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