Insights into the Recent 2019 Novel Coronavirus (SARS-CoV-2) in Light of Past Human Coronavirus Outbreaks
TL;DR: Wang et al. as mentioned in this paper discuss structure, genome organization, entry of CoVs into target cells, and provide insights into past and present outbreaks of human CoV outbreaks and develop efficient prevention and treatment strategies to deal with this continuous threat.
Abstract: Coronaviruses (CoVs) are RNA viruses that have become a major public health concern since the Severe Acute Respiratory Syndrome-CoV (SARS-CoV) outbreak in 2002. The continuous evolution of coronaviruses was further highlighted with the emergence of the Middle East Respiratory Syndrome-CoV (MERS-CoV) outbreak in 2012. Currently, the world is concerned about the 2019 novel CoV (SARS-CoV-2) that was initially identified in the city of Wuhan, China in December 2019. Patients presented with severe viral pneumonia and respiratory illness. The number of cases has been mounting since then. As of late February 2020, tens of thousands of cases and several thousand deaths have been reported in China alone, in addition to thousands of cases in other countries. Although the fatality rate of SARS-CoV-2 is currently lower than SARS-CoV, the virus seems to be highly contagious based on the number of infected cases to date. In this review, we discuss structure, genome organization, entry of CoVs into target cells, and provide insights into past and present outbreaks. The future of human CoV outbreaks will not only depend on how the viruses will evolve, but will also depend on how we develop efficient prevention and treatment strategies to deal with this continuous threat.
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TL;DR: This systematic review and meta-analysis of existing research works and findings in relation to the prevalence of stress, anxiety and depression in the general population during the COVID-19 pandemic found that it is essential to preserve the mental health of individuals and to develop psychological interventions that can improve themental health of vulnerable groups during the pandemic.
Abstract: The COVID-19 pandemic has had a significant impact on public mental health Therefore, monitoring and oversight of the population mental health during crises such as a panedmic is an immediate priority The aim of this study is to analyze the existing research works and findings in relation to the prevalence of stress, anxiety and depression in the general population during the COVID-19 pandemic In this systematic review and meta-analysis, articles that have focused on stress and anxiety prevalence among the general population during the COVID-19 pandemic were searched in the Science Direct, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases, without a lower time limit and until May 2020 In order to perform a meta-analysis of the collected studies, the random effects model was used, and the heterogeneity of studies was investigated using the I2 index Moreover data analysis was conducted using the Comprehensive Meta-Analysis (CMA) software The prevalence of stress in 5 studies with a total sample size of 9074 is obtained as 296% (95% confidence limit: 243–354), the prevalence of anxiety in 17 studies with a sample size of 63,439 as 319% (95% confidence interval: 275–367), and the prevalence of depression in 14 studies with a sample size of 44,531 people as 337% (95% confidence interval: 275–406) COVID-19 not only causes physical health concerns but also results in a number of psychological disorders The spread of the new coronavirus can impact the mental health of people in different communities Thus, it is essential to preserve the mental health of individuals and to develop psychological interventions that can improve the mental health of vulnerable groups during the COVID-19 pandemic
2,133 citations
Cites background from "Insights into the Recent 2019 Novel..."
...Although COVID-19 is a new strain of coronaviruses, it is known to cause diseases ranging from cold to more severe illnesses such as SARS and MERS [5]....
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...Abbreviations SARS: Severe Acute Respiratory Syndrome; MERS: Middle East Respiratory Syndrome; STROBE: Strengthening the Reporting of Observational studies in Epidemiology; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analysis Acknowledgements By Student Research Committee of Kermanshah University of Medical Sciences....
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...There have been several viral diseases in the past 20 years including Severe Acute Respiratory Syndrome (SARS) in 2003, influenza virus with the H1N1 subtype in 2009, Middle East Respiratory Syndrome (MERS) in 2012, and Ebola virus in 2014 [3–5]....
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...There have been several viral diseases in the past 20 years including Severe Acute Respiratory Syndrome (SARS) in 2003, influenza virus with the H1N1 subtype in 2009, Middle East Respiratory Syndrome (MERS) in 2012, and Ebola virus in 2014 [3-5]....
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TL;DR: An overview of the known clinical features and treatment options for COVID‐19 is provided and quarantine is the only intervention that appears to be effective in decreasing the contagion rate.
Abstract: Severe acute respiratory syndrome coronavirus (SARS-CoV)-2, a novel coronavirus from the same family as SARS-CoV and Middle East respiratory syndrome coronavirus, has spread worldwide leading the World Health Organization to declare a pandemic. The disease caused by SARS-CoV-2, coronavirus disease 2019 (COVID-19), presents flu-like symptoms which can become serious in high-risk individuals. Here, we provide an overview of the known clinical features and treatment options for COVID-19. We carried out a systematic literature search using the main online databases (PubMed, Google Scholar, MEDLINE, UpToDate, Embase and Web of Science) with the following keywords: 'COVID-19', '2019-nCoV', 'coronavirus' and 'SARS-CoV-2'. We included publications from 1 January 2019 to 3 April 2020 which focused on clinical features and treatments. We found that infection is transmitted from human to human and through contact with contaminated environmental surfaces. Hand hygiene is fundamental to prevent contamination. Wearing personal protective equipment is recommended in specific environments. The main symptoms of COVID-19 are fever, cough, fatigue, slight dyspnoea, sore throat, headache, conjunctivitis and gastrointestinal issues. Real-time PCR is used as a diagnostic tool using nasal swab, tracheal aspirate or bronchoalveolar lavage samples. Computed tomography findings are important for both diagnosis and follow-up. To date, there is no evidence of any effective treatment for COVID-19. The main therapies being used to treat the disease are antiviral drugs, chloroquine/hydroxychloroquine and respiratory therapy. In conclusion, although many therapies have been proposed, quarantine is the only intervention that appears to be effective in decreasing the contagion rate. Specifically designed randomized clinical trials are needed to determine the most appropriate evidence-based treatment modality.
900 citations
TL;DR: Effective interventions are available to help mitigate the psychological distress experienced by staff caring for patients in an emerging disease outbreak and these interventions were similar despite the wide range of settings and types of outbreaks covered in this review.
Abstract: OBJECTIVE: To examine the psychological effects on clinicians of working to manage novel viral outbreaks, and successful measures to manage stress and psychological distress. DESIGN: Rapid review and meta-analysis. DATA SOURCES: Cochrane Central Register of Controlled Trials, PubMed/Medline, PsycInfo, Scopus, Web of Science, Embase, and Google Scholar, searched up to late March 2020. ELIGIBILITY CRITERIA FOR STUDY SELECTION: Any study that described the psychological reactions of healthcare staff working with patients in an outbreak of any emerging virus in any clinical setting, irrespective of any comparison with other clinicians or the general population. RESULTS: 59 papers met the inclusion criteria: 37 were of severe acute respiratory syndrome (SARS), eight of coronavirus disease 2019 (covid-19), seven of Middle East respiratory syndrome (MERS), three each of Ebola virus disease and influenza A virus subtype H1N1, and one of influenza A virus subtype H7N9. Of the 38 studies that compared psychological outcomes of healthcare workers in direct contact with affected patients, 25 contained data that could be combined in a pairwise meta-analysis comparing healthcare workers at high and low risk of exposure. Compared with lower risk controls, staff in contact with affected patients had greater levels of both acute or post-traumatic stress (odds ratio 1.71, 95% confidence interval 1.28 to 2.29) and psychological distress (1.74, 1.50 to 2.03), with similar results for continuous outcomes. These findings were the same as in the other studies not included in the meta-analysis. Risk factors for psychological distress included being younger, being more junior, being the parents of dependent children, or having an infected family member. Longer quarantine, lack of practical support, and stigma also contributed. Clear communication, access to adequate personal protection, adequate rest, and both practical and psychological support were associated with reduced morbidity. CONCLUSIONS: Effective interventions are available to help mitigate the psychological distress experienced by staff caring for patients in an emerging disease outbreak. These interventions were similar despite the wide range of settings and types of outbreaks covered in this review, and thus could be applicable to the current covid-19 outbreak.
772 citations
TL;DR: Genetic variability across the three major histocompatibility complex (MHC) class I genes may affect susceptibility to and severity of the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronav virus disease 2019 (COVID-19), and the potential for cross-protective immunity conferred by prior exposure to four common human coronaviruses.
Abstract: Genetic variability across the three major histocompatibility complex (MHC) class I genes (human leukocyte antigen A [HLA-A], -B, and -C genes) may affect susceptibility to and severity of the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). We performed a comprehensive in silico analysis of viral peptide-MHC class I binding affinity across 145 HLA-A, -B, and -C genotypes for all SARS-CoV-2 peptides. We further explored the potential for cross-protective immunity conferred by prior exposure to four common human coronaviruses. The SARS-CoV-2 proteome was successfully sampled and was represented by a diversity of HLA alleles. However, we found that HLA-B*46:01 had the fewest predicted binding peptides for SARS-CoV-2, suggesting that individuals with this allele may be particularly vulnerable to COVID-19, as they were previously shown to be for SARS (M. Lin, H.-T. Tseng, J. A. Trejaut, H.-L. Lee, et al., BMC Med Genet 4:9, 2003, https://bmcmedgenet.biomedcentral.com/articles/10.1186/1471-2350-4-9). Conversely, we found that HLA-B*15:03 showed the greatest capacity to present highly conserved SARS-CoV-2 peptides that are shared among common human coronaviruses, suggesting that it could enable cross-protective T-cell-based immunity. Finally, we reported global distributions of HLA types with potential epidemiological ramifications in the setting of the current pandemic.IMPORTANCE Individual genetic variation may help to explain different immune responses to a virus across a population. In particular, understanding how variation in HLA may affect the course of COVID-19 could help identify individuals at higher risk from the disease. HLA typing can be fast and inexpensive. Pairing HLA typing with COVID-19 testing where feasible could improve assessment of severity of viral disease in the population. Following the development of a vaccine against SARS-CoV-2, the virus that causes COVID-19, individuals with high-risk HLA types could be prioritized for vaccination.
418 citations
TL;DR: It is shown that children with SARS-CoV-2 infection may have a less severe pattern of disease in comparison to adults and larger epidemiological and clinical cohort studies are needed to better understand possible implications of COVID-19 infection in children.
Abstract: A recent outbreak of a novel Coronavirus responsible for a Severe Acute Respiratory Syndrome (SARS-CoV-2) is spreading globally. The aim of this study was to systematically review main clinical characteristics and outcomes of SARS-CoV-2 infections in pediatric age. An electronic search was conducted in PubMed database. Papers published between 1 January and 1 May 2020 including children aged 0–18 years were selected. Sixty-two studies and three reviews were included, with a total sample size of 7480 children (2428/4660 males, 52.1%; weighted mean age 7.6 years). Patients showed mainly mild (608/1432, 42.5%) and moderate (567/1432, 39.6%) signs of the infection. About 2% of children were admitted to the pediatric intensive care unit. The most commonly described symptoms were fever (51.6%) and cough (47.3%). Laboratory findings were often unremarkable. Children underwent a chest CT scan in 73.9% of all cases, and 32.7% resulted normal. Overall, the estimated mortality was 0.08%. A higher proportion of newborns was severely ill (12%) and dyspnea was the most common reported sign (40%). Conclusion: SARS-CoV-2 affects children less severely than adults. Laboratory and radiology findings are mainly nonspecific. Larger epidemiological and clinical cohort studies are needed to better understand possible implications of COVID-19 infection in children.
399 citations
Cites background from "Insights into the Recent 2019 Novel..."
...The virus was provisionally named novel coronavirus (2019-nCoV) [2] to differentiate it from the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) [3] and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) [4], responsible for two previous outbreaks, in 2002 and 2012, respectively [5]....
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References
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Na Zhu1, Dingyu Zhang, Wenling Wang1, Xingwang Li2, Bo Yang1, Jingdong Song1, Xiang Zhao1, Baoying Huang1, Weifeng Shi, Roujian Lu1, Peihua Niu1, Faxian Zhan1, Xuejun Ma1, Dayan Wang1, Wenbo Xu3, Wenbo Xu1, Guizhen Wu1, George F. Gao, Wenjie Tan1 •
TL;DR: Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily, which is the seventh member of the family of coronaviruses that infect humans.
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.).
21,455 citations
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. Gao1, George F. Gao6, 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
"Insights into the Recent 2019 Novel..." refers result in this paper
...Another study estimated the R0 to have a high average value of 2.5 [84] , which is consistent with other groups that reported values from 2 to 3 [83, [85] [86] [87] [88] ....
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Roujian Lu1, Xiang Zhao1, Juan Li2, Peihua Niu1, Bo Yang3, Honglong Wu, Wenling Wang1, Hao Song4, Baoying Huang1, Na Zhu1, Yuhai Bi4, Xuejun Ma1, Faxian Zhan3, Liang Wang4, Tao Hu2, Hong Zhou2, Zhenhong Hu, Weimin Zhou1, Li Zhao1, Jing Chen5, Yao Meng1, Ji Wang1, Yang Lin, Jianying Yuan, Zhihao Xie, Jinmin Ma, William J. Liu1, Dayan Wang1, Wenbo Xu1, Edward C. Holmes6, George F. Gao4, George F. Gao1, Guizhen Wu1, Weijun Chen, Weifeng Shi2, Wenjie Tan4, Wenjie Tan1 •
TL;DR: The phylogenetic analysis suggests that bats might be the original host of this virus, an animal sold at the seafood market in Wuhan might represent an intermediate host facilitating the emergence of the virus in humans.
9,474 citations
"Insights into the Recent 2019 Novel..." refers background or result in this paper
...Another recent study confirmed that SARS-CoV-2 significantly clustered with a sequence from the bat SARS-like CoV that was isolated in 2015 [76] ....
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...Genetic analyses of viral samples from patients with SARS-CoV-2 infections revealed that the SARS-CoV-2 is a betacoronavirus that has 88% sequence identity to two bat SARSr-CoV: 79% identity to SARS-CoV and only 50% identity to MERS-CoV [42] ....
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...The study showed that the genomes of these viruses differed by less than 0.1 percent (more than 99.98% of sequence identity), which indicates that the virus has only recently emerged in humans and has been detected rapidly after its emergence [42] ....
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...Since December 2019, SARS-CoV-2 infection rates have been rising in China and worldwide [42] ....
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...The Wuhan market is known to have a lot of exotic animals and exotic animal parts [42] ....
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Jasper Fuk-Woo Chan1, Shuofeng Yuan1, Kin-Hang Kok1, Kelvin K. W. To1, Kelvin K. W. To2, Hin Chu1, Jin Yang2, Fanfan Xing2, Jieling Liu2, Cyril C. Y. Yip1, Rosana W.S. Poon1, Hoi Wah Tsoi1, Simon Kam Fai Lo2, Kwok-Hung Chan1, Vincent Kwok-Man Poon1, Wan Mui Chan1, Jonathan Daniel Ip1, Jian Piao Cai1, Vincent C.C. Cheng1, Honglin Chen1, Honglin Chen2, Christopher K.M. Hui2, Kwok-Yung Yuen2 •
TL;DR: The findings are consistent with person-to-person transmission of this novel coronavirus in hospital and family settings, and the reports of infected travellers in other geographical regions.
7,392 citations
"Insights into the Recent 2019 Novel..." refers background in this paper
...It is not well understood why outbreaks of CoV infections are mostly occurring in China....
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TL;DR: The authors show that this protein binds at least 10 times more tightly than the corresponding spike protein of severe acute respiratory syndrome (SARS)–CoV to their common host cell receptor, and test several published SARS-CoV RBD-specific monoclonal antibodies found that they do not have appreciable binding to 2019-nCoV S, suggesting that antibody cross-reactivity may be limited between the two RBDs.
Abstract: The outbreak of a novel coronavirus (2019-nCoV) represents a pandemic threat that has been declared a public health emergency of international concern. The CoV spike (S) glycoprotein is a key target for vaccines, therapeutic antibodies, and diagnostics. To facilitate medical countermeasure development, we determined a 3.5-angstrom-resolution cryo-electron microscopy structure of the 2019-nCoV S trimer in the prefusion conformation. The predominant state of the trimer has one of the three receptor-binding domains (RBDs) rotated up in a receptor-accessible conformation. We also provide biophysical and structural evidence that the 2019-nCoV S protein binds angiotensin-converting enzyme 2 (ACE2) with higher affinity than does severe acute respiratory syndrome (SARS)-CoV S. Additionally, we tested several published SARS-CoV RBD-specific monoclonal antibodies and found that they do not have appreciable binding to 2019-nCoV S, suggesting that antibody cross-reactivity may be limited between the two RBDs. The structure of 2019-nCoV S should enable the rapid development and evaluation of medical countermeasures to address the ongoing public health crisis.
7,324 citations
"Insights into the Recent 2019 Novel..." refers background in this paper
...In one study, several SARS-CoV RBD-specific monoclonal antibodies did not bind to SARS-CoV-2 S protein [43]....
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...A recent study published in Science showed that SARS-CoV-2 S protein has higher affinity to ACE2 than SARS-CoV S protein [43]....
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