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A Novel Coronavirus from Patients with Pneumonia in China, 2019.

ABSTRACT: In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.).

SUBMITTER: Zhu N

PROVIDER: S-EPMC7092803 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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A Novel Coronavirus from Patients with Pneumonia in China, 2019.

Zhu Na N Zhang Dingyu D Wang Wenling W Li Xingwang X Yang Bo B Song Jingdong J Zhao Xiang X Huang Baoying B Shi Weifeng W Lu Roujian R Niu Peihua P Zhan Faxian F Ma Xuejun X Wang Dayan D Xu Wenbo W Wu Guizhen G Gao George F GF Tan Wenjie W

The New England journal of medicine 20200124 8

In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seve ...[more]

PMID: 31978945

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Project description:Background:Recently, a large-scale novel coronavirus pneumonia (NCP) outbreak swept China. As of Feb. 9, 2020, a total of 40,260 patients have been diagnosed with NCP, and 23,589 patients were suspected to have infected by the 2019 novel coronavirus (COVID-19), which puts forward a great challenge for public health and clinical treatment in China. Until now, we are in the high-incidence season of NCP. Thus, the analysis of the transmissibility change of NCP and its potential factors may provide a reliable reference for establishing effective prevention and control strategies. Method:By means of the method of calculating the instantaneous basic reproduction number R 0t proposed by Cori et al. (2013), we use R 0t to describe the transmissibility change of COVID-19 in China, 2019-2020. In addition, the Baidu Index (BDI) and Baidu Migration Scale (BMS) were selected to measure the public awareness and the effect of Wuhan lockdown (restricted persons in Wuhan outflow from the epidemic area) strategy, respectively. The Granger causality test (GCT) was carried out to explore the association between public awareness, the effect of the Wuhan lockdown strategy, and the transmissibility of COVID-19. Results:The estimated averaged basic reproduction number of NCP in China was 3.44 with 95% CI (2.87, 4.0) during Dec. 8, 2019, to Feb. 9, 2020. The instantaneous basic reproduction numbers (R 0t ) have two waves and reaching peaks on Jan. 8 and Jan. 27, respectively. After reaching a peak on Jan. 27, R 0t showed a continuous decline trend. On Feb. 9, R 0t has fallen to 1.68 (95% CI: 1.66, 1.7), but it is still larger than 1. We find a significantly negative association between public awareness and the transmissibility change of COVID-19, with one unit increase in cumulative BDI leading to a decrease of 0.0295% (95% CI: 0.0077, 0.051) R 0t . We also find a significantly negative association between the effect of the Wuhan lockdown strategy and the transmissibility change of COVID-19, and a one unit decrease in BMS may lead to a drop of 2.7% (95% CI: 0.382, 4.97) R 0t . Conclusion:The current prevention and control measures have effectively reduced the transmissibility of COVID-19; however, R 0t is still larger than the threshold 1. The results show that the government adopting the Wuhan lockdown strategy plays an important role in restricting the potential infected persons in Wuhan outflow from the epidemic area and avoiding a nationwide spread by quickly controlling the potential infection in Wuhan. Meanwhile, since Jan. 18, 2020, the people successively accessed COVID-19-related information via the Internet, which may help to effectively implement the government's prevention and control strategy and contribute to reducing the transmissibility of NCP. Therefore, ongoing travel restriction and public health awareness remain essential to provide a foundation for controlling the outbreak of COVID-19.

Project description:BackgroundA recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients.MethodsAll patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not.FindingsBy Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0-58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0-13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNF?.InterpretationThe 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies.FundingMinistry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.

Project description:Almost the entire world, not only China, is currently experiencing the outbreak of a novel coronavirus that causes respiratory disease, severe pneumonia, and even death. The outbreak began in Wuhan, China, in December of 2019 and is currently still ongoing. This novel coronavirus is highly contagious and has resulted in a continuously increasing number of infections and deaths that have already surpassed the SARS-CoV outbreak that occurred in China between 2002 and 2003. It is now officially a pandemic, announced by WHO on the 11th of March. Currently, the 2019 novel coronavirus (SARS-CoV-2) can be identified by virus isolation or viral nucleic acid detection; however, false negatives associated with the nucleic acid detection provide a clinical challenge and thus make the imaging examination crucial. Imaging exams have been a main clinical diagnostic criteria for the 2019 novel coronavirus disease (COVID-19) in China. Imaging features of multiple patchy areas of ground glass opacity and consolidation predominately in the periphery of the lungs are characteristic manifestations on chest CT and extremely helpful in the early detection and diagnosis of this disease, which aids prompt diagnosis and the eventual control of this emerging global health emergency. Key Points • In December 2019, China, an outbreak of pneumonia caused by a novel, highly contagious coronavirus raised grave concerns and posed a huge threat to global public health. • Among the infected patients, characteristic findings on CT imaging include multiple, patchy, ground-glass opacity, crazy-paving pattern, and consolidation shadows, mainly distributed in the peripheral and subpleural areas of both lungs, which are very helpful for the frontline clinicians. • Imaging examination has become the indispensable means not only in the early detection and diagnosis but also in monitoring the clinical course, evaluating the disease severity, and may be presented as an important warning signal preceding the negative RT-PCR test results.

Dataset Information

A Novel Coronavirus from Patients with Pneumonia in China, 2019.

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A Novel Coronavirus from Patients with Pneumonia in China, 2019.

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