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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
A10AE04 LANTUS SOLOSTAR BioTech Insulin glargine - 100IU/ml 100IU/ml Injectable solution 4,992,375 L.L
B03XA01 EPOMAX BioTech Erythropoietin recombinant human (Epoetin alfa) - 2000UI/ml 2000UI/ml Injectable solution 7,849,606 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 300mg 300mg Injectable solution 123,001,362 L.L
A10AE04 LANTUS BioTech Insulin glargine - 100IU/ml 100IU/ml Injectable solution 3,327,354 L.L
B03XA01 BINOCRIT BioTech Erythropoietin recombinant human (Epoetin alfa) - 4,000IU/0.4ml 4,000IU/0.4ml Injectable solution 5,582,795 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 300mg 300mg Injectable solution 123,001,362 L.L
A16AB04 FABRAZYME BioTech Agalsidase beta - 35mg 35mg Injectable powder for concentrate for solution L.L
A10AE04 TOUJEO BioTech Insulin glargine - 300Units/ml 300Units/ml Injectable solution 4,559,658 L.L
B03XA01 EPOMAX BioTech Erythropoietin recombinant human (Epoetin alfa) - 4000UI/ml 4000UI/ml Injectable solution 1,243,054 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 200mg 200mg Injectable solution 123,001,362 L.L
A10AE06 TRESIBA BioTech Insulin degludec - 100IU/ml 100IU/ml Injectable solution 6,857,628 L.L
B03XA01 EPOTEX 4000 BENTA BioTech Erythropoietin recombinant human (Epoetin alfa) - 4,000IU 4,000IU Injectable solution 1,209,458 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 200mg 200mg Injectable solution 123,001,362 L.L
A10AE54 SULIQUA BioTech Insulin glargine - 100IU/ml, Lixisenatide - 50mcg/ml Injectable solution 11,286,573 L.L
B03XA01 EPOTEX 4000 BENTA BioTech Erythropoietin recombinant human (Epoetin alfa) - 4,000IU 4,000IU Injectable solution 5,488,046 L.L
C10AX13 REPATHA BioTech Evolocumab - 140mg/1ml Injectable solution 44,151,793 L.L
A10AE54 SULIQUA BioTech Insulin glargine - 100IU/ml, Lixisenatide - 33mcg/ml Injectable solution 7,975,793 L.L
B03XA01 ALPEEN BioTech Erythropoietin recombinant human (Epoetin alfa) - 10,000IU 10000IU Injectable solution 4,036,903 L.L
L04AB02 IXIFI BioTech Infliximab - 100mg 100mg Injectable powder for concentrate for solution L.L
A10AE56 XULTOPHY BioTech Insulin degludec - 100U/ml, Liraglutide - 3.6mg/ml Injectable solution 13,503,847 L.L
B03XA01 ALPEEN BioTech Erythropoietin recombinant human (Epoetin alfa) - 10,000IU 10,000IU Injectable solution 10,661,285 L.L
B02BD04 BENEFIX BioTech Nonacog alfa (recombinant coagulation factor IX) - 500IU 500IU Injectable powder for solution+diluent L.L
A10AE56 XULTOPHY BioTech Insulin degludec - 100U/ml, Liraglutide - 3.6mg/ml Injectable solution 13,503,847 L.L
B03XA01 BINOCRIT BioTech Erythropoietin recombinant human (Epoetin alfa) - 10,000IU/ml 10,000IU/ml Injectable solution 16,325,433 L.L
L01FF04 BAVENCIO BioTech Avelumab - 200mg/10ml 200mg/10ml Injectable concentrate for solution L.L
B03XA01 EPOMAX BioTech Erythropoietin recombinant human (Epoetin alfa) - 10000UI/ml 10000UI/ml Injectable solution 2,486,109 L.L
L04AA23 TYSABRI BioTech Natalizumab - 300mg/15ml 300mg/15ml Injectable concentrated solution 126,830,594 L.L
L04AB01 ALTEBREL BioTech Etanercept - 50mg/1ml 50mg/1ml Injectable solution L.L
B03XA01 BINOCRIT BioTech Erythropoietin recombinant human (Epoetin alfa) - 40,000IU/ml 40,000IU/ml Injectable solution 11,726,826 L.L
H01AC01 CINNATROPIN BioTech Somatropin recombinant - 5mg/1.5ml 5mg/1.5ml Injectable solution 4,699,417 L.L
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