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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
C05AA01 SINAHEAL-H G Hydrocortisone acetate - 0.275g/100g, Lidocaine - 5g/100g, Zinc oxide - 18g/100g, Aluminium Subacetate - 3.5g/100g Ointment 330,585 L.L
C09CA04 IRTAN G Irbesartan - 300mg 300mg Tablet 554,175 L.L
C10AA07 ROSUPHAR G Rosuvastatin (calcium) - 10mg 10mg Tablet, film coated 487,623 L.L
D10AD51 RETINOMYCIN G Tretinoin - 0.025%, Erythromycin - 4% Gel 662,962 L.L
G04BE08 AMOS G Tadalafil - 20mg 20mg Film, orodispersible 2,175,745 L.L
J01DB05 ROXIL G Cefadroxil (monohydrate) - 500mg 500mg Capsule 869,466 L.L
J01MA12 LEVOFLOX G Levofloxacin - 500mg 500mg Tablet, coated, scored 602,041 L.L
L04AA27 SCLEMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule 18,264,981 L.L
M01AE51 FLUMIX BENTA G Ibuprofen - 200mg, Guaifenesin - 200mg, Chlorpheniramine maleate - 2mg, Phenylephrine HCl - 5mg Tablet, film coated 875,417 L.L
N02BE01 DOLOPAN G Paracetamol - 500mg 500mg Tablet, film coated 380,115 L.L
N04BA03 COMBIPAR G Levodopa - 50mg, Carbidopa - 12.5mg, Entacapone - 200mg Tablet, film coated 1,061,373 L.L
N06AB10 PRAMACYT 20 G Escitalopram (oxalate) - 20mg 20mg Tablet, film coated 972,686 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 500mcg/dose Inhalation powder 2,605,711 L.L
A02BC02 LUGANOR G Pantoprazole - 40mg 40mg Injectable lyophilised powder for solution 463,050 L.L
A11CC03 DERIL G Alfacalcidol - 1mcg 1mcg Capsule, soft 783,460 L.L
B05CX01 DEXTROSE 7.5% INJECTION USP G Glucose - 7.5% 7.5% Injectable solution 148,566 L.L
C05AE01 RECTOGESIC G Glyceryl trinitrate - 0.2% w/w 0.2% w/w Ointment 2,553,301 L.L
C09CA04 ZIOREL G Irbesartan - 300mg 300mg Tablet, film coated 575,933 L.L
C10AA07 ROSUVAS G Rosuvastatin (calcium) - 10mg 10mg Tablet, film coated 450,187 L.L
D10AD51 CLINIDERM T G Tretinoin - 0.025%, Clindamycin (phosphate) - 1% Gel 801,186 L.L
G04BE08 AMOS G Tadalafil - 10mg 10mg Film, orodispersible 1,662,781 L.L
J01MA12 LEVOKEY 500 G Levofloxacin (hemihydrate) - 500mg 500mg Tablet, film coated 141,103 L.L
L04AA27 SCLEMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule 17,079,643 L.L
M01AE51 FLUMIX BENTA G Ibuprofen - 200mg, Guaifenesin - 200mg, Chlorpheniramine maleate - 2mg, Phenylephrine HCl - 5mg Tablet, film coated 460,746 L.L
N02BE01 DOLOPAN G Paracetamol - 500mg 500mg Tablet, film coated 317,403 L.L
N06AB10 PRYLEX 20 G Escitalopram (oxalate) - 20mg 20mg Tablet, film coated 972,686 L.L
R03AK06 SEROFLO 500 G Salmeterol (xinafoate) - 50mcg/inhalation, Fluticasone propionate - 500mcg/inhalation Inhalation suspension 2,031,890 L.L
A02BC02 LUGANOR G Pantoprazole - 40mg 40mg Injectable lyophilised powder for solution 4,146,714 L.L
B05CX01 DEXTROSE 7.5% INJECTION USP G Glucose - 7.5% 7.5% Injectable solution 179,456 L.L
C05AE03 DILTIGEL G Diltiazem HCl - 2% 2% Gel 632,950 L.L
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