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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
L01XX02 ERWINASE BioTech Erwinia L-asparaginase - 10,000IU 10,000IU Injectable lyophilised powder for solution 444,434,845 L.L
H05BX01 CINACALCET ARROW BioTech Cinacalcet - 90mg 90mg Tablet, coated, scored 22,062,995 L.L
L01XX02 SPECTRILA BioTech Asparaginase, recombinant - 10,000IU 10,000IU Injectable powder for concentrate for solution 21,370,813 L.L
H05BX01 CINACALCET ARROW BioTech Cinacalcet - 60mg 60mg Tablet, coated, scored 16,494,074 L.L
G03DA04 BIOGEST BioTech Progesterone, bio-identical - 100mg/2ml 100mg/2ml Injectable solution 2,328,879 L.L
L01XX44 ZALTRAP BioTech Aflibercept - 100mg/4ml 100mg/4ml Injectable concentrate for solution 35,658,713 L.L
L01XX44 ZALTRAP BioTech Aflibercept - 100mg/4ml 100mg/4ml Injectable concentrate for solution 35,658,713 L.L
L01XX44 ZALTRAP BioTech Aflibercept - 200mg/8ml 200mg/8ml Injectable concentrate for solution 63,807,499 L.L
M05BX04 PROLIA BioTech Denosumab - 60mg/ml 60mg/ml Injectable solution 21,603,638 L.L
V03AB37 PRAXBIND BioTech Idarucizumab - 50mg/ml 50mg/ml Injectable solution 287,986,627 L.L
L01XX44 ZALTRAP BioTech Aflibercept - 200mg/8ml 200mg/8ml Injectable concentrate for solution 63,807,499 L.L
M05BX04 XGEVA BioTech Denosumab - 120mg 120mg Injectable solution 33,545,669 L.L
M05BX06 EVENITY BioTech Romosozumab - 105mg/1.17ml 105mg/1.17ml Injectable solution 56,729,091 L.L
L01XY02 PHESGO BioTech Pertuzumab - 600mg, Trastuzumab - 600mg Injectable solution 326,054,156 L.L
L01XY02 PHESGO BioTech Pertuzumab - 1200mg, Trastuzumab - 600mg Injectable solution 591,417,874 L.L
G03GA09 ELONVA BioTech Corifollitropin alfa - 150mcg/0.5ml 150mcg/0.5ml Injectable solution 44,141,610 L.L
B01AD02 ACTILYSE BioTech Alteplase - 50mg 50mg Injectable dry powder for solution+diluent 97,130,035 L.L
B01AD11 METALYSE BioTech Tenecteplase - 10,000IU 10,000IU Injectable powder for solution+diluent 74,851,424 L.L
A06AD04 EPSOM SALT G Magnesium sulfate - 40g 40g Granules 89,590 L.L
A10BD20 FLORIMET 5/1000 G Metformin - 1000mg, Empagliflozin - 12.5mg Tablet, film coated 1,836,585 L.L
B01AF01 RIXALTA 15 G Rivaroxaban - 15mg 15mg Tablet, film coated 1,164,664 L.L
B05BC01 MANNITOL G Mannitol - 10g/100ml 10g/100ml Injectable solution 494,147 L.L
C01EX CARDIOVITEX G Coenzyme Q10 - 300mg, Magnesium oxide - 100mg Tablet 2,822,069 L.L
C10AA05 LORVAST G Atorvastatin (calcium) - 10mg 10mg Tablet, film coated 1,114,045 L.L
J01CR02 AMOCLAN FORTE G Amoxicillin (trihydrate) - 250mg/5ml, Clavulanic Acid (potassium) - 62.5mg/5ml 312mg/5ml Powder for suspension 288,926 L.L
J01FA10 AZICIN 500 BENTA G Azithromycin - 500mg 500mg Tablet, film coated 573,373 L.L
L01EB01 APO-GEFITINIB G Gefitinib - 250mg 250mg Tablet 87,345,820 L.L
L02BG04 LETROZOLE ARROW LAB G Letrozole - 2.5mg 2.5mg Tablet, coated 2,000,981 L.L
N03AX14 LEVIPRAM IV G Levetiracetam - 500mg/100ml 500mg/100ml Injectable solution 1,869,733 L.L
R01AA07 DECOZAL G Xylometazoline HCl - 0.05% 0.05% Metered dose spray 108,851 L.L
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