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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
A10BD07 JANUMET B Metformin HCl - 500mg, Sitagliptin - 50mg Tablet 3,237,317 L.L
C08CA13 LERCADIP B Lercanidipine HCl - 10mg 10mg Tablet, film-scored 1,021,320 L.L
G03DA04 UTROGESTAN B Progesterone micronised natural - 200mg 200mg Capsule 587,259 L.L
L04AD02 PROGRAF 5MG B Tacrolimus - 5mg 5mg Capsule 94,286,686 L.L
N06BX06 SOMAZINA B Citicoline - 1000mg/sachet 1000mg/sachet Solution 974,286 L.L
R03BB06 SEEBRI BREEZHALER B Glycopyronium Bromide - 50mcg 50mcg Capsule, inhalation 2,687,685 L.L
S01CA01 FRAKIDEX B Dexamethasone disodium phosphate - 0.1g/100g, Framycetin sulfate - 0.5g/100g Ointment 141,103 L.L
A10BD07 JANUMET B Metformin HCl - 500mg, Sitagliptin - 50mg Tablet 3,237,317 L.L
C08CA13 LERCADIP B Lercanidipine HCl - 20mg 20mg Tablet, film-scored 1,679,803 L.L
D06AX BANEOCIN B Neomycin sulfate - 5000IU/g, Bacitracin zinc - 250IU/g Ointment 173,356 L.L
G03DA04 UTROGESTAN B Progesterone micronised natural - 200mg 200mg Capsule 587,259 L.L
H05BA01 MIACALCIC B Calcitonin (salmon synthetic) - 100IU/ml 100IU/ml Injectable solution 1,720,118 L.L
J01DH02 MERONEM B Meropenem (trihydrate) - 500mg 500mg Injectable powder for solution 10,398,061 L.L
L04AD02 PROGRAF 5MG B Tacrolimus - 5mg 5mg Capsule 94,286,686 L.L
N06BX06 SOMAZINA B Citicoline (sodium) - 1,000mg/4ml 1,000mg/4ml Injectable solution 787,492 L.L
R03BB08 YUPELRI B Revefenacin - 175mcg/3ml 175mcg/3ml Inhalation solution 3,104,276 L.L
C08DA01 ISOPTIN B Verapamil (HCl) - 80mg 80mg Tablet, film coated 397,704 L.L
C09DX03 VOCADO HCT B Olmesartan medoxomil - 40mg, Amlodipine - 10mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,523,917 L.L
D06AX BATRAMYCIN B Neomycin (sulfate) - 5000IU/g, Bacitracin - 250IU/g Ointment 249,955 L.L
H05BA01 MIACALCIC 200 UI/ACTUATION B Calcitonin (salmon synthetic) - 200IU/actuation 200IU/actuation Solution 5,399,559 L.L
J02AX06 ECALTA B Anidulafungin - 100mg 100mg Injectable concentrated powder for solution 16,977,343 L.L
N06CA02 DEANXIT B Flupentixol (dihydrochloride) - 0.5mg, Melitracen (HCl) - 10mg Tablet, film coated 1,372,063 L.L
S01CA01 NETILDEX B Dexamethasone - 0.1%, Netilmicin - 0.3% Drops solution 752,552 L.L
L01EX08 LENVIMA B Lenvatinib - 10mg 10mg Capsule, hard L.L
A10BD07 JANUMET XR B Metformin HCl - 500mg, Sitagliptin - 50mg Tablet 4,777,360 L.L
C08DA01 ISOPTIN SR B Verapamil (HCl) - 240mg 240mg Tablet, film coated, prolonged release 1,128,821 L.L
J04AB03 DIARENTIS B Rifamycin sodium - 200mg 200mg Tablet, extended release 1,100,671 L.L
L04AD02 PROGRAF 0.5 MG B Tacrolimus - 0.5mg 0.5mg Capsule 13,942,481 L.L
L01EX08 LENVIMA B Lenvatinib - 4mg 4mg Capsule, hard L.L
A10BD07 JANUMET XR B Metformin HCl - 1,000mg, Sitagliptin - 50mg Tablet 4,777,360 L.L
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