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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
J01DB05 CEFADRIL G Cefadroxil (monohydrate) - 250mg/5ml 250mg/5ml Powder for suspension 268,769 L.L
J01MA12 FLOXIN-L 500 G Levofloxacin (hemihydrate) - 500mg 500mg Tablet, film coated 831,903 L.L
L01EX01 SUNITINIB AQVIDA G Sunitinib maleate - 12.5mg 12.5mg Capsule, hard 38,073,237 L.L
M01AH05 ETOXIB G Etoricoxib - 60mg 60mg Tablet, film coated 1,217,521 L.L
N02BE01 SULDEX 250 G Paracetamol - 250mg 250mg Suppository 127,985 L.L
N05AD01 HALOPERIDOL G Haloperidol - 20mg 20mg Tablet 339,160 L.L
N06AX21 LOXYT 30 G Duloxetine HCl - 30mg 30mg Capsule, delayed release 716,716 L.L
A06AD04 EPSOM SALT G Magnesium sulfate - 40g 40g Granules 89,590 L.L
A10BG03 PIODIAB 30 G Pioglitazone HCl - 30mg 30mg Tablet 2,111,753 L.L
B01AF01 XAVIRAN G Rivaroxaban - 20mg 20mg Tablet, film coated 952,208 L.L
B05CX01 DEXTROSE 10% INJECTION, USP G Glucose - 10% 10% Injectable solution 191,913 L.L
C03CA01 BIOLASOMIDE G Furosemide - 40mg 40mg Tablet 181,419 L.L
C09CA03 TABUVAN G Valsartan - 80mg 80mg Tablet, film coated 387,027 L.L
C10AA05 ATOR MEDIS G Atorvastatin - 40mg 40mg Tablet, film coated 694,767 L.L
D07XC04 AZONIT - D G Diflucortolone valerate - 1mg/g, Isoconazole nitrate - 10mg/g Cream 225,766 L.L
G04BE08 LINK G Tadalafil - 5mg 5mg Tablet, film coated 3,926,708 L.L
J01DB05 ROXIL G Cefadroxil (monohydrate) - 250mg/5ml 250mg/5ml Powder for suspension 459,594 L.L
J01MA12 JOSWE AVOXIN 500 G Levofloxacin - 500mg 500mg Tablet, film coated 786,148 L.L
L04AA32 APRIVA G Apremilast - 30mg 30mg Tablet, film coated 41,455,526 L.L
N02BE01 ADOL G Paracetamol - 500mg 500mg Suppository 131,697 L.L
N05AE05 LURABIL G Lurasidone - 20mg 20mg Tablet, film coated 2,535,831 L.L
N06AX21 PMS-DULOXETINE G Duloxetine HCl - 30mg 30mg Capsule, delayed release 642,357 L.L
R03BA01 CORTIS G Beclometasone dipropionate - 250mcg/actuation 250mcg/actuation Inhalation solution 674,609 L.L
B01AF01 ZARLAN G Rivaroxaban - 20mg 20mg Tablet, film coated 1,343,843 L.L
B05CX01 DEXTROSE 10% INJECTION, USP G Glucose - 10% 10% Injectable solution 168,929 L.L
C03CA01 DIURESAL G Furosemide - 40mg 40mg Tablet, scored 118,258 L.L
C09CA03 VALSANET G Valsartan - 80mg 80mg Tablet, film coated 479,944 L.L
C10AA05 ATORLIP 40 G Atorvastatin (calcium) - 40mg 40mg Tablet, film coated 1,484,626 L.L
D08AC52 CYTEAL Solution Antiseptique G Chlorhexidine digluconate - 0.5ml/100ml, Hexamidine - 0.1g/100ml, Chlorocresol - 0.3g/100ml Solution 362,420 L.L
G04BE08 RAVANA G Tadalafil - 5mg 5mg Tablet 1,501,264 L.L
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