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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
L01EC01 ZELBORAF B Vemurafenib - 240mg 240mg Tablet, film coated L.L
L01EF02 KISQALI B Ribociclib - 200mg 200mg Tablet, film coated L.L
L01EB04 TAGRISSO B Osimertinib - 80mg 80mg Tablet, film coated L.L
L01BB04 MAVENCLAD B Cladribine - 10mg 10mg Tablet L.L
V03AC03 DEFIROX G Deferasirox - 500mg 500mg Tablet, dispersible L.L
L04AC05 STELARA BioTech Ustekinumab - 130mg 130mg Injectable concentrate for solution L.L
L04AC16 TREMFYA BioTech Guselkumab - 100mg/ml 100mg/ml Injectable solution L.L
L01EA03 TASIGNA B Nilotinib - 150mg 150mg Capsule L.L
R03DX05 XOLAIR BioTech Omalizumab - 150mg 150mg Injectable solution L.L
B03XA01 HEMAX BioTech Erythropoietin recombinant human (Epoetin alfa) - 10,000IU 10,000IU Injectable freeze dried substance+diluent L.L
B03XA01 HEMAX BioTech Erythropoietin recombinant human (Epoetin alfa) - 40,000IU 40,000IU Injectable freeze dried powder + diluent L.L
S01LA05 EYLEA BioTech Aflibercept - 40mg/ml 40mg/ml Injectable solution L.L
L01XX52 VENCLEXTA B Venetoclax - 100mg 100mg Tablet L.L
L04AA52 KESIMPTA BioTech Ofatumumab - 20mg/0.4ml 20mg/0.4ml Injectable solution L.L
L03AX03 BCG-MEDAC G BCG seed RIVM derived from seed 1173-P2 - 2x10? to 3x10? viable units Injectable powder for suspension+diluent L.L
L01EA03 TASIGNA B Nilotinib - 200mg 200mg Capsule L.L
L02BB04 ENZASTIK 40 G Enzalutamide - 40mg 40mg Capsule L.L
B05AA01 ALBUREL HUMAN ALBUMIN BP BioHuman Albumin human - 20% 20% Injectable solution L.L
L04AB04 ADALIREL BioTech Adalimumab - 40mg 40mg Injectable solution L.L
B03XA01 EPOMAX BioTech Erythropoietin recombinant human (Epoetin alfa) - 4000UI/ml 4000UI/ml Injectable solution L.L
L01BB05 FLUDARABINE PHOSPHATE NEAPOLIS G Fludarabine Dihydrogenophosphate - 50mg/2ml 50mg/2ml Injectable solution L.L
L01BA04 PEMETREXED NEAPOLIS G Pemetrexed (disodium) - 100mg 100mg Injectable solution L.L
L01FB01 BESPONSA FOR INJECTION BioTech Inotuzumab Ozogamicin - 0.9mg 0.9mg Injectable powder for suspension L.L
L01FX02 MYLOTARG BioTech Gemtuzumab Ozogamicin - 4.5mg 4.5mg Injectable powder L.L
L01ED05 LORBRENA B Lorlatinib - 100mg 100mg Tablet L.L
L01EA04 BOSULIF B Bosutinib - 100mg 100mg Tablet, film coated L.L
S01LA06 BEOVU BioTech Brolucizumab - 120mg/ml 120mg/ml Injectable solution L.L
S01LA04 LUCENTIS BioTech Ranibizumab - 10mg/ml 10mg/ml Injectable solution L.L
L04AC10 COSENTYX BioTech Secukinumab - 150mg/ml 150mg/ml Injectable solution L.L
L04AA06 MYFORTIC B Mycophenolic acid (sodium) - 360mg 360mg Tablet, gastroresistant L.L
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