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Coronavirus: invasive/novel

Generalities
Agent Coronaviruses belong to a large family of viruses that can cause diseases ranging from the common cold to Severe Acute Respiratory Syndrome (SARS).
1) Classical coronavirus: viruses that can infect humans and animals.
- Human coronavirus (HCoV): causing mild illness (229E, OC43, NL63, and HKU1...)
- Animal coronavirus: may infect pigs, domestic and wild birds, bats, rodents, dogs, cats and cattle. They cause acute and chronic diseases in animals such as respiratory and gastro-enteric diseases, neurologic diseases, and liver disease.
2) Novel coronavirus:
- Severe Acute Respiratory Syndrome (SARS-CoV) who caused a large outbreak in 2002-2003.
- Middle East respiratory syndrome–Novel Coronavirus (MERS-CoV): first identified in 2012
- Novel Coronavirus 2019 (COVID-19)
Incubation period - HCoV: 2-4 days
- SARS-CoV: 2-10 days (mean; 5 days)
- MERS-CoV: 2-14 days
- COVID-19: 4-7 days (up to 14 days)
Period of transmissibility - HCoV: during the active disease
- SARS-CoV: from onset to 21 days
- MERS-CoV: during illness. The duration of infectivity after resolution of symptoms is unknown.
- COVID-19: usually during illness
Reservoir - HCoV: Humans
- SARS-CoV: cave-dwelling bats (genus Rhinolophus), Himalayan masked palm civet (Paguma larvata), other wildlife animals
- MERS-CoV: may be camels and bats
Modes of transmission - HCoV: person-to-person transmission via repiratory droplets, aerosls, fecal oral route, fomites
- SARS-CoV: 1) Animal-to-person; 2) Person-to-person: while caring for, or living with a patient; via respiratory secretions, via body fluids; or airborne (aerosolized sewage, mechanical ventilation...)
- MERS-CoV: 1) Limited person-to-person transmission: close contact, when providing unprotected care to a patient; 2) Suspected animal-to-person transmission via droplet contact, fomite transmission, food-borne, airbone
- COVID-19: 1) Person-to-person: droplets (directly or indirectly), aerosol generating medical procedures, 2) Animal-to-peron
Clinical presentation - HCoV: usually self-limited illness as upper respiratory infection, otitis media, gastroenteritis. Complications: pneumonia, encephalitis, peritonitis...
- SARS-CoV: pneumonia, acute respiratory distress syndrome (ARDS). Global case fatality in 2003: 10%.
- MERS-CoV: usually, acute lower respiratory infection with or without gastrointestinal symptoms. It may be asymptomatic. The illness may be severe in people with chronic medical conditions. It may evolve to respiratory failure, organ failure (as renal failure), septic shock... Global case fatality: 27%.
- COVID-19: usually acute respiratory infection
Resources
Case definition - MOPH circular no. 35 (2012): SARS-CoV
- MOPH circular no. 37 (2014): MERS-CoV
- MOPH circular no. 42 (2020): COVID-19
Forms - General reporting form
- Novel Coronavirus reporting form
- Laboratory request form
- Patient transfert request form
- SARS-CoV investigation form
- MERS-CoV investigation form
Data - SARS-CoV: No SARS-CoV was detected in Lebanon in 2003
- MERS-CoV: 2 cases detected and confirmed in 2014 and 2017
- COVID-19: Daily report on COVID-19
Other Resources - Specimen collection for COVID-19
- Questions and Answers
- Presentation: coronavirus, A, E
- Presentation: resources, A, E
- Presentation: questions and answers, A, E
- Presentation: case definition, A, E
- Presentation: specimen collection, A, E
- Presentation: areas with community transmission, A, E
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ATC Name B/G Ingredients Dosage Form Price
A10AB05 NOVORAPID FLEXPEN BioTech Insulin aspart - 100IU/ml 100IU/ml Injectable solution 3,123,090 L.L
H01AC01 NORDITROPIN NORDIFLEX BioTech Somatropin recombinant - 10mg/1.5ml 10mg/1.5ml Injectable solution 14,532,052 L.L
M03AX01 NEURONOX BioTech Clostridium botulinum type A neurotoxin complex - 100units 100units Injectable lyophilised powder for solution 13,011,437 L.L
A10AB05 NOVORAPID FLEXPEN BioTech Insulin aspart - 100IU/ml 100IU/ml Injectable solution 3,123,090 L.L
M03AX01 NEURONOX BioTech Clostridium botulinum type A neurotoxin complex - 200units 200units Injectable lyophilised powder for solution 25,175,058 L.L
M03AX01 NEURONOX BioTech Clostridium botulinum type A neurotoxin complex - 50units 50units Injectable lyophilised powder for solution 8,904,323 L.L
A10AD05 NOVOMIX 30 BioTech Insulin aspart - 30%, Insulin aspart protamine - 70% 100IU/ml Injectable suspension 4,264,012 L.L
A10AD05 NOVOMIX 30 BioTech Insulin aspart - 30%, Insulin aspart protamine - 70% 100IU/ml Injectable suspension 4,264,012 L.L
A10AD05 NOVOMIX 30 BioTech Insulin aspart - 30%, Insulin aspart protamine - 70% 100IU/ml Injectable suspension 4,264,012 L.L
L03AA02 NEOGRASTIM 30 BioTech Filgrastim - 300mcg/ml 300mcg/ml Injectable solution 1,970,969 L.L
L03AA02 NEUTROMAX BioTech Filgrastim - 300mcg/ml 300mcg/ml Injectable solution 2,553,301 L.L
L03AA02 NEUPOGEN BioTech Filgrastim - 300mcg/0.5ml 300mcg/0.5ml Injectable solution 5,250,393 L.L
L03AA02 NIVESTIM BioTech Filgrastim - 30MIU/0.5ml 30MIU/0.5ml Injectable solution 17,110,745 L.L
L03AA13 NEULASTIM BioTech Pegfilgrastim - 6mg/0.6ml 6mg/0.6ml Injectable solution 56,925,965 L.L
M01AE17 NORMODEX G Dexketoprofen - 25mg 25mg Tablet, film coated 279,519 L.L
M01AE17 NORMODEX G Dexketoprofen (trometamol) - 50mg/2ml 50mg/2ml Injectable solution 329,241 L.L
N02BE01 NOMAL G Paracetamol - 500mg 500mg Tablet 305,884 L.L
M01AH01 NORMOCOXIB G Celecoxib - 200mg 200mg Capsule, hard 798,242 L.L
A02BC01 NEOOPRAZOLE G Omeprazole - 20mg 20mg Capsule, hard, gastro-resistant 407,184 L.L
S01AE02 NAFLOX G Norfloxacin - 3mg/ml 3mg/ml Drops 370,901 L.L
J01DD02 NEGACEF G Ceftazidime (pentahydrate) - 1g 1g Injectable dry powder for solution 4,421,242 L.L
D10AF05 NADIXA G Nadifloxacin - 1% 1% Cream 850,652 L.L
D10AF05 NAXIDERM G Nadifloxacin - 1% 1% Gel 826,783 L.L
R03BB04 NEUMOTROPIO G Tiotropium bromide - 10mcg 10mcg Capsule, inhalation 2,997,155 L.L
J01XE01 NITROFURANTOIN G Nitrofurantoin - 100mg 100mg Tablet 972,942 L.L
C10AB05 NANOFIB G Fenofibrate - 145mg 145mg Tablet, film coated 1,371,615 L.L
H01BA02 NICTUR G Desmopressin acetate - 360mcg/ml 360mcg/ml Solution 5,270,550 L.L
A02BC05 NEXPRAZOL 20 G Esomeprazole - 20mg 20mg Tablet, enteric coated 275,168 L.L
N02BG06 NEO-PAN G Nefopam HCl - 20mg/ml 20mg/ml Injectable solution 494,534 L.L
A11DB NEURORUBINE G Vitamin B12 - 1mg, Vitamin B6 - 100mg, Vitamin B1 - 100mg Injectable solution 302,365 L.L
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