COVID Moonshot Drove Discovery of Potential COVID-19 Antivirals
0
Citation
0
Reference
10
Related Paper
Abstract:
Using tools such as crowdsourcing, machine learning, and molecule simulations, an open-science campaign known as COVID Moonshot Consortium drove the formulation of novel potential antiviral treatments for COVID-19, according to results published in Science.Keywords:
2019-20 coronavirus outbreak
Crowdsourcing
Betacoronavirus
Coronavirus Infections
Pandemic
2019-20 coronavirus outbreak
Coronavirus Infections
Betacoronavirus
Coronavirus
Pandemic
Cite
Citations (7)
2019-20 coronavirus outbreak
Betacoronavirus
Coronavirus
Coronavirus Infections
Pandemic
Sars virus
Viral therapy
Cite
Citations (0)
In The Lancet Gastroenterology & Hepatology, Gwilym Webb and colleagues present a multicentre analysis of outcomes for 151 liver transplant recipients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with data collected from March 25, 2020, to June 26, 2020.1Webb GJ Marjot T Cook JA et al.Outcomes following SARS-CoV-2 infection in liver transplant recipients: an international registry study.Lancet Gastroenterol Hepatol. 2020; (published online Aug 28.)https://doi.org/10.1016/S2468-1253(20)30271-5Summary Full Text Full Text PDF Scopus (169) Google Scholar The study, which included liver transplant recipients from 18 countries, represents the largest reported series of liver transplant recipients with confirmed SARS-CoV-2 infection to date. The study is also the first to include a comparison with patients with COVID-19 who have not received a liver transplant (n=627), having collected data from the electronic patient records of group of four hospitals in Oxford, UK. Importantly, the report provides an estimation of the risks for liver transplant recipients—who must balance the need for ongoing medical care with the need to remain isolated to reduce exposure to SARS-CoV-2—and also demonstrates the power of international collaboration in solving critical health-care challenges. The study found no difference in the proportion of patients hospitalised between the liver transplant (124 [82%] patients) and the non-liver transplant cohort (474 [76%] patients; p=0·106). Despite an increased need for invasive ventilation support among recipients of liver transplants (30 [20%] vs 32 [5%] in the comparison cohort, p<0·0001), mortality was significantly lower in liver transplant recipients (28 [19%]) than in patients who had not received a liver transplant (167 [27%]; p=0·046). In a propensity score-matched analysis (adjusting for age, sex, creatinine concentration, obesity, hypertension, diabetes, and ethnicity), liver transplantation did not significantly increase the risk of death in patients with SARS-CoV-2 infection (absolute risk difference 1·4% [95% CI −7·7 to 10·4]). COVID-19 lung disease was the main cause of death in both groups and, importantly, there were no liver-related deaths among the transplant recipients. Multivariable analysis showed that factors associated with death among liver transplant recipients included age and creatinine concentration, as well as the presence of non-liver malignancy, whereas time from transplantation and type of immunosuppression were not related to risk of death. In the control population, multivariable analysis showed age, male sex, and diabetes to be the major risk factors for death. An additional notable finding was the higher rates of gastrointestinal symptoms in the liver transplant cohort, with 30% having abdominal pain, vomiting, or diarrhoea at diagnosis compared with just 12% of the control group having abdominal symptoms (p<0·0001). There are some important caveats to the current analysis, such as the significant differences between the two cohorts. Although age, a key risk factor, was higher in the comparison cohort (median 73 years [IQR 55–84]) than the liver transplant cohort (median 60 years [47–66]), the liver transplant group had significantly greater proportions of men (68% vs 52% in the comparison cohort) and patients with diabetes (43% vs 23% in the comparison cohort). In addition, testing rates and thresholds for hospitalisation and admission to an intensive care unit might have differed across different centres and between the cohorts. Furthermore, the liver transplant cohort might have been subject to reporting bias because the data were collected from two registries of clinician-submitted cases; those clinicians might have been more likely to be aware of, and thus submit data on, hospitalised liver transplant recipients with more severe infections (as compared with the comparison cohort, which was drawn from consecutive cases of patients testing positive for SARS-CoV-2). However, this bias would only serve to strengthen the main conclusion that liver transplant recipients are not at a higher risk of death than patients who have not undergone transplantation. It is essential to note that the median time from transplantation in this liver transplant cohort was 5 years (IQR 2–11), and thus the current experience cannot be extrapolated to patients who might acquire SARS-CoV-2 infection in the perioperative period. Despite these limitations, Webb and colleagues' study1Webb GJ Marjot T Cook JA et al.Outcomes following SARS-CoV-2 infection in liver transplant recipients: an international registry study.Lancet Gastroenterol Hepatol. 2020; (published online Aug 28.)https://doi.org/10.1016/S2468-1253(20)30271-5Summary Full Text Full Text PDF Scopus (169) Google Scholar represents the largest experience of SARS-CoV-2 infection in liver transplant recipients to date, and found no adverse effect of liver transplantation on survival following COVID-19 compared with a UK population cohort of patients without liver transplant. A recently published single-centre study of 36 kidney transplant recipients in the USA showed a similar rate of hospitalisation (78%), with a potentially higher rate of death (28%), although, unlike the present series of liver transplant recipients, at least some kidney transplant recipients were within weeks of transplantation.2Akalin E Azzi Y Bartash R et al.COVID 19 and kidney transplantation.N Engl J Med. 2020; 382: 2475-2477Crossref PubMed Scopus (594) Google Scholar A larger multicentre series of 144 kidney transplant recipients, which included only hospitalised patients, found a mortality rate of 32% in a cohort with a median time from transplantation of 5 years, although that study also included some patients with less than 1 year since transplantation.3Cravedi P Suraj SM Azzi Y et al.COVID-19 and kidney transplantation: results from the TANGO international transplant consortium.Am J Transplant. 2020; (published online July 10.)https://doi.org/10.1111/ajt.16185Crossref Scopus (276) Google Scholar Whether there are actually differences in outcome between patients undergoing liver or kidney transplantation, or transplantation of other organs, remains to be determined, although the question is likely to be answered best by large collaborative efforts, as reflected in Webb and colleagues' study.1Webb GJ Marjot T Cook JA et al.Outcomes following SARS-CoV-2 infection in liver transplant recipients: an international registry study.Lancet Gastroenterol Hepatol. 2020; (published online Aug 28.)https://doi.org/10.1016/S2468-1253(20)30271-5Summary Full Text Full Text PDF Scopus (169) Google Scholar Despite the unprecedented challenges imposed by the current pandemic on all aspects of our lives, centres across the globe were able to work together to collect and analyse detailed outcome data for more than 700 patients with SARS-CoV-2 infection, thus providing crucial information on a potentially at-risk population, with an efficiency and scale only possible through international collaboration. We declare no competing interests.
Cite
Citations (9)
Since Tang and colleagues commented on the current Wuhan novel coronavirus (2019-nCoV) outbreak four weeks ago,1Tang J.W. Tambyah P.A. Hui D.S.C. Emergence of a novel coronavirus causing respiratory illness from Wuhan, China.J Infect. 2020; (pii: S0163-4453(20)30038-4[Epub ahead of print])https://doi.org/10.1016/j.jinf.2020.01.014Abstract Full Text Full Text PDF Scopus (113) Google Scholar the situation has worsened dramatically. As of today (1 February 2020), there have been an estimated 14,599 infected cases with a total of 305 deaths and 345 recovered involving 27 countries.2Wuhan coronavirus outbreak.2 February 2020. https://www.worldometers.info/coronavirus/.Google Scholar Online estimate of the case fatality rate is about 2% with a R0 (basic reproductive number) value of 3–4, indicating that every positive case may give rise to further 3–4 new cases. Nearly all confirmed cases (14,422, 98.8%) are in the mainland China, with most of the remaining cases in nearby countries or cities in East Asia (Japan, South Korea, Hong Kong, Taiwan, Macau), Southeast Asia (Thailand, Singapore, Malaysia, Vietnam) and Australia accounting for the majority of the remaining cases.2Wuhan coronavirus outbreak.2 February 2020. https://www.worldometers.info/coronavirus/.Google Scholar We would like to shed light on how the epidemic will develop in Hong Kong based on the characteristics of current cases in this region. Hong Kong is a former British colony and a city situated in a small (426 m2iles) area officially designated as a Special Administrative Region (SAR) of the People's Republic of China. With a population of over 7.4 million, it has one of the highest population densities in the world. The geography of Hong Kong includes: (i) Hong Kong island, (ii) the Kowloon Peninsula and (iii) the New Territories which borders mainland China. It also consists of multiple islands, including the Lantau Island (the site of the Hong Kong International Airport). The busiest boundary control point with mainland China is in the New Territories at Lo Wu, where estimates from previous years indicate that around 239,000 passengers may be expected to cross daily during the Chinese New Year (CNY) period.3Government of Hong Kong SAR. Cross-boundary passenger traffic estimation and arrangements for Lunar New Year festive period. 7 Feb 2018. https://www.info.gov.hk/gia/general/201802/07/P2018020700291.htm.Google Scholar The closest city on the other side is Shenzhen within the Guangdong Province, and there are many people who work in Hong Kong and live in Shenzhen, commuting across the border each day. At the time of writing, 14 cases of the 2019-nCoV have been confirmed in Hong Kong and all are currently being managed at the designated infectious disease center - Princess Margaret Hospital (PMH). The first case was detected on 23 January 2020 and the most recent one was on the 1 February 2020. Most of these cases were residents from mainland China: Wuhan (7/14=50%) and Shenzhen (1/14=7.1%), visiting Hong Kong while the remaining 6 cases are Hong Kong citizens (Fig. 1). At least two of these 14 cases had not travelled to the mainland China, including Wuhan, within the 14-day maximum incubation period of 2019-nCoV. They may therefore represent cases of inter-person transmission, having acquired their infections from infected individuals with such a travel history. Several cases of inter-person transmission have been reported in the other countries (including Japan, Germany and the United States).4The Japan Times. Japan reports first domestic transmission of coronavirus. 28 January 2020. https://www.japantimes.co.jp/news/2020/01/28/national/japan-first-domestic-transmission-coronavirus/.Google Scholar, 5Global News. German man who never visited china catches coronavirus through human-to-human transmission. 28 January 2020. https://globalnews.ca/news/6472303/german-coronavirus-human-to-human-transmission/.Google Scholar, 6CNN Health. First case of person-to-person transmission of Wuhan virus in the US confirmed. 30 January 2020. https://edition.cnn.com/2020/01/30/health/coronavirus-illinois-person-to-person-cdc/index.html.Google Scholar This has also been reported in a family from Shenzhen who visited Wuhan (but not any wet markets) then infected one family member who had not travelled upon their return.7Chan J.F. Yuan S. Kok K.H. To K.K. Chu H. Yang J. et al.A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster.Lancet. 2020 Jan 24; (pii: S0140-6736(20)30154-9[Epub ahead of print])https://doi.org/10.1016/S0140-6736(20)30154-9Abstract Full Text Full Text PDF Scopus (6149) Google Scholar This Hong Kong cohort also consists of two husband-and-wife couples and a family of three (husband, wife and adult daughter), all of whom had a travel history to Wuhan. The mean age of these 14 Hong Kong cases was 59.8 (S.D. 13.4) years and most (9/14 = 64.3%) were male. 12/14 (85.7%) cases presented with fever (including 5 with cough, 1 with blocked nose, 1 with muscle aches, and the remaining 2 afebrile cases exhibited coughing and shortness of breath). 10/14 (71.4%) cases presented to the Accident and Emergency departments in Hong Kong to seek care, 2/14 (14.3%) were intercepted by the Hong Kong Department of Health teams (using thermal imaging or temperature screening at border control points), and 2/14 (14.3%) developed symptoms and tested positive for 2019-nCoV during quarantine as a contact of a confirmed case. At present, 3/14 (21.4%) cases are in the intensive care unit (ICU) whereas the other 11 cases are clinically stable at PMH. An earlier report8Huang C. Wang Y. Li X. Ren L. Zhao J. Hu Y. et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.Lancet. 2020 Jan 24; (pii: S0140-6736(20)30183-5[Epub ahead of print])https://doi.org/10.1016/S0140-6736(20)30183-5Abstract Full Text Full Text PDF Scopus (32455) Google Scholar on some of the earliest cases of 2019-nCoV infection also describes a higher proportion of cases to be male (30/41=73%), with a slightly higher proportion (13/41=32%) requiring ICU monitoring – though it is still yet possible that more Hong Kong cases may deteriorate and require ICU admission. What do these early cases imply for Hong Kong? The period over which these cases were detected (23 January to 1 February 2020) includes the week before and the week after the CNY (starting from 25 January 2020). Does this suggest that this period represents the highest incidence of cases developing in Hong Kong because the highest intensity of population movement occurs over CNY, and that this may be expected to decrease once the celebrations are over? Not necessarily, we think, as many of the normal CNY activities in Hong Kong and mainland China were quite severely curtailed to limit the potential spread of this infection.9Al Jazeera. Hong Kong cancels Chinese New Year celebrations. 18 January 2020. https://www.aljazeera.com/news/2020/01/hong-kong-cancels-chinese-year-celebrations-200118140832768.html.Google Scholar,10The Washington Post. Chinese cities cancel New Year celebrations, travel ban widens in effort to stop coronavirus outbreak. 24 January 2020. https://www.washingtonpost.com/world/coronavirus-china-wuhan-latest/2020/01/23/2dc947a8-3d45-11ea-afe2-090eb37b60b1_story.html.Google Scholar In which case, these incidence figures may represent more of the baseline rate of 2019-nCoV cases appearing in Hong Kong. Indeed, a closer look at Fig. 1 suggests that Hong Kong is already experiencing some degree of local inter-person transmission, as the earlier cases were associated with travel to Wuhan and other parts of mainland China, but the more recent cases involved no recent travel to these affected areas. If this is the case, what can Hong Kong do? A previous study indicated that the mean daily contact rate for an individual in Hong Kong could be characterized as contacting 12–13 other people (both children and adults) spread over a total of nine-hour duration,11Kwok K.O. Cowling B. Wei V. Riley S. Read J.M. Temporal variation of human encounters and the number of locations in which they occur: a longitudinal study of Hong Kong residents.J R Soc Interface. 2018; 15 (pii: 20170838)https://doi.org/10.1098/rsif.2017.0838Crossref PubMed Scopus (23) Google Scholar so presumably reducing the number of social contacts can reduce the risk of inter-person transmission. At present, all primary and secondary schools are closed in Hong Kong, and the universities are either postponing classes until March 2020 or are using distant/remote learning methods.12South China Morning Post. Hong Kong schools, kindergartens closed until at least March 2 as coronavirus fears grow, three universities take similar action. 30 January 2020. https://www.scmp.com/news/hong-kong/education/article/3048305/hong-kong-universities-suspend-classes-until-march-china.Google Scholar Another approach is to limit the number of potentially infected cases entering Hong Kong.13South China Morning Post. China coronavirus: hong kong will ban anyone who has been to Hubei province from entering city, in response to mounting calls to tighten border checks. 26 January 2020. https://www.scmp.com/news/hong-kong/health-environment/article/3047689/china-coronavirus-hong-kong-has-its-sixth-patient.Google Scholar This strategy is controversial and our current modelling work is exploring its potential impact. This work has been partially supported by Research Fund for the Control of Infectious Diseases, Hong Kong (Number: INF-CUHK-1); General Research Fund (Number: 14112818); Health and Medical Research Fund (Ref: 18170312); Wellcome Trust (UK, 200861/Z/16/Z). The authors also thank Li Ka Shing Institute of Health Sciences for technical support.
Case fatality rate
Coronavirus
China mainland
2019-20 coronavirus outbreak
Cite
Citations (49)
The newly identified coronavirus, COVID-19, was first reported in Wuhan, China on December 31, 2019. In one month, reported cases outnumber those from the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) epidemic [[1]Wu J.T. Leung K. Leung G.M. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study.Lancet. 2020; (Published online ahead of print.)https://doi.org/10.1016/S0140-6736(20)30260-9Summary Full Text Full Text PDF Scopus (2827) Google Scholar]. Public health experts are working to better understand and address this epidemic. Herein, we briefly discuss key cultural, policy and epidemiological aspects that might have contributed to this scenario. The COVID-19 belongs to the same family as SARS and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), and all are zoonotic infections. The SARS-CoV 2002–03 epidemic originated from civet cats, sold in live wild animal markets – similar to the one in Wuhan, where COVID-19 has been linked to snakes, bats and pangolins [[2]Ji W. Wang W. Zhao X. Zai J. Li X. Cross-species transmission of the newly identified coronavirus 2019-nCoV.J Med Virol. 2020; 92: 433-440https://doi.org/10.1002/jmv.25682Crossref PubMed Scopus (635) Google Scholar]. Those so-called 'wet markets' are common in parts of Asia, Africa, South America and Oceania and frequently sell live wild animals– making it difficult to ensure meat safety. 'Wet markets' provide the perfect environment for viral and bacterial transmission from infected urine, feces, blood and other biofluids from slaughtered animals [[3]Lo M.Y. Ngan W.Y. Tsun S.M. Hsing H.L. Lau K.T. Hung H.P. et al.A field study into Hong Kong's wet markets: raised questions into the hygienic maintenance of meat contact surfaces and the dissemination of microorganisms associated with nosocomial infections.Front Microbiol. 2019; 10: 2618Crossref PubMed Scopus (17) Google Scholar]. In addition, their hygienic practices tend to be sub-optimal, contributing to transmission of a broad range of infections, including COVID-19. Another aspect that may have influenced COVID-19 rapid spread is China's highly centralized, hierarchical and bureaucratic surveillance and health response system. During the SARS-CoV epidemic (over 8300 cases in 26 countries), the government initially withheld information from the public and obstructed infectious diseases experts' efforts to investigate and report outbreaks, which ultimately delayed the response [[4]Huang Y. The SARS epidemic and its aftermath in China: a political perspective.in: Knobler S. Mahmoud A. Lemon S. Learning from SARS: preparing for the next disease outbreak: workshop summary. National Academies Press (US), WashingtonDC2004https://www.ncbi.nlm.nih.gov/books/NBK92479/Google Scholar]. Almost two decades after the SARS-CoV epidemic, China's political system and pattern of crisis management may have jeopardized the country's initial response to COVID-19. Rapid spread of COVID-19 is also influenced by high population density and mobility. Wuhan is a major transport hub in China, with a population exceeding 11 million people. In response to COVID-19, the Chinese government restricted 'unnecessary or non-essential large-scale public gatherings' in late January, 2020, in anticipation of domestic and international travel of millions of people for the Chinese New Year celebration. Nearly half of China's population (more than 750 million people) are currently living under various forms of travel restrictions. Several countries have evacuated their nationals from Wuhan and many airlines suspended flights to China. Thousands cruise ship passengers where COVID-19 cases were confirmed are been quarantined. While these measures may have curtailed transmission, by February 19, 2020, COVID-19 was reported in roughly 30 countries, with almost 75,000 confirmed cases. Thousands patients had severe infections, and over 2,100 deaths were reported so far [[5]World Health Organization. Novel coronavirus(2019-ncov): situation reports. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/Google Scholar]. Dozens of new deaths and thousands of new cases are still being reported every day. A recent mathematical modeling estimated that, by the end of January 2020, more than 75,000 people were infected with COVID-19 only in Wuhan [[1]Wu J.T. Leung K. Leung G.M. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study.Lancet. 2020; (Published online ahead of print.)https://doi.org/10.1016/S0140-6736(20)30260-9Summary Full Text Full Text PDF Scopus (2827) Google Scholar]. Notably, cases have occurred in patients who had not traveled to Wuhan, indicative of person-to-person transmission. The World Health Organization (WHO) declared COVID-19 a Public Health Emergency of International Concern (PHEIC) on January 30, 2020 [[5]World Health Organization. Novel coronavirus(2019-ncov): situation reports. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/Google Scholar]. Substandard implementation of appropriate infection prevention and control measures could influence COVID-19 global spread. These include early recognition, source control and additional precautions at point-of-care for persons under investigation or with confirmed COVID-19. Healthcare workers are at increased risk; Dr. Li Wenliang, a Chinese ophthalmologist at Wuhan Central Hospital who was one of the first to warn the public about COVID-19 on 30 December 2019 (and was later detained for doing so), died from the virus at aged 33 on February 7, 2020. More than 1,700 health care workers have been infected so far, with 6 fatalities. The myriad factors influencing the COVID-19 pandemic are not unique. High population density, unsanitary conditions and an inadequate health care infrastructure were also at the core of the Zika epidemic [[6]Lowe R. Barcellos C. Brasil P. Cruz O.G. Honorio N.A. Kuper H. Carvalho M.S. The zika virus epidemic in Brazil: from discovery to future implications.Int J Environ Res Public Health. 2018; 15: 96Crossref PubMed Scopus (207) Google Scholar]. Brazil reported the first confirmed case of Zika virus (ZIKV) in May 2015, followed by a sharp increase in the number of neonates born with microcephaly. The government quickly declared ZIKV a national public health emergency in November 2015, followed by WHO three months later. However, the Brazilian Zika emergency protocol did not mention or authorize legal abortion, despite WHO recommendations. More than 2700 babies were born with congenital Zika syndrome in Brazil. Systemic problems continue to affect disenfranchised and densely populated communities in Brazil that remain at risk of emerging or reemerging arboviruses [[6]Lowe R. Barcellos C. Brasil P. Cruz O.G. Honorio N.A. Kuper H. Carvalho M.S. The zika virus epidemic in Brazil: from discovery to future implications.Int J Environ Res Public Health. 2018; 15: 96Crossref PubMed Scopus (207) Google Scholar]. If another ZIKV outbreak occurs, young Brazilian women still cannot access safe abortion and might need to provide lifelong care for a severely disabled child. Crowding, poverty, lack of basic health services, and a highly mobile population also played a key role in the Ebolavirus outbreak in West Africa from 2014 to 2016 and the ongoing outbreak in the Democratic Republic of the Congo. Ebolavirus outbreaks, like novel coronavirus outbreaks are a result of zoonotic spillover and subsequent human-to-human transmission. However, Ebola differs in mode of transmission (direct contact) and has a much higher case fatality rate (CFR; 50%–80%) [[7]Alexander K.A. Sanderson C.E. Marathe M. Lewis B.L. Rivers C.M. Shaman J. et al.What factors might have led to the emergence of Ebola in West Africa?.PLoS Negl Trop Dis. 2015; 9e0003652Crossref Scopus (168) Google Scholar]. The CFR and basic reproductive rate (Ro) of COVID-19 is still unknown. Some experts contend this virus is less pathogenic than MERS-CoV and SARS-CoV, which had CFRs of 34.4% and 11%, respectively. MERS-CoV and SARS-CoV were associated with high levels of nonsocomial transmissions in hospitals. One single patient with SARS-CoV who traveled from Hong Kong to Canada resulted in 128 additional SARS cases in Toronto. Similarly, one patient with MERS-CoV transferred from Saudi Arabia to South Korea was linked to 186 additional MERS-CoV cases [[8]Munster V.J. Koopmans M. van Doremalen N. van Riel D. de Wit E. A novel coronavirus emerging in China—key questions for impact assessment.N Engl J Med. 2020; 10 ([Published online ahead of print.)https://doi.org/10.1056/NEJMp2000929Crossref Scopus (912) Google Scholar]. COVID-19 could foster a similar scenario. In global public health systems struggling with sub-optimal resources and inadequate infrastructure, this could be a recipe for disaster. As with any infectious disease emergency, public health officials need also to address the epidemic of fear. Inappropriate prevention and treatment strategies such as herbal remedies and exaggerated numbers of persons affected by COVID-19 cases have circulated on social media. The COVID-19 pandemic, rapid spread and magnitude unleashed panic and episodes of racism against people of Asian descent. Efforts to address this scenario in the COVID-19 and future epidemics need to consider traditional and social media communication, among other sources of information to curtail misinformation and prejudice. To avoid a global pandemic, timely surveillance, epidemiologic information about the pathogenicity and transmissibility of COVID-19 are needed. Healthcare workers should be adequately trained to identify, notify local authorities and provide appropriate care. Animal markets, specifically 'wet markets' should be closely monitored and meat safety ensured by public health authorities. According to Munster et al. [[8]Munster V.J. Koopmans M. van Doremalen N. van Riel D. de Wit E. A novel coronavirus emerging in China—key questions for impact assessment.N Engl J Med. 2020; 10 ([Published online ahead of print.)https://doi.org/10.1056/NEJMp2000929Crossref Scopus (912) Google Scholar] "If we are proactive (…) perhaps we will never have to discover the true epidemic or pandemic potential of 2019-nCoV [COVID-19]." Unfortunately, as of February 6, 2020, the COVID-19 scale constitutes a pandemic and China's delayed response influenced this scenario. Ma Guoqiang, municipal Communist Party secretary for Wuhan, said "Right now I'm in a state of guilt, remorse and self-reproach. If strict control measures had been taken earlier, the result would have been better than now" [[9]CBS News. "U.S. health officials issue quarantine order for 195 Americans evacuated from China" Available from: https://www.cbsnews.com/live-updates/coronavirus-outbreak-china-evacuations-wuhan-death-toll-today-flights-us-cases-2020-01-31/Google Scholar] During the first reports from the Chinese government, COVID-19 was referred as "preventable and controllable". At present, it is neither. None. Download .pdf (.24 MB) Help with pdf files
Coronavirus
Betacoronavirus
Pandemic
2019-20 coronavirus outbreak
Cite
Citations (109)
Although SARS-CoV-2 may primarily enter the cells of the lungs, the small bowel may also be an important entry or interaction site, as the enterocytes are rich in angiotensin converting enzyme (ACE)-2 receptors. The initial gastrointestinal symptoms that appear early during the course of Covid-19 support this hypothesis. Furthermore, SARS-CoV virions are preferentially released apically and not at the basement of the airway cells. Thus, in the setting of a productive infection of conducting airway epithelia, the apically released SARS-CoV may be removed by mucociliary clearance and gain access to the GI tract via a luminal exposure. In addition, post-mortem studies of mice infected by SARS-CoV have demonstrated diffuse damage to the GI tract, with the small bowel showing signs of enterocyte desquamation, edema, small vessel dilation and lymphocyte infiltration, as well as mesenteric nodes with severe hemorrhage and necrosis. Finally, the small bowel is rich in furin, a serine protease which can separate the S-spike of the coronavirus into two "pinchers" (S1 and 2). The separation of the S-spike into S1 and S2 is essential for the attachment of the virion to both the ACE receptor and the cell membrane. In this special review, we describe the interaction of SARS-CoV-2 with the cell and enterocyte and its potential clinical implications.
2019-20 coronavirus outbreak
Coronavirus
Betacoronavirus
Coronavirus Infections
Sars virus
Pandemic
Coronaviridae
Cite
Citations (109)
2019-20 coronavirus outbreak
Betacoronavirus
Coronavirus Infections
Pandemic
Cite
Citations (28)
2019-20 coronavirus outbreak
Coronavirus
Pandemic
Betacoronavirus
Coronavirus Infections
Cite
Citations (4)
2019-20 coronavirus outbreak
Betacoronavirus
Coronavirus
Coronavirus Infections
Pandemic
Cite
Citations (29)
Preview this article: Note from the editors: novel coronavirus (2019-nCoV), Page 1 of 1 < Previous page | Next page > /docserver/preview/fulltext/eurosurveillance/25/3/eurosurv-25-3-1-1.gif
Coronavirus
2019-20 coronavirus outbreak
Betacoronavirus
Coronavirus Infections
Cite
Citations (42)