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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
J05AB01 ZOVIRAX B Aciclovir - 200mg/5ml 200mg/5ml Suspension 487,815 L.L
J01FA10 ZOMAX G Azithromycin (dihydrate) - 200mg/5ml 200mg/5ml Powder for suspension 258,018 L.L
L01XX44 ZALTRAP BioTech Aflibercept - 200mg/8ml 200mg/8ml Injectable concentrate for solution 63,807,499 L.L
L01XX44 ZALTRAP BioTech Aflibercept - 200mg/8ml 200mg/8ml Injectable concentrate for solution 63,807,499 L.L
C10AA01 ZOCOR B Simvastatin - 20mg 20mg Tablet 976,526 L.L
C09AA03 ZESTRIL B Lisinopril (dihydrate) - 20mg 20mg Tablet 636,981 L.L
N06AB10 ZELAX 20 G Escitalopram (oxalate) - 20mg 20mg Caplet 1,544,075 L.L
B01AF01 ZARLAN G Rivaroxaban - 20mg 20mg Tablet, film coated 1,343,843 L.L
D06AX01 ZETA G Fusidic acid - 20mg/g 20mg/g Cream 178,731 L.L
C08DB01 ZALDEM CR G Diltiazem HCl - 240mg 240mg Capsule, controlled release 1,002,123 L.L
L01EC01 ZELBORAF B Vemurafenib - 240mg 240mg Tablet, film coated 142,041,587 L.L
J05AB01 ZOVIRAX IV B Aciclovir - 250mg 250mg Injectable freeze dried substance 2,146,116 L.L
J01FA10 ZITHROMAX B Azithromycin (dihydrate) - 250mg 250mg Capsule 591,291 L.L
J01FA10 ZIMAX G Azithromycin (dihydrate) - 250mg 250mg Capsule 360,150 L.L
J01FA10 ZOMAX G Azithromycin (dihydrate) - 250mg 250mg Capsule 360,150 L.L
J01FA10 ZETRON G Azithromycin (dihydrate) - 250mg 250mg Capsule 360,150 L.L
J01FA10 ZEVLEN G Azithromycin (dihydrate) - 250mg 250mg Tablet, film coated 409,552 L.L
J01DC02 ZINNAT B Cefuroxime (axetil) - 250mg 250mg Tablet, film coated 349,399 L.L
J01DC02 ZINNAT B Cefuroxime (axetil) - 250mg/5ml 250mg/5ml Granules for suspension 1,081,904 L.L
L02AE03 ZOLADEX DEPOT B Goserelin (acetate) - 3.6mg 3.6mg Injectable suspension 8,820,074 L.L
C09CA04 ZIOREL G Irbesartan - 300mg 300mg Tablet, film coated 575,933 L.L
M04AA01 ZYLORIC B Allopurinol - 300mg 300mg Tablet 302,365 L.L
J01FA10 ZITHROMAX B Azithromycin (dihydrate) - 300mg/7.5ml 300mg/7.5ml Powder for suspension 489,159 L.L
L03AA02 ZARZIO BioTech Filgrastim - 300mcg/0.5ml 30MU/0.5ml Injectable solution 13,053,190 L.L
L03AA02 ZARZIO BioTech Filgrastim - 300mcg/0.5ml 30MU/0.5ml Injectable solution 13,053,190 L.L
P02CA03 ZENTEL B Albendazole - 400mg 400mg Tablet 169,324 L.L
L01FG01 ZIRABEV BioTech Bevacizumab - 400mg/16ml 400mg/16ml Injectable solution 49,965,229 L.L
C10AA01 ZOCOR B Simvastatin - 40mg 40mg Tablet 1,435,992 L.L
M05BA08 ZOLEDRA G Zoledronic acid - 4mg 4mg Injectable powder for solution 6,368,470 L.L
A04AA01 ZOFRAN INJECTION B Ondansetron (HCl dihydrate) - 4mg/2ml 4mg/2ml Injectable solution 6,600,249 L.L
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