Abstract
Introduction
Virology and origin
Epidemiology
Clinical manifestations
Pathology
Treatment
Conclusion
Ethical approval
Funding source
Conflicts of interest
Author contributions
Acknowledgment
Appendix A. Supplementary data
References
Abstract
Background: The rapid spread of the coronavirus disease 2019 (COVID-19), caused by a zoonotic betacoronavirus entitled 2019 novel coronavirus (2019-nCoV), has become a global threat. Awareness of the biological features of 2019-nCoV should be updated in time and needs to be comprehensively summarized to help optimize control measures and make therapeutic decisions. Methods: Based on recently published literature, official documents and selected up-to-date preprint studies, we reviewed the virology and origin, epidemiology, clinical manifestations, pathology and treatment of 2019-nCoV infection, in comparison with severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Results: The genome of 2019-nCoV partially resembled SARS-CoV and MERS-CoV, and indicated a bat origin. The COVID-19 generally had a high reproductive number, a long incubation period, a short serial interval and a low case fatality rate (much higher in patients with comorbidities) than SARS and MERS. Clinical presentation and pathology of COVID-19 greatly resembled SARS and MERS, with less upper respiratory and gastrointestinal symptoms, and more exudative lesions in post-mortems. Potential treatments included remdesivir, chloroquine, tocilizumab, convalescent plasma and vaccine immunization (when possible). Conclusion: The initial experience from the current pandemic and lessons from the previous two pandemics can help improve future preparedness plans and combat disease progression.
Introduction
In late December 2019, a pneumonia outbreak of unknown etiology took place in Wuhan, Hubei province, China, and spread quickly nationwide. The Chinese Center for Disease Control and Prevention (CCDC) identified a novel beta-coronavirus called 2019- nCoV, now officially known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Gorbalenya et al., 2020), that was responsible for the pandemic. This was the third zoonotic coronavirus breakout in the first two decades of the 21st century, allowing human-to-human transmission and raising global health concerns. The Chinese government had taken immediate, transparent and extraordinary measures, and reached initial achievements to control the outbreak. As of 11 March 2020, the pandemic caused an accumulation of 80955 confirmed cases and 3162 deaths in China, and 37364 confirmed cases and 1130 deaths in 113 other countries worldwide. World Health Organization (WHO) is deeply concerned by the unprecedented swift global spread and severity of the outbreak, and by the ignorance and inaction of some countries. Therefore, WHO announced that COVID-19 can be characterized as a pandemic (WHO, 2020). The biological features of 2019-nCoV and experiences combating COVID-19 should be updated in time and need to be comprehensively summarized to help optimize control measures and make therapeutic decisions. What’s more, 2019-nCoV demonstrated partial resemblance with SARS-CoV and MERSCoV, in phylogenetic analysis, clinical manifestations and pathological findings. Scientific advances from the SARS and MERS outbreaks can provide valuable insight into rapid understanding and control measures of the current pandemic.