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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
L01BC08 DACOGEN B Decitabine - 50mg 50mg Injectable lyophilised powder for solution 90,495,926 L.L
L04AD01 SANDIMMUN B Ciclosporin - 50mg/ml 250mg/5ml Injectable concentrated solution 6,992,013 L.L
M02AA31 ROXONIN TAPE B Loxoprofen Sodium Hydrate - 100mg 100mg Patch 896,343 L.L
R03BB01 ATROVENT B Ipratropium bromide - 500mcg/2ml 500mcg/2ml Inhaltion solution with nebuliser 713,580 L.L
S01BC01 INDOCOLLYRE B Indometacine - 5mg/5ml 0.1% Drops 408,528 L.L
L04AD02 PROGRAF 0.5 MG B Tacrolimus - 0.5mg 0.5mg Capsule L.L
A10BD06 DUETACT B Glimepiride - 2mg, Pioglitazone - 30mg Tablet 2,803,255 L.L
G03CX01 LIVIAL B Tibolone - 2.5mg 2.5mg Tablet 1,135,547 L.L
H03BB02 TAPAZOLE B Methimazole (Thiamazole) - 5mg 5mg Tablet 565,694 L.L
J01DD15 OMNICEF B Cefdinir - 250mg/5ml 250mg/5ml Powder for suspension 3,670,034 L.L
J02AX04 CANCIDAS B Caspofungin (acetate) - 70mg 70mg Injectable concentrated powder for solution 31,611,335 L.L
L01BC59 LONSURF B Trifluridine - 20mg, Tipiracil - 8.19mg Tablet, film coated 75,019,126 L.L
L04AD01 SANDIMMUN NEORAL SOFT GELATIN B Ciclosporin - 50mg 50mg Capsule, soft gelatin 4,309,703 L.L
M02AA31 ROXONIN TAPE B Loxoprofen Sodium Hydrate - 50mg 50mg Patch 710,893 L.L
L04AD02 PROGRAF 1MG B Tacrolimus - 1mg 1mg Capsule L.L
A10BD06 DUETACT B Glimepiride - 4mg, Pioglitazone - 30mg Tablet 3,287,039 L.L
C09DX01 EXFORGE HCT B Valsartan - 160mg, Amlodipine - 10mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,417,754 L.L
G03DA03 PROLUTON DEPOT B Hydroxyprogesterone caproate - 250mg/ml 250mg/ml Injectable solution 270,112 L.L
H03BB02 THYROZOL B Methimazole (Thiamazole) - 5mg 5mg Tablet, film coated 233,829 L.L
J01DD52 ZAVICEFTA B Ceftazidime - 2g, Avibactam - 0.5g Injectable powder for concentrate for solution 101,659,975 L.L
L01BC59 LONSURF B Trifluridine - 15mg, Tipiracil - 6.14mg Tablet, film coated 58,102,683 L.L
L04AD01 SANDIMMUN NEORAL SOFT GELATIN B Ciclosporin - 25mg 25mg Capsule, soft gelatin 2,385,320 L.L
M02AX10 ALGESAL SURACTIVE B Salycilic acid - 6.54g/100g, Diethylamine - 3.46g/100g, Myrtecaine - 1g/100g Cream 1,006,538 L.L
R03BB01 ATROVENT N B Ipratropium bromide - 20mcg/actuation 20mcg/actuation Inhalation aerosol metered dose 428,686 L.L
S01BC04 EDOLFENE B Flurbiprofen sodium - 0.03% 0.03% Drops solution 388,370 L.L
L04AD02 PROGRAF 5MG B Tacrolimus - 5mg 5mg Capsule L.L
A10BD07 JANUMET B Metformin HCl - 1000mg, Sitagliptin - 50mg Tablet 3,093,525 L.L
G03DA04 UTROGESTAN B Progesterone micronised natural - 100mg 100mg Capsule 525,442 L.L
H03BB02 THYROZOL B Methimazole (Thiamazole) - 10mg 10mg Tablet, film coated 326,554 L.L
L04AD01 SANDIMMUN NEORAL SOFT GELATIN B Ciclosporin - 100mg 100mg Capsule, soft gelatin 8,264,592 L.L
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