Covid-19 — Navigating the Uncharted
28 Feb 2020-The New England Journal of Medicine (Massachusetts Medical Society)-Vol. 382, Iss: 13, pp 1268-1269
TL;DR: Covid-19 — Navigating the Uncharted Fauci, Lane, and Redfield comment on the early clinical features and epidemiology of cases reported in Wuhan, China, along with current mortality data, noting the importance of knowing the carrier and removal status of canine coronavirus.
Abstract: Covid-19 — Navigating the Uncharted Fauci, Lane, and Redfield comment on the early clinical features and epidemiology of cases reported in Wuhan, China, along with current mortality data, noting th...
Citations
More filters
Jonathan Grein1, Norio Ohmagari1, Daniel Shin1, George Diaz1, Erika Asperges1, Antonella Castagna1, Torsten Feldt1, Gary M. Green1, Margaret L. Green1, François-Xavier Lescure1, Emanuele Nicastri1, Rentaro Oda1, Kikuo Yo1, Eugenia Quiros-Roldan1, Alex Studemeister1, John Redinski1, Seema Ahmed1, Jorge Bernett1, Daniel Chelliah1, Danny Chen1, Shingo Chihara1, Stuart H. Cohen1, Jennifer Cunningham1, Antonella D’Arminio Monforte1, Saad Ismail1, Hideaki Kato1, Giuseppe Lapadula1, Erwan L’Her1, Toshitaka Maeno1, Sumit Majumder1, Marco Massari1, Marta Mora-Rillo1, Yoshikazu Mutoh1, Duc Nguyen1, Ewa Verweij1, Alexander Zoufaly1, Anu Osinusi1, Adam DeZure1, Yang Zhao1, Lijie Zhong1, Anand Chokkalingam1, Emon Elboudwarej1, Laura Telep1, Leighann Timbs1, Ilana Henne1, Scott Sellers1, Huyen Cao1, Susanna K. Tan1, Lucinda Winterbourne1, Polly Desai1, Robertino Mera1, Anuj Gaggar1, Robert P. Myers1, Diana M. Brainard1, Richard Childs1, Timothy Flanigan1 •
TL;DR: In this cohort of patients hospitalized for severe Covid-19 who were treated with compassionate-use remdesivir, clinical improvement was observed in 36 of 53 patients, and Measurement of efficacy will require ongoing randomized, placebo-controlled trials of remdesavir therapy.
Abstract: Background Remdesivir, a nucleotide analogue prodrug that inhibits viral RNA polymerases, has shown in vitro activity against SARS-CoV-2. Methods We provided remdesivir on a compassionate-...
2,314 citations
Cites background from "Covid-19 — Navigating the Uncharted..."
...Acute respiratory distress syndrome 1 (3) 1 (5) 2 (4)...
[...]
...Any adverse event 22 (65) 10 (53) 32 (60) Adverse events occurring in 2 or more patients Hepatic enzyme increased* 8 (24) 4 (21) 12 (23) Diarrhea 1 (3) 4 (21) 5 (9) Rash 3 (9) 1 (5) 4 (8) Renal impairment 4 (12) 0 4 (8) Hypotension 3 (9) 1 (5) 4 (8) Acute kidney injury 2 (6) 1 (5) 3 (6)...
[...]
TL;DR: Coronavirus disease 2019 is associated with a high inflammatory burden that can induce vascular inflammation, myocarditis, and cardiac arrhythmias and should be judiciously controlled per evidence-based guidelines.
Abstract: Importance Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19) has reached a pandemic level. Coronaviruses are known to affect the cardiovascular system. We review the basics of coronaviruses, with a focus on COVID-19, along with their effects on the cardiovascular system. Observations Coronavirus disease 2019 can cause a viral pneumonia with additional extrapulmonary manifestations and complications. A large proportion of patients have underlying cardiovascular disease and/or cardiac risk factors. Factors associated with mortality include male sex, advanced age, and presence of comorbidities including hypertension, diabetes mellitus, cardiovascular diseases, and cerebrovascular diseases. Acute cardiac injury determined by elevated high-sensitivity troponin levels is commonly observed in severe cases and is strongly associated with mortality. Acute respiratory distress syndrome is also strongly associated with mortality. Conclusions and Relevance Coronavirus disease 2019 is associated with a high inflammatory burden that can induce vascular inflammation, myocarditis, and cardiac arrhythmias. Extensive efforts are underway to find specific vaccines and antivirals against SARS-CoV-2. Meanwhile, cardiovascular risk factors and conditions should be judiciously controlled per evidence-based guidelines.
1,467 citations
Nicolas Vabret1, Graham J. Britton1, Conor Gruber1, Samarth Hegde1, Joel Kim1, Maria Kuksin1, Rachel Levantovsky1, Louise Malle1, Alvaro Moreira1, Matthew D. Park1, Luisanna Pia1, Emma Risson1, Miriam Saffern1, Bérengère Salomé1, Myvizhi Esai Selvan1, Matthew P. Spindler1, Jessica Tan1, Verena van der Heide1, Jill Gregory1, Konstantina Alexandropoulos1, Nina Bhardwaj1, Brian D. Brown1, Benjamin Greenbaum1, Zeynep H. Gümüş1, Dirk Homann1, Amir Horowitz1, Alice O. Kamphorst1, Maria A. Curotto de Lafaille1, Saurabh Mehandru1, Miriam Merad1, Robert M. Samstein1, Manasi Agrawal, Mark Aleynick, Meriem Belabed, Matthew Brown1, Maria Casanova-Acebes, Jovani Catalan, Monica Centa, Andrew Charap, Andrew K Chan, Steven T. Chen, Jonathan Chung, Cansu Cimen Bozkus, Evan Cody, Francesca Cossarini, Erica Dalla, Nicolas F. Fernandez, John A. Grout, Dan Fu Ruan, Pauline Hamon, Etienne Humblin, Divya Jha, Julia Kodysh, Andrew Leader, Matthew Lin, Katherine E. Lindblad, Daniel Lozano-Ojalvo, Gabrielle Lubitz, Assaf Magen, Zafar Mahmood2, Gustavo Martinez-Delgado, Jaime Mateus-Tique, Elliot Meritt, Chang Moon1, Justine Noel, Timothy O'Donnell, Miyo Ota, Tamar Plitt, Venu Pothula, Jamie Redes, Ivan Reyes Torres, Mark P. Roberto, Alfonso R. Sanchez-Paulete, Joan Shang, Alessandra Soares Schanoski, Maria Suprun, Michelle Tran, Natalie Vaninov, C. Matthias Wilk, Julio A. Aguirre-Ghiso, Dusan Bogunovic1, Judy H. Cho, Jeremiah J. Faith, Emilie K. Grasset, Peter S. Heeger, Ephraim Kenigsberg, Florian Krammer1, Uri Laserson1 •
TL;DR: The current state of knowledge of innate and adaptive immune responses elicited by SARS-CoV-2 infection and the immunological pathways that likely contribute to disease severity and death are summarized.
1,350 citations
Cites background from "Covid-19 — Navigating the Uncharted..."
...While SARS-CoV-2 is not as lethal as SARSCoV-1 or MERS-CoV (Fauci et al., 2020), the considerable spread of the current pandemic has brought tremendous pressure and disastrous consequences for public health and medical systems worldwide....
[...]
Jason D Goldman, David C. Lye1, David S.C. Hui2, Kristen M. Marks3, Raffaele Bruno4, Rocio Montejano5, Christoph D. Spinner6, Massimo Galli7, Mi Young Ahn, Ronald Nahass, Yao Shen Chen, Devi SenGupta, Robert H. Hyland, Anu Osinusi, Huyen Cao, Christiana Blair, Xuelian Wei, Anuj Gaggar, Diana M. Brainard, William J. Towner8, Jose Muñoz9, Kathleen M. Mullane10, Francisco M. Marty11, Karen T. Tashima12, George A. Diaz, Aruna Subramanian13 •
Tan Tock Seng Hospital1, The Chinese University of Hong Kong2, NewYork–Presbyterian Hospital3, University of Pavia4, Autonomous University of Madrid5, Technische Universität München6, University of Milan7, Kaiser Permanente8, University of Barcelona9, University of Chicago10, Harvard University11, Brown University12, Stanford University13
TL;DR: In patients with severe Covid-19 not requiring mechanical ventilation, a randomized, open-label, phase 3 trial involving hospitalized patients with confirmed SARS-CoV-2 infection, oxygen saturation of 94% or less while they were breathing ambient air, and radiologic evidence of pneumonia, the magnitude of benefit cannot be determined.
Abstract: Background Remdesivir is an RNA polymerase inhibitor with potent antiviral activity in vitro and efficacy in animal models of coronavirus disease 2019 (Covid-19). Methods We conducted a ra...
1,086 citations
Additional excerpts
...Aminotransferase levels increased 3 (2) 2 (1)...
[...]
TL;DR: In the preanalytical stage, collecting the proper respiratory tract specimen at the right time from the right anatomic site is essential for a prompt and accurate molecular diagnosis of COVID-19, and real-time reverse transcription-PCR assays remain the molecular test of choice for the etiologic diagnosis of SARS-CoV-2 infection while antibody-based techniques are being introduced as supplemental tools.
Abstract: The COVID-19 outbreak has had a major impact on clinical microbiology laboratories in the past several months. This commentary covers current issues and challenges for the laboratory diagnosis of infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the preanalytical stage, collecting the proper respiratory tract specimen at the right time from the right anatomic site is essential for a prompt and accurate molecular diagnosis of COVID-19. Appropriate measures are required to keep laboratory staff safe while producing reliable test results. In the analytic stage, real-time reverse transcription-PCR (RT-PCR) assays remain the molecular test of choice for the etiologic diagnosis of SARS-CoV-2 infection while antibody-based techniques are being introduced as supplemental tools. In the postanalytical stage, testing results should be carefully interpreted using both molecular and serological findings. Finally, random-access, integrated devices available at the point of care with scalable capacities will facilitate the rapid and accurate diagnosis and monitoring of SARS-CoV-2 infections and greatly assist in the control of this outbreak.
955 citations
References
More filters
Wei-jie Guan1, Zhengyi Ni1, Yu Hu1, Wenhua Liang1, Chun-Quan Ou1, Jianxing He1, Lei Liu1, Hong Shan1, Chunliang Lei1, David S.C. Hui1, Bin Du1, Lanjuan Li1, Guang Zeng1, Kowk-Yung Yuen1, Ruchong Chen1, Chun-Li Tang1, Tao Wang1, Ping-Yan Chen1, Jie Xiang1, Shiyue Li1, Jinlin Wang1, Zi-jing Liang1, Yi-xiang Peng1, Li Wei1, Yong Liu1, Ya-hua Hu1, Peng Peng1, Jian-ming Wang1, Ji-yang Liu1, Zhong Chen1, Gang Li1, Zhi-jian Zheng1, Shao-qin Qiu1, Jie Luo1, Chang-jiang Ye1, Shao-yong Zhu1, Nanshan Zhong1 •
TL;DR: During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness, and patients often presented without fever, and many did not have abnormal radiologic findings.
Abstract: Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of...
22,622 citations
"Covid-19 — Navigating the Uncharted..." refers background in this paper
...Emerging Infect Dis 2020; 26(5) (Epub ahead of print)....
[...]
Qun Li1, Xuhua Guan1, Peng Wu2, Xiaoye Wang1, Lei Zhou1, Yeqing Tong1, Ruiqi Ren1, Kathy Leung2, Eric H. Y. Lau2, Jessica Y. Wong2, Xuesen Xing1, Nijuan Xiang1, Yang Wu1, Chao Li1, Chen Qi1, Dan Li1, Tian Liu1, Jing Zhao1, Man Liu1, Wenxiao Tu1, Chuding Chen1, Lianmei Jin1, Rui Yang1, Qi Wang1, Suhua Zhou1, Rui Wang1, Hui Liu1, Yingbo Luo1, Yuan Liu1, Ge Shao1, Huan Li1, Zhongfa Tao1, Yang Yang3, Yang Yang4, Zhiqiang Deng5, Boxi Liu5, Zhitao Ma5, Yanping Zhang1, Guoqing Shi1, Tommy Tsan-Yuk Lam2, Joseph T. Wu2, George F. Gao6, George F. Gao1, Benjamin J. Cowling2, Bo Yang5, Gabriel M. Leung2, Zijian Feng1 •
TL;DR: There is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019 and considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere.
Abstract: Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the...
13,101 citations
Michelle Holshue1, Chas DeBolt2, Scott Lindquist, Kathy H Lofy, John Wiesman, Hollianne Bruce, Christopher Spitters, Keith M. Marzilli Ericson, Sara Wilkerson, Ahmet Tural, George Diaz, Amanda C. Cohn, LeAnne Fox, Anita Patel, Susan I. Gerber, Lindsay Kim, Suxiang Tong, Xiaoyan Lu, Steve Lindstrom, Mark A. Pallansch, William C. Weldon, Holly M. Biggs, Timothy M. Uyeki, Satish K. Pillai •
TL;DR: This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.
Abstract: An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient's initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.
4,970 citations
Lirong Zou1, Feng Ruan1, Mingxing Huang2, Lijun Liang1, Huitao Huang1, Zhongsi Hong2, Jianxiang Yu1, Min Kang1, Yingchao Song1, Jinyu Xia2, Qianfang Guo1, Tie Song1, Jianfeng He1, Hui-Ling Yen3, Malik Peiris3, Jie Wu1 •
TL;DR: Results of an analysis of nasal and throat swabs from 17 patients in Zhuhai, China, who had received a diagnosis of Covid-19 and found SARS-CoV-2 Viral Load in Upper Respiratory Specimens positive.
Abstract: SARS-CoV-2 Viral Load in Upper Respiratory Specimens The authors report results of an analysis of nasal and throat swabs from 17 patients in Zhuhai, China, who had received a diagnosis of Covid-19....
4,236 citations
TL;DR: The emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012 marked the second introduction of a highly pathogenic coronav virus into the human population in the twenty-first century, and the current state of development of measures to combat emerging coronaviruses is discussed.
Abstract: The emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012 marked the second introduction of a highly pathogenic coronavirus into the human population in the twenty-first century. The continuing introductions of MERS-CoV from dromedary camels, the subsequent travel-related viral spread, the unprecedented nosocomial outbreaks and the high case-fatality rates highlight the need for prophylactic and therapeutic measures. Scientific advancements since the 2002-2003 severe acute respiratory syndrome coronavirus (SARS-CoV) pandemic allowed for rapid progress in our understanding of the epidemiology and pathogenesis of MERS-CoV and the development of therapeutics. In this Review, we detail our present understanding of the transmission and pathogenesis of SARS-CoV and MERS-CoV, and discuss the current state of development of measures to combat emerging coronaviruses.
2,794 citations
Related Papers (5)
Wei-jie Guan, Zhengyi Ni, Yu Hu, Wenhua Liang, Chun-Quan Ou, Jianxing He, Lei Liu, Hong Shan, Chunliang Lei, David S.C. Hui, Bin Du, Lanjuan Li, Guang Zeng, Kowk-Yung Yuen, Ruchong Chen, Chun-Li Tang, Tao Wang, Ping-Yan Chen, Jie Xiang, Shiyue Li, Jinlin Wang, Zi-jing Liang, Yi-xiang Peng, Li Wei, Yong Liu, Ya-hua Hu, Peng Peng, Jian-ming Wang, Ji-yang Liu, Zhong Chen, Gang Li, Zhi-jian Zheng, Shao-qin Qiu, Jie Luo, Chang-jiang Ye, Shao-yong Zhu, Nanshan Zhong
Chaolin Huang, Yeming Wang, Xingwang Li, Lili Ren, Jianping Zhao, Yi Hu, Li Zhang, Guohui Fan, Jiuyang Xu, Xiaoying Gu, Zhenshun Cheng, Ting Yu, Jia'an Xia, Yuan Wei, Wenjuan Wu, Xuelei Xie, Wen Yin, Li Hui, Min Liu, Yan Xiao, Hong Gao, Li Guo, Jungang Xie, Guang-Fa Wang, Rongmeng Jiang, Zhancheng Gao, Qi Jin, Jianwei Wang, Bin Cao
Qun Li, Xuhua Guan, Peng Wu, Xiaoye Wang, Lei Zhou, Yeqing Tong, Ruiqi Ren, Kathy Leung, Eric H. Y. Lau, Jessica Y. Wong, Xuesen Xing, Nijuan Xiang, Yang Wu, Chao Li, Chen Qi, Dan Li, Tian Liu, Jing Zhao, Man Liu, Wenxiao Tu, Chuding Chen, Lianmei Jin, Rui Yang, Qi Wang, Suhua Zhou, Rui Wang, Hui Liu, Yingbo Luo, Yuan Liu, Ge Shao, Huan Li, Zhongfa Tao, Yang Yang, Yang Yang, Zhiqiang Deng, Boxi Liu, Zhitao Ma, Yanping Zhang, Guoqing Shi, Tommy Tsan-Yuk Lam, Joseph T. Wu, George F. Gao, George F. Gao, Benjamin J. Cowling, Bo Yang, Gabriel M. Leung, Zijian Feng