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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
D06BX01 ROZEX B Metronidazole - 0.75g/100g 0.75% Gel 584,571 L.L
J05AX12 TIVICAY B Dolutegravir - 50mg 50mg Tablet, film coated 54,508,037 L.L
A05AA04 OCALIVA B Obeticholic acid - 10mg 10mg Tablet, film coated 224,503,943 L.L
C01EA01 PROSTIN VR B Alprostadil - 500mcg/ml 500mcg/ml Injectable concentrated solution 19,894,577 L.L
G03HB01 DIANE '35' B Ethinylestradiol - 0.035mg, Cyproterone acetate - 2mg Tablet 494,534 L.L
J01FA09 KLACID RM B Clarithromycin - 500mg 500mg Tablet, modified release 1,173,175 L.L
J05AX18 PREVYMIS B Letermovir - 240mg 240mg Tablet, film coated 460,943,945 L.L
N03AX14 KEPPRA B Levetiracetam - 500mg 500mg Tablet, film coated 6,478,288 L.L
V06DD KETOSTERIL B Calcium - 0.05g, Total nitrogen - 36mg, L-Tyrosine - 30mg, L-Histidine - 38mg, L-Tryptophan - 23mg, L-Threonine - 53mg, L-Lysine Monoacetate - 105mg, Alpha Hydroxyanalogue-DL-Methionine, Calcium Salt - 59mg, Alpha Ketoanalogue-Valine,Calcium Salt - 86mg, Alpha Ketoanalogue-Phenylalanine,Calcium Salt - 68mg, Alpha-Ketoanalogue- Leucine,Calcium Salt - 101mg, Alpha-Ketoanalogue-DL-isoleucine,Calcium Salt - 67mg Tablet, film coated 3,950,897 L.L
A05AA04 OCALIVA B Obeticholic acid - 5mg 5mg Tablet, film coated 224,503,943 L.L
A10BD19 GLYXAMBI B Linagliptin - 5mg, Empagliflozin - 10mg Tablet, film coated 4,482,387 L.L
B01AE07 PRADAXA B Dabigatran etexilate (mesilate) - 110mg 110mg Capsule, hard 1,603,204 L.L
J05AX18 PREVYMIS B Letermovir - 480mg 480mg Tablet, film coated 961,233,292 L.L
L02BB03 CASODEX B Bicalutamide - 150mg 150mg Tablet, film coated 10,863,782 L.L
A10BD19 GLYXAMBI B Linagliptin - 5mg, Empagliflozin - 10mg Tablet, film coated 4,482,387 L.L
B01AE07 PRADAXA B Dabigatran etexilate (mesilate) - 110mg 110mg Capsule, hard 3,205,064 L.L
C01EB15 VASTAREL B Trimetazidine - 35mg 35mg Tablet, film coated, modified release 1,053,573 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 1mg/g 0.1% Cream 215,015 L.L
J05AX18 PREVYMIS B Letermovir - 240mg/12ml 240mg/12ml Injectable concentrate for solution 25,111,114 L.L
L02BB04 XTANDI B Enzalutamide - 40mg 40mg Capsule, soft 267,649,535 L.L
R06AB54 ALERGICAL EXPECTORANT B Chlorpheniramine maleate - 50mg/100ml, Guaifenesin - 2000mg/100ml, Dihydroxypropyltheophylline - 500mg/100ml, Paracetamol - 2000mg/100ml Syrup 485,127 L.L
A06AB02 DULCOLAX B Bisacodyl - 5mg 5mg Tablet, sugar coated 520,067 L.L
C09AA05 TRITACE B Ramipril - 10mg 10mg Tablet 689,391 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 1mg/g 0.1% Cream 215,015 L.L
G04B FONCITRIL 4000 B Citric acid - 1.189g, Potassium Citrate - 1.73g, Sodium citrate - 1.845g Granules 1,613,955 L.L
A06AB02 DULCOLAX B Bisacodyl - 5mg 5mg Tablet, sugar coated 219,046 L.L
A10BD19 GLYXAMBI B Linagliptin - 5mg, Empagliflozin - 25mg Tablet, film coated 4,482,387 L.L
B01AE07 PRADAXA B Dabigatran etexilate (mesilate) - 150mg 150mg Capsule, hard 3,031,709 L.L
C01EB17 PROCORALAN B Ivabradin (HCl) - 5mg 5mg Tablet, film coated 1,890,786 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.1% Lipocream 221,734 L.L
    ...
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