mg/ml 0.5mg/ml Inhalation suspension for nebuliser 2,015,764 L.L
R03BA02 BUDESONIDE ARROW G Budesonide - 1mg/2ml 1mg/2ml Inhalation suspension for nebuliser 1,342,499 L.L
R03BA02 BUDESONIDE ARROW G Budesonide - 1mg/2ml 1mg/2ml Inhalation suspension for nebuliser 1,342,499 L.L
R03BA02 CORTAIR G Budesonide - 1mg/2ml 0.5mg/ml Inhalation suspension for nebuliser 1,209,458 L.L
R03BA02 BUDECORT G Budesonide - 1mg 1mg Respule 1,226,928 L.L
R03BA02 BUDESONIDE ARROW G Budesonide - 0.5mg/2ml 0.5mg/2ml Inhalation suspension for nebuliser 1,342,499 L.L
R03BA02 BUDESONIDE ARROW G Budesonide - 0.5mg/2ml 0.5mg/2ml Inhalation suspension for nebuliser 1,342,499 L.L
R03BA02 BUDENA G Budesonide - 50mcg/actuation 50mcg/actuation Inhalation suspension 823,775 L.L
R03BA05 FLIXOTIDE EVOHALER B Fluticasone propionate - 250mcg/actutaion 250mcg/actutaion Inhalation suspension 1,484,946 L.L
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