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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
L01DB07 MITOXANTRON EBEWE G Mitoxantrone - 20mg/10ml 20mg/10ml Injectable concentrated solution 11,064,120 L.L
M01AB05 ROFENAC D G Diclofenac free acid - 50mg 50mg Tablet, dispersible 408,528 L.L
N03AX11 TOPIRATE 100 BENTA G Topiramate - 100mg 100mg Tablet, film coated 2,559,700 L.L
N05AX15 REAGILA G Cariprazine HCl - 1.5mg 1.5mg Capsule, hard 6,394,003 L.L
P01AB01 SOLUFLEX METRONIDAZOLE G Metronidazole - 500mg/100ml 500mg/100ml Injectable solution 162,541 L.L
R05FB02 MUCUS RELIEF DM G Dextromethorphan HBr - 20mg, Guaifenesin - 400mg Tablet 413,903 L.L
V03AC03 DIFIRAX G Deferasirox - 500mg 500mg Tablet, dispersible 38,637,010 L.L
A04AA01 NAUSETRON G Ondansetron - 4mg/5ml 4mg/5ml Solution 958,608 L.L
A10BD07 ZERILUX G Sitagliptin - 25mg/ml 25mg/ml Solution 1,127,529 L.L
B01AC06 ASPROTHIN G Acetylsalicylic acid - 81mg 81mg Tablet, enteric coated 148,463 L.L
B05BB02 SERUFLEX DEXTROSE 5% SODIUM CHLORIDE 0.45% INJECTION, USP G Sodium chloride - 0.45%, Glucose - 5% Injectable solution 180,421 L.L
C01CA07 DOBUTAMINE PANPHARMA G Dobutamine (HCl) - 250mg/20ml 250mg/20ml Injectable concentrated solution 2,701,123 L.L
C09AA01 APO-CAPTO G Captopril - 25mg 25mg Tablet, scored 1,132,859 L.L
C09DX03 OLMENOR TRIPLE G Olmesartan medoxomil - 40mg, Amlodipine (besylate) - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,067,011 L.L
D06AX01 DERMOFUCIN G Fusidic acid - 2% 2% Cream 290,270 L.L
J01AA07 TETRAN G Tetracycline HCl - 250mg 250mg Capsule 168,940 L.L
J01DH51 IMIPENEM-CILASTATIN LABATEC G Imipenem (monohydrate) - 500mg, Cilastatin (sodium) - 500mg Injectable powder for solution 8,922,845 L.L
J05AF10 HEPCAVIR 0.5 G Entecavir monohydrate - 0.5mg 0.5mg Tablet, film coated 18,998,515 L.L
M01AB05 DICLO-DENK 100 RETARD G Diclofenac sodium - 100mg 100mg Tablet, sustained release 1,756,402 L.L
M09AX NUCLEO C.M.P. FORTE G UTP+UDP+UMP - 3mg, CMP - 5mg Capsule 448,843 L.L
N03AX11 TOPIRAMATE ARROW G Topiramate - 200mg 200mg Tablet, film coated 1,440,599 L.L
N05AX15 REAGILA G Cariprazine HCl - 3mg 3mg Capsule, hard 6,394,003 L.L
P01AB01 ? METRONIDAZOL G Metronidazole - 500mg/100ml 500mg/100ml Injectable solution 162,541 L.L
R05X MUCOTAL PROMETHAZINE G Promethazine HCl - 2.5mg/5ml, Carbocysteine - 100mg/5ml Syrup 243,172 L.L
V03AC03 ENFEROX G Deferasirox - 500mg 500mg Tablet, dispersible 37,720,158 L.L
A04AA01 NAUSETRON G Ondansetron - 4mg/5ml 4mg/5ml Solution 802,466 L.L
B05BB02 SOLUFLEX DEXTROSE 5% SODIUM CHLORIDE 0.45% INJECTION, USP G Sodium chloride - 0.45%, Glucose - 5% Injectable solution 236,731 L.L
C01CA24 ADRENALINE 1 MG I.V. G Adrenaline - 1mg/ml 1mg/ml Injectable solution 2,239,738 L.L
C09AA01 CAPTACE G Captopril - 25mg 25mg Tablet, scored 486,343 L.L
D06AX01 FUTASOLE G Fusidic acid - 20mg/g 2% Cream 145,135 L.L
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